(before any rebate, loading or discount)
Covers one adult & dependants (2 or more people, only one of whom is an adult)
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 or an insurer discount. Check with your insurer for details.
This policy covers children and other dependants up to and including the age of 22, students up to and including the age of 24, as well as persons with a disability who qualify as a child or other dependant or student in these age ranges.
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 | Gynaecology | Plastic and reconstructive surgery (medically necessary) |
| Back, neck and spine | Heart and vascular system | Pregnancy and birth |
| Blood | Hernia and appendix | Rehabilitation |
| Bone, joint and muscle | Implantation of hearing devices | Skin |
| Brain and nervous system | Insulin pumps | Sleep studies |
| Breast surgery (medically necessary) | Joint reconstructions | Tonsils, adenoids and grommets |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Kidney and bladder | Cataracts |
| Dental surgery | Lung and chest | Dialysis for chronic kidney failure |
| Diabetes management (excluding insulin pumps) | Male reproductive system | Hospital psychiatric services |
| Digestive system | Miscarriage and termination of pregnancy | Joint replacements |
| Ear, nose and throat | Pain management | Weight loss surgery |
| Eye (not cataracts) | Pain management with device | |
| Gastrointestinal endoscopy | Palliative care |
| Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
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 $500 per person and $500 per policy per year.
Excess payments do not apply to hospital admissions for dependants.
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.
Ambulance Levy included for NSW and ACT residents. Ambulance services in Tasmania provided free by State Government to Tasmanian residents.
This health insurer does not operate a preferred provider scheme.
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
|---|---|---|---|
| General dental | 2 | $500 per person | Periodic oral examination - $33.00 Scale & clean - $54.00 Fluoride treatment - $17.00 Surgical tooth extraction - $139.00 |
| Optical | 6 | $200 per person | Single vision lenses & frames - $200.00 Multi-focal lenses & frames - $200.00 |
| Physiotherapy | 2 | $500 per person (combined limit for physiotherapy, acupuncture & remedial massage - Sub-limits apply) | Initial visit - $45.00 Subsequent visit - $34.00 |
| Acupuncture | 2 | Initial visit - $25.00 Subsequent visit - $25.00 | |
| Remedial massage | 2 | Initial visit - $32.00 Subsequent visit - $27.00 |
| Blood glucose monitors | Major dental | Psychology |
| Chiropractic | Non PBS pharmaceuticals | Other treatments - check with your insurer |
| Endodontic | Orthodontic | |
| Hearing aids | Podiatry |
South Australia has a subscription service to cover ambulance within the state, with an additional fee to cover interstate travel (http://www.saambulance.com.au/ProductsServices/AmbulanceCover.aspx).
https://www.stlukes.com.au/forms-brochures?tag=Information+sheet
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.