(before any rebate, loading or discount)
Covers only one person
Available in NSW & ACT
# 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 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: You will have to pay an excess of $750 per admission. This is limited to a maximum of $750 per person and $750 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.
Health Partners Support Programs: Hospital to Home; includes Hospital Guide, Hospital in the Home and Rehab in the Home. Health Management Programs; Health Coaching. Benefits directly related to an admission and medically necessary: PBS approved prescriptions - 100% benefit & unlimited, Aids for recovery benefit 75% with $100 limit, non-surgically implanted medical devices and human tissue products benefit 75% with $150 limit. Members can also access a range of discounts, refer to the ‘Member Discount’ page at healthpartners.com.au.
Health Partners operates a preferred provider scheme available only in South Australia. See https://www.healthpartners.com.au/members/providers/.
| Note, for items marked with an asterisk *: Health Partners and participating providers are in SA only. If you attend a Health Partners Dental or participating dental provider, higher benefits and 100% back on a dental check-up, including x-rays, will apply. General dental benefits are based on the Health Partners schedule of fees. If your provider charges a higher fee, a larger gap payment will apply. At Health Partners Optical get 100% back up to your optical limit and 40% thereafter once you’ve reached your limit. At Health Partners participating physiotherapists higher benefits apply. T&Cs apply. | |||
|---|---|---|---|
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
| General dental* | 2 | $350 per policy | Periodic oral examination - 35% of charge Scale & clean - 35% of charge Fluoride treatment - 35% of charge Surgical tooth extraction - 35% of charge |
| Optical* | 2 | $100 per policy | Single vision lenses & frames - 40% of charge Multi-focal lenses & frames - 40% of charge |
| Non PBS pharmaceuticals* | 2 | $100 per policy (combined limit for non pbs pharmaceuticals & vaccinations) | Per eligible prescription - n/a |
| Physiotherapy* | 2 | $150 per policy (combined limit for physiotherapy, chiropractic, exercise physiology & osteopathy - Sub-limits apply) | Initial visit - $30.00 Subsequent visit - $25.00 |
| Chiropractic | 2 | Initial visit - $30.00 Subsequent visit - $25.00 | |
| Exercise physiology | 2 | Initial visit - $30.00 Subsequent visit - $25.00 | |
| Osteopathy | 2 | Initial visit - $30.00 Subsequent visit - $25.00 | |
| Vaccinations* | 2 | Combined limit - see Non PBS pharmaceuticals | Per service - n/a |
| In South Australia, get more from your cover by using Health Partners Dental and Optical practices - like 100% back on your dental check-up (including x-rays), and 40% benefit on other general dental services. At Health Partners Optical, you get 100% back on your optical limit, and an unlimited 40% benefit after you’ve reached your limit. At our participating physios get 100% back on a physio visit and 40% thereafter, up to your limit. Save 20% every day on full-price, non-prescription products at over 50 pharmacies across South Australia, which include participating Priceline and TerryWhite Chemmart stores. T&Cs apply. | |||
| Acupuncture | Major dental | Remedial massage |
| Blood glucose monitors | Orthodontic | Other treatments - check with your insurer |
| Endodontic | Podiatry | |
| Hearing aids | Psychology |
Combined limit for physio, chiro, exercise physiology & osteopathy provides flexibility for you to use your limit on what's important to you. T&Cs apply.
In NSW & ACT this policy provides:
Emergency: Unlimited with no waiting period.
Call-out fees: will not be paid.
https://www.healthpartners.com.au/health-insurance/understanding-private-health-insurance/
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.