(before any rebate, loading or discount)
Covers two adults & dependants (3 or more people, only 2 of whom are adults)
Available in South Australia
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, an age-based discount 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.
This cover is available to select nib corporate groups.
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).
| Assisted reproductive services | Eye (not cataracts) | Miscarriage and termination of pregnancy |
| Back, neck and spine | Gastrointestinal endoscopy | Pain management |
| Blood | Gynaecology | Pain management with device |
| Bone, joint and muscle | Heart and vascular system | Palliative care |
| Brain and nervous system | Hernia and appendix | Plastic and reconstructive surgery (medically necessary) |
| Breast surgery (medically necessary) | Hospital psychiatric services | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Cataracts | Implantation of hearing devices | Pregnancy and birth |
| 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 | Weight loss surgery |
| Ear, nose and throat | Male reproductive system |
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: No excess
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.
Our Going to Hospital Pack provides more ways to reduce out-of-pockets, ask us for your copy.
By using our FirstChoice providers, you may have lower out-of-pocket costs on many allied health services. A list of "preferred providers" is available from the health insurer. See https://www.nib.com.au/find-a-provider.
| Note, for items marked with an asterisk *: Benefit paid after current PBS patient contribution deducted | |||
|---|---|---|---|
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
| General dental | 2 | General dental/Oral surgery/Restorative services $500 Endodontia/Periodontia $500 Prosthetic dental - crowns and bridges/dentures $750; Service Limits Apply | Periodic oral examination - 85% of charge Scale & clean - 85% of charge Fluoride treatment - 85% of charge Surgical tooth extraction - 85% of charge |
| Major dental | 12 | Full crown veneered - 85% of charge | |
| Endodontic | 12 | Filling of one root canal - 85% of charge | |
| Orthodontic | 12 | $500 per person | Braces for upper & lower teeth, including removal plus fitting of retainer - 85% of charge |
| Optical | 6 | $225 per person | Single vision lenses & frames - 85% of charge Multi-focal lenses & frames - 85% of charge |
| Non PBS pharmaceuticals* | 2 | $600 per person | Per eligible prescription - 85% of charge |
| Physiotherapy | 2 | $700 per person (combined limit for physiotherapy, ante-natal/post-natal classes & exercise physiology) | Initial visit - 85% of charge Subsequent visit - 85% of charge |
| Chiropractic | 2 | $300 per person (combined limit for chiropractic & osteopathy) | Initial visit - 85% of charge Subsequent visit - 85% of charge |
| Podiatry | 2 | $250 per person | Initial visit - 85% of charge Subsequent visit - 85% of charge |
| Psychology | 2 | $300 per person | Initial visit - 85% of charge Subsequent visit - 85% of charge |
| Acupuncture | 2 | $170 per single policy $340 per couple/family policy | Initial visit - 85% of charge Subsequent visit - 85% of charge |
| Remedial massage | 2 | Initial visit - 85% of charge Subsequent visit - 85% of charge | |
| Hearing aids | 36 | $650 per person 2 appliance(s) every 5 years | Hearing aid - 85% of charge |
| Blood glucose monitors | 12 | $500 per person 2 appliance(s) every 1 year (combined limit for blood glucose monitors, orthotics (podiatric orthoses) & other services) | Per monitor - 85% of charge |
| Ante-natal/Post-natal classes | 2 | Combined limit - see Physiotherapy | Initial visit - 85% of charge Subsequent visit - 85% of charge |
| Chinese medicine | 2 | Combined limit - see Acupuncture | Initial visit - 85% of charge Subsequent visit - 85% of charge |
| Dietetics/dietary advice | 2 | $200 per person | Initial visit - 85% of charge Subsequent visit - 85% of charge |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - 85% of charge Subsequent visit - 85% of charge |
| Eye therapy (orthoptics) | 2 | $200 per person | Initial visit - 85% of charge Subsequent visit - 85% of charge |
| Health management / Healthy lifestyle | 2 | $100 per single policy $200 per couple/family policy | Health management - 100% of charge |
| Home nursing | 2 | $500 per person | Initial visit - 85% of charge Subsequent visit - 85% of charge |
| Occupational therapy | 2 | $200 per person | Initial visit - 85% of charge Subsequent visit - 85% of charge |
| Orthotics (podiatric orthoses) | 0 | Combined limit - see Blood glucose monitors | Orthotics supply & fit - 85% of charge |
| Osteopathy | 2 | Combined limit - see Chiropractic | Initial visit - 85% of charge Subsequent visit - 85% of charge |
| Speech therapy | 2 | $200 per person | Initial visit - 85% of charge Subsequent visit - 85% of charge |
| Artificial aids / Orthotics / Speech processor ($500 limit per person per calendar year) e.g. spacer, peak flow meter, nebuliser, blood glucose monitor, Irlen lens (service limits apply). Myotherapy: combined with acupuncture, remedial massage and Chinese herbalism. Healthier Lifestyle includes nib approved weight management, quit smoking and health management programs (gym memberships) and more. Waiting periods for dental treatment range between 2 and 12 months. No Benefit for Post-natal classes Psychology has a sublimit of $150 for Digital Cognitive Behavioural Therapy (CBT). Non-PBS pharmaceuticals have a sub limit of $150 for Weight Management Medication. | |||
| Other treatments - check with your insurer |
Comprehensive hospital cover with a range of Extras with benefits up to 85%. Of course, you can see your choice of provider, but by choosing a FirstChoice provider, you may have less to pay towards the cost of your treatment. We’ve created the FirstChoice network to help you access quality healthcare and a better deal for you and your family. We’ve locked in lower costs with our FirstChoice providers, so you can enjoy competitive treatment fees when you visit the dentist or a discount the next time you claim for glasses.
In South Australia this policy provides:
Emergency: Unlimited with a waiting period of 1 day.
Call-out fees: will be paid for each attendance, including emergency treatment without transport to hospital.
All our health covers include unlimited emergency ambulance (1 day waiting period on all emergency ambulance). Emergency ambulance is when you need immediate transport by a State or Territory ambulance to get to a hospital or other facility for urgent medical treatment. No annual limits for emergency ambulance apply.
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.