Private Health Information Statement - Combined policy

Mid Hospital $500 (Basic Plus) & Flex Up Extras

Monthly Premium

$580.02 #

(before any rebate, loading or discount)

Covers two adults & dependants (3 or more people, only 2 of whom are adults)

Available in Tasmania

Closed to new members

# 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 covers children and other dependants up to and including the age of 20, students up to and including the age of 30, as well as persons with a disability who qualify as a child or other dependant or student in these age ranges.

Hospital cover

This policy exempts you from the Medicare Levy Surcharge.

This policy does not provide accident cover or benefits for travel and accommodation (outside of hospital).

This policy includes cover for

Hospital Cover Legend
BloodImplantation of hearing devicesAssisted reproductive services
Bone, joint and muscleInsulin pumpsCataracts
Brain and nervous systemJoint reconstructionsDialysis for chronic kidney failure
Breast surgery (medically necessary)Kidney and bladderEye (not cataracts)
Chemotherapy, radiotherapy and immunotherapy for cancerMale reproductive systemHeart and vascular system
Dental surgeryMiscarriage and termination of pregnancyHospital psychiatric services
Diabetes management (excluding insulin pumps)Pain managementJoint replacements
Digestive systemPain management with deviceLung and chest
Ear, nose and throatPodiatric surgery (provided by a registered podiatric surgeon – limited benefits)Palliative care
Gastrointestinal endoscopySkinPregnancy and birth
GynaecologySleep studiesRehabilitation
Hernia and appendixTonsils, adenoids and grommets

This policy does not include cover for

Hospital Cover Legend
Back, neck and spinePlastic and reconstructive surgery (medically necessary)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.

The following payments may also apply for hospital admissions

Excess: You will have to pay an excess on admission. This is limited to a maximum of $500 per person and $1000 per policy per year.

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members

Waiting periods:

  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 12 months for pregnancy and birth (obstetrics)
  • 2 months for all other treatments

Gap Cover

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.

Other features of this hospital cover

No waiting period applies for hospital treatment resulting from an accident.

For further information about this policy see

https://www.peoplecare.com.au/siteassets/documents/cd/oms/mid-hospital-basic-plus---500-excess-flex-up-extras.pdf

General Treatment Cover

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.

This policy includes General treatment (Extras) cover for

General treatment legend
TreatmentWaiting period (months)Benefit limits (per 12 months unless otherwise stated)Examples of maximum benefits
General dental2$1,000 per person
(combined limit for general dental, major dental, endodontic, physiotherapy, chiropractic, psychology, acupuncture, remedial massage, chinese medicine, dietetics/dietary advice, exercise physiology, health management / healthy lifestyle, occupational therapy & osteopathy - Sub-limits apply)
Periodic oral examination - 60% of charge
Scale & clean - 60% of charge
Fluoride treatment - 60% of charge
Surgical tooth extraction - 60% of charge
Major dental12Full crown veneered - 60% of charge
Endodontic12Filling of one root canal - 60% of charge
Optical6$200 per personSingle vision lenses & frames - $200.00
Multi-focal lenses & frames - $200.00
Physiotherapy2Combined limit - see General dentalInitial visit - 60% of charge
Subsequent visit - 60% of charge
Chiropractic2Combined limit - see General dentalInitial visit - 60% of charge
Subsequent visit - 60% of charge
Psychology2Combined limit - see General dentalInitial visit - 60% of charge
Subsequent visit - 60% of charge
Acupuncture2Combined limit - see General dentalInitial visit - 60% of charge
Subsequent visit - 60% of charge
Remedial massage2Combined limit - see General dentalInitial visit - 60% of charge
Subsequent visit - 60% of charge
Chinese medicine2Combined limit - see General dentalInitial visit - 60% of charge
Subsequent visit - 60% of charge
Dietetics/dietary advice2Combined limit - see General dentalInitial visit - 60% of charge
Subsequent visit - 60% of charge
Exercise physiology2Combined limit - see General dentalInitial visit - 60% of charge
Subsequent visit - 60% of charge
Health management / Healthy lifestyle6Combined limit - see General dentalHealth management - 60% of charge
Occupational therapy2Combined limit - see General dentalInitial visit - 60% of charge
Subsequent visit - 60% of charge
Osteopathy2Combined limit - see General dentalInitial visit - 60% of charge
Subsequent visit - 60% of charge

This policy does not include General treatment (Extras) cover for

General treatment legend
Blood glucose monitorsNon PBS pharmaceuticalsPodiatry
Hearing aidsOrthodonticOther treatments - check with your insurer

For further information about this policy see

https://www.peoplecare.com.au/siteassets/documents/cd/oms/mid-hospital-basic-plus---500-excess-flex-up-extras.pdf

Ambulance cover

Ambulance cover is provided by the State government for residents of Tasmania. This may include cover whilst interstate, except for South Australia and Queensland where no cover applies. In other states please check with Ambulance Tasmania - https://www.health.tas.gov.au/ambulance/fees_and_accounts.

Other features of this ambulance cover

Tasmanian residents don’t need to worry about ambulance travel in their state, as it’s free.  This cover will include Ambulance transport whilst on the mainland for land, sea & air.

For further information about this policy see

https://www.peoplecare.com.au/health-insurance/hospital-cover/ambulance

Disclaimer

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.

Covered

For information on what is covered under each category, see https://www.privatehealth.gov.au/categories

Restricted

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.

Not Covered

These categories are not covered by this policy.