(before any rebate, loading or discount)
Covers 2 adults (and no-one else)
Available in NSW & ACT
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 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.
| Dental surgery | Hernia and appendix | Tonsils, adenoids and grommets |
| Eye (not cataracts) | Joint reconstructions | Hospital psychiatric services |
| Gastrointestinal endoscopy | Male reproductive system | Palliative care |
| Gynaecology | Miscarriage and termination of pregnancy | Rehabilitation |
| Assisted reproductive services | Dialysis for chronic kidney failure | Pain management |
| Back, neck and spine | Digestive system | Pain management with device |
| Blood | Ear, nose and throat | Plastic and reconstructive surgery (medically necessary) |
| Bone, joint and muscle | Heart and vascular system | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Brain and nervous system | Implantation of hearing devices | Pregnancy and birth |
| Breast surgery (medically necessary) | Insulin pumps | Skin |
| Cataracts | Joint replacements | Sleep studies |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Kidney and bladder | Weight loss surgery |
| Diabetes management (excluding insulin pumps) | Lung and chest |
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.
No excess for dependents under the age of 22.
This health insurer does not operate a preferred provider scheme.
| Note, for items marked with an asterisk *: 100% back on a range of no-gap services through our More for program, and no-gap network providers, subject to your cover, waiting periods and annual limits. Find out more: https://www.rthealth.com.au/health-services/find-a-dental-clinic and https://www.rthealth.com.au/health-services/find-an-optical-provider. | |||
|---|---|---|---|
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
| General dental* | 2 | $500 per person (combined limit for general dental, major dental & endodontic) | Periodic oral examination - 60% of charge Scale & clean - 60% of charge Fluoride treatment - 60% of charge |
| Major dental | 12 | Surgical tooth extraction - 60% of charge Full crown veneered - 60% of charge | |
| Endodontic | 12 | Filling of one root canal - 60% of charge | |
| Optical* | 2 | $225 per person | Single vision lenses & frames - $225.00 Multi-focal lenses & frames - $225.00 |
| Non PBS pharmaceuticals | 2 | $400 per person up to $800 per policy | Per eligible prescription - $50.00 |
| Physiotherapy | 2 | $400 per person (combined limit for physiotherapy, chiropractic, podiatry, osteopathy & other services) | Initial visit - $42.00 Subsequent visit - $36.00 |
| Chiropractic | 2 | Initial visit - $40.00 Subsequent visit - $31.00 | |
| Podiatry | 2 | Initial visit - $37.00 Subsequent visit - $27.00 | |
| Acupuncture | 2 | $200 per person (combined limit for acupuncture & remedial massage - Sub-limits apply) | Initial visit - $32.00 Subsequent visit - $27.00 |
| Remedial massage | 2 | Initial visit - $32.00 Subsequent visit - $32.00 | |
| Health management / Healthy lifestyle | 2 | $300 per person up to $200 per service up to $600 per policy (Sub-limits apply) | Health management - 70% of charge |
| Osteopathy | 2 | Combined limit - see Physiotherapy | Initial visit - $44.00 Subsequent visit - $33.00 |
| RT Health members pay no gap on a range of popular dental and optical services through HCF Dental or Optical Centres and the More for provider network. Annual and service limits apply. | |||
| Blood glucose monitors | Orthodontic | Other treatments - check with your insurer |
| Hearing aids | Psychology |
Benefits available for Myotherapy. Health management / Healthy lifestyle includes approved weight loss, stress management and quit smoking programs, MRI Scans not claimable through Medicare & skin tests. Benefits for Tai Chi, Yoga and Pilates are payable at 100% of the cost, subject to applicable sub‑limits and conditions. Annual limits, sub‑limits and membership limits apply. Contact the fund for further details.
In NSW & ACT this policy provides:
Emergency: with a waiting period of 1 day, limited to $5,000 per person per year.
Call-out fees: will be paid for each attendance, including emergency treatment without transport to hospital.
Unlimited cover for emergency ambulance attendance and transportation, and medically necessary, non-emergency ambulance transportation. The service must be provided by a state government operated, authorised, or approved ambulance scheme. Cover applies anywhere in Australia.
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.