(before any rebate, loading or discount)
Covers only one person
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, 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 and benefits for travel or accommodation (outside of hospital) - check with your insurer for details.
| Blood | Eye (not cataracts) | Miscarriage and termination of pregnancy |
| Bone, joint and muscle | Gastrointestinal endoscopy | Pain management |
| Brain and nervous system | Gynaecology | Plastic and reconstructive surgery (medically necessary) |
| Breast surgery (medically necessary) | Heart and vascular system | Skin |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Hernia and appendix | Tonsils, adenoids and grommets |
| Dental surgery | Joint reconstructions | Hospital psychiatric services |
| Diabetes management (excluding insulin pumps) | Kidney and bladder | Palliative care |
| Digestive system | Lung and chest | Rehabilitation |
| Ear, nose and throat | Male reproductive system |
| Assisted reproductive services | Implantation of hearing devices | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Back, neck and spine | Insulin pumps | Pregnancy and birth |
| Cataracts | Joint replacements | Sleep studies |
| Dialysis for chronic kidney failure | Pain management with device | 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 of $500 per admission. This is limited to a maximum of $500 per person and $500 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.
Phoenix Health Hospital Cover features include... *Access Gap – Where your Doctor agrees to participate in our Access Gap Program, you can eliminate or reduce your out-of-pocket costs that you may have otherwise incurred towards your hospital procedure. *Hospital Care Programs – supporting you beyond a hospitalisation, you have access to programs designed to support your health and wellbeing before and after a hospital admission. *Full Ambulance Cover – medically required emergency and non-emergency Ambulance treatment and transport is covered on all of our Hospital Covers, Australia-wide.
This health insurer does not operate a preferred provider scheme.
| Note, for items marked with an asterisk *: 100% benefit available on preventative dental services– includes items 012, 013, 111, 114, 115, 121, 161. Claimable once per appointment, up to twice per person per calendar year up to General Dental limits. | |||
|---|---|---|---|
| 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 - 100% of charge Scale & clean - 100% of charge Fluoride treatment - 100% of charge |
| Non PBS pharmaceuticals | 2 | $200 per policy (combined limit for non pbs pharmaceuticals & vaccinations) | Per eligible prescription - 50% of charge |
| Physiotherapy | 2 | $400 per policy (combined limit for physiotherapy, chiropractic, acupuncture, remedial massage, exercise physiology & osteopathy - Sub-limits apply) | Initial visit - 50% of charge Subsequent visit - 50% of charge |
| Chiropractic | 2 | Initial visit - 50% of charge Subsequent visit - 50% of charge | |
| Acupuncture | 2 | Initial visit - 50% of charge | |
| Remedial massage | 2 | Initial visit - 50% of charge Subsequent visit - 50% of charge | |
| Exercise physiology | 2 | Initial visit - 50% of charge Subsequent visit - 50% of charge | |
| Osteopathy | 2 | Initial visit - 50% of charge Subsequent visit - 50% of charge | |
| Vaccinations | 2 | Combined limit - see Non PBS pharmaceuticals | Per service - 50% of charge |
| *$200 sublimit for Physiotherapy/ Myotherapy & Exercise Physiology; $200 sublimit for Chiropractic, Osteopathy & Remedial Massage; up to overall combined limit of $400. *Non PBS Pharmaceuticals benefit applies after PBS co-payment is applied. | |||
| Blood glucose monitors | Major dental | Podiatry |
| Endodontic | Optical | Psychology |
| Hearing aids | Orthodontic | Other treatments - check with your insurer |
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.
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.