(before any rebate, loading or discount)
Covers only one person
Available in Western 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 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).
| Blood | Gynaecology | Palliative care |
| Bone, joint and muscle | Hernia and appendix | Plastic and reconstructive surgery (medically necessary) |
| Brain and nervous system | Implantation of hearing devices | Skin |
| Breast surgery (medically necessary) | Insulin pumps | Sleep studies |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Joint reconstructions | Tonsils, adenoids and grommets |
| Dental surgery | Kidney and bladder | Assisted reproductive services |
| Diabetes management (excluding insulin pumps) | Lung and chest | Heart and vascular system |
| Digestive system | Male reproductive system | Hospital psychiatric services |
| Ear, nose and throat | Miscarriage and termination of pregnancy | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Eye (not cataracts) | Pain management | Pregnancy and birth |
| Gastrointestinal endoscopy | Pain management with device | Rehabilitation |
| Back, neck and spine | Dialysis for chronic kidney failure | Weight loss surgery |
| Cataracts | Joint replacements |
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 of $750 per admission. This is limited to a maximum of $750 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 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 | $500 per policy | Periodic oral examination - 65% of charge Scale & clean - 65% of charge Fluoride treatment - 65% of charge |
| Major dental | 12 | $600 per policy (combined limit for major dental & endodontic) | Surgical tooth extraction - 65% of charge Full crown veneered - 65% of charge |
| Endodontic | 12 | Filling of one root canal - 65% of charge | |
| Orthodontic | 12 | $200 per policy $1,000 lifetime limit | Braces for upper & lower teeth, including removal plus fitting of retainer - 65% of charge |
| Optical | 6 | $250 per policy | Single vision lenses & frames - 65% of charge Multi-focal lenses & frames - 65% of charge |
| Non PBS pharmaceuticals* | 2 | $200 per policy | Per eligible prescription - 65% of charge |
| Physiotherapy | 2 | $350 per policy (combined limit for physiotherapy, chiropractic, exercise physiology & osteopathy) | Initial visit - 65% of charge Subsequent visit - 65% of charge |
| Chiropractic | 2 | Initial visit - 65% of charge Subsequent visit - 65% of charge | |
| Psychology | 2 | $200 per policy | Initial visit - 65% of charge Subsequent visit - 65% of charge |
| Acupuncture | 2 | $200 per policy (combined limit for acupuncture, remedial massage, chinese medicine, dietetics/dietary advice & other services - Sub-limits apply) | Initial visit - 65% of charge Subsequent visit - 65% of charge |
| Remedial massage | 2 | Initial visit - 65% of charge Subsequent visit - 65% of charge | |
| Chinese medicine | 2 | Initial visit - 65% of charge Subsequent visit - 65% of charge | |
| Dietetics/dietary advice | 2 | Initial visit - 65% of charge Subsequent visit - 65% of charge | |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - 65% of charge Subsequent visit - 65% of charge |
| Health management / Healthy lifestyle | 6 | $150 per policy | Health management - 65% of charge |
| Osteopathy | 2 | Combined limit - see Physiotherapy | Initial visit - 65% of charge Subsequent visit - 65% of charge |
| Myotherapy: combined limit of $200 with acupuncture, remedial massage, dietary advice and Chinese herbalism. Healthier Lifestyle includes e.g. approved weight management, quit smoking and nicotine replacement (gym, personal training), preventative health tests (service limits apply). Psychology has a sublimit of $150 for Digital Cognitive Behavioural Therapy (CBT). | |||
| Blood glucose monitors | Podiatry |
| Hearing aids | Other treatments - check with your insurer |
Great for young people who were not thinking about kids, but who wanted more cover for things like major dental. 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 Western 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.