(before any rebate, loading or discount)
Covers 2 adults (and no-one else)
Available in South Australia
# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include a Lifetime Health Cover loading or an insurer discount. Check with your insurer for details.
This policy exempts you from the Medicare Levy Surcharge.
This policy provides accident cover - check with your insurer for details.
This policy does not provide benefits for travel or accommodation (outside of hospital).
| Back, neck and spine | Eye (not cataracts) | Miscarriage and termination of pregnancy |
| Blood | Gastrointestinal endoscopy | Pain management |
| Bone, joint and muscle | Gynaecology | Pain management with device |
| Brain and nervous system | Heart and vascular system | Palliative care |
| Breast surgery (medically necessary) | Hernia and appendix | Plastic and reconstructive surgery (medically necessary) |
| Cataracts | Implantation of hearing devices | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Insulin pumps | Rehabilitation |
| Dental surgery | Joint reconstructions | Skin |
| Diabetes management (excluding insulin pumps) | Joint replacements | Sleep studies |
| Dialysis for chronic kidney failure | Kidney and bladder | Tonsils, adenoids and grommets |
| Digestive system | Lung and chest | Hospital psychiatric services |
| Ear, nose and throat | Male reproductive system |
| Assisted reproductive services | Pregnancy and birth | Weight loss surgery |
The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.
Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.
Excess: You will have to pay an excess on admission. This is limited to a maximum of $750 per person and $1500 per policy per year.
Co-payments: No co-payments
Waiting periods:
This provider offers 'known gap' or 'no gap' cover for medical bills for this product.
The Medical Costs Finder lets you find out more about the cost of specialist medical services.
By using Peoplecare's 'preferred providers' you may have lower out of pocket costs on Dental and Optical treatments and have access to more 'no gap' treatments. A list of 'preferred providers' is available from Peoplecare. See https://peoplecare.com.au/Members/Providers/Other-health-providers.
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
|---|---|---|---|
| General dental | 2 | $1,500 per person | Periodic oral examination - 80% of charge Scale & clean - 80% of charge Fluoride treatment - 80% of charge Surgical tooth extraction - 80% of charge |
| Major dental | 12 | $1,500 per person (combined limit for major dental & endodontic) | Full crown veneered - 80% of charge |
| Endodontic | 12 | Filling of one root canal - 80% of charge | |
| Orthodontic | 12 | $1,000 per person $3,000 lifetime limit | Braces for upper & lower teeth, including removal plus fitting of retainer - 80% of charge |
| Optical | 6 | $300 per person | Single vision lenses & frames - $300.00 Multi-focal lenses & frames - $300.00 |
| Non PBS pharmaceuticals | 2 | $500 per person up to $1,000 per policy (combined limit for non pbs pharmaceuticals & vaccinations - Sub-limits apply) | Per eligible prescription - $80.00 |
| Physiotherapy | 2 | $600 per person up to $1,200 per policy (combined limit for physiotherapy, exercise physiology, eye therapy (orthoptics), occupational therapy & other services) | Initial visit - $59.00 Subsequent visit - $59.00 |
| Chiropractic | 2 | $600 per person up to $1,200 per policy (combined limit for chiropractic & osteopathy) | Initial visit - $55.00 Subsequent visit - $55.00 |
| Podiatry | 2 | $500 per person up to $1,000 per policy | Initial visit - $50.00 Subsequent visit - $40.00 |
| Psychology | 2 | $500 per person up to $1,000 per policy | Initial visit - $110.00 Subsequent visit - $90.00 |
| Acupuncture | 2 | $400 per person up to $800 per policy (combined limit for acupuncture, remedial massage, chinese medicine & dietetics/dietary advice) | Initial visit - $50.00 Subsequent visit - $50.00 |
| Remedial massage | 2 | Initial visit - $50.00 Subsequent visit - $50.00 | |
| Hearing aids | 24 | $1,500 per person 1 appliance(s) every 5 years | Hearing aid - 80% of charge |
| Blood glucose monitors | 2 | $700 per person up to $1,400 per policy 1 appliance(s) every 3 years (combined limit for blood glucose monitors, ante-natal/post-natal classes, home nursing, orthotics (podiatric orthoses) & other services - Sub-limits apply) | Per monitor - 80% of charge |
| Ante-natal/Post-natal classes | 2 | Initial visit - 80% of charge Subsequent visit - 80% of charge | |
| Chinese medicine | 2 | Combined limit - see Acupuncture | Initial visit - $50.00 Subsequent visit - $50.00 |
| Dietetics/dietary advice | 2 | Combined limit - see Acupuncture | Initial visit - $50.00 Subsequent visit - $50.00 |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Eye therapy (orthoptics) | 2 | Combined limit - see Physiotherapy | Initial visit - $59.00 Subsequent visit - $49.00 |
| Health management / Healthy lifestyle | 6 | $250 per person up to $500 per policy | Health management - 80% of charge |
| Home nursing | 2 | Combined limit - see Blood glucose monitors | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Occupational therapy | 2 | Combined limit - see Physiotherapy | Initial visit - $59.00 Subsequent visit - $49.00 |
| Orthotics (podiatric orthoses) | 2 | Combined limit - see Blood glucose monitors | Orthotics supply & fit - $200.00 |
| Osteopathy | 2 | Combined limit - see Chiropractic | Initial visit - $55.00 Subsequent visit - $55.00 |
| Speech therapy | 2 | $500 per person up to $1,000 per policy | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Vaccinations | 2 | Combined limit - see Non PBS pharmaceuticals | Per service - $80.00 |
| Other treatments - check with your insurer |
Orthotics limited to 1 appliance every 2 financial years.
In South Australia this policy provides:
Emergency: Unlimited with a waiting period of 1 day.
Non-emergency: Unlimited transport with a waiting period of 1 day.
Call-out fees: will be paid for each attendance, including emergency treatment without transport to hospital.
Unlimited Ambulance covers you Australia wide for land, sea and air transport.
https://www.peoplecare.com.au/health-insurance/hospital-cover/ambulance
The information contained in this Private Health Information Statement was provided by the insurer and is intended as general information. It may not take into account your particular circumstances. For information please contact the insurer.
For information on what is covered under each category, see https://www.privatehealth.gov.au/categories
Restricted categories partially cover your hospital costs as a private patient in a public hospital. You may incur significant expenses in a private room or private hospital.
These categories are not covered by this policy.