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Health Partners

Basic Hospital Plus $750 Excess with Flex Extras: Teeth Pro / Body / Wellness

$318.80 / month

(Before Rebate, Discount & Loading)

Available in NT

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 covers: Two adults & dependants (3 or more people, only 2 of whom are adults).

Children (0 - 17), non-classified* dependant (18 - 20) and students (21 - 31), as well as persons with a disability who qualify as a child, non-classified* dependant and student in these age ranges. *Non-classified dependant: Non-classified dependant means a person who is aged between 18 and 20 (inclusive), is not married or living in a de facto relationship, and is a child of the policyholder or child of the policyholder's partner. References to Child Dependant include Non-Classified Dependant.

Policy ID: SPS/C75/DMWY2D

Source: Private Health Information Statement (PHIS)

Hospital Cover

  • This policy exempts you from the Medicare Levy Surcharge.
  • This policy provides accident cover - check with insurer for details.
  • This policy does not provide benefits for travel or accommodation outside of hospital.
Covered
Restricted Cover
Not Covered
This policy includes cover for
Dental surgery
Gastrointestinal endoscopy
Gynaecology
Hernia and appendix
Hospital psychiatric services
Joint reconstructions
Male reproductive system
Miscarriage and termination of pregnancy
Palliative care
Rehabilitation
Tonsils, adenoids and grommets
This policy does not include cover for
Assisted reproductive services
Back, neck and spine
Blood
Bone, joint and muscle
Brain and nervous system
Breast surgery (medically necessary)
Cataracts
Chemotherapy, radiotherapy and immunotherapy for cancer
Diabetes management (excluding insulin pumps)
Dialysis for chronic kidney failure
Digestive system
Ear, nose and throat
Eye (not cataracts)
Heart and vascular system
Implantation of hearing devices
Insulin pumps
Joint replacements
Kidney and bladder
Lung and chest
Pain management
Pain management with device
Plastic and reconstructive surgery (medically necessary)
Podiatric surgery (provided by a registered podiatric surgeon)
Pregnancy and birth
Skin
Sleep studies
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.

The following payments may also apply for hospital admissions

Excess: You will have to pay an excess of $750 per admission. This is limited to a maximum of $750 per person and $1500 per policy per year.

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members Waiting periods:
  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 2 months for all other treatments
Gap Cover

This provider offers 'known gap' or 'no gap' cover for medical bills for this product. The Medical Costs Finder (https://www.health.gov.au/resources/apps-and-tools/medical-costs-finder) lets you find out more about the cost of specialist medical services.

Other features of this hospital cover

Accident Cover provides you with protection for all excluded clinical categories on your policy. Meaning, you will receive the highest level of cover if you require treatment as a result of an accident (as defined by Health Partners). T&Cs apply. Members can also access a range of discounts, refer to the ‘Member Discount’ page at healthpartners.com.au.

Extras Cover

Health Partners operates a preferred provider scheme available only in South Australia. See https://www.healthpartners.com.au/members/providers/.

This policy includes General treatment (Extras) cover for

Treatment & waiting period (months)
Benefit limits per 12 months unless otherwise stated
Examples of maximum benefits
Acupuncture 2

$200 per person

combined limit for acupuncture, chinese medicine & remedial massage

  • Initial visit: 60% of charge
  • Subsequent visit: 60% of charge
Chinese medicine 2

$200 per person

combined limit for acupuncture, chinese medicine & remedial massage

  • Initial visit: 60% of charge
  • Subsequent visit: 60% of charge
Chiropractic 2

$400 per person

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

  • Initial visit: 60% of charge
  • Subsequent visit: 60% of charge
Dietetics/dietary advice 2

$200 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), health management / healthy lifestyle, occupational therapy, podiatry, psychology & speech therapy

  • Initial visit: 60% of charge
  • Subsequent visit: 60% of charge
Endodontic* 12

$1,000 per person

combined limit for endodontic, general dental, major dental & orthodontic

  • Filling of one root canal: 60% of charge
Exercise physiology 2

$400 per person

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

  • Initial visit: 60% of charge
  • Subsequent visit: 60% of charge
Eye therapy (orthoptics) 2

$200 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), health management / healthy lifestyle, occupational therapy, podiatry, psychology & speech therapy

  • Initial visit: 60% of charge
  • Subsequent visit: 60% of charge
General dental* 2

$1,000 per person

combined limit for endodontic, general dental, major dental & orthodontic

  • Fluoride treatment: 60% of charge
  • Scale & clean: 60% of charge
  • Surgical tooth extraction: 60% of charge
  • Periodic oral examination: 60% of charge
Health management / Healthy lifestyle 0

$200 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), health management / healthy lifestyle, occupational therapy, podiatry, psychology & speech therapy

  • Health management: 60% of charge
Major dental* 12

$1,000 per person

combined limit for endodontic, general dental, major dental & orthodontic

  • Full crown veneered: 60% of charge
Non PBS pharmaceuticals* 2

$200 per person

combined limit for non pbs pharmaceuticals & vaccinations

  • Per eligible prescription: $0
Occupational therapy 2

$200 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), health management / healthy lifestyle, occupational therapy, podiatry, psychology & speech therapy

  • Initial visit: 60% of charge
  • Subsequent visit: 60% of charge
Orthodontic 12

$1,000 per person

$1,800 lifetime limit

combined limit for endodontic, general dental, major dental & orthodontic

sub-limits apply

  • Braces for upper & lower teeth, including removal plus fitting of retainer: 60% of charge
Osteopathy 2

$400 per person

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

  • Initial visit: 60% of charge
  • Subsequent visit: 60% of charge
Physiotherapy* 2

$400 per person

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

  • Initial visit: 60% of charge
  • Subsequent visit: 60% of charge
Podiatry 2

$200 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), health management / healthy lifestyle, occupational therapy, podiatry, psychology & speech therapy

  • Initial visit: 60% of charge
  • Subsequent visit: 60% of charge
Psychology 2

$200 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), health management / healthy lifestyle, occupational therapy, podiatry, psychology & speech therapy

  • Initial visit: 60% of charge
  • Subsequent visit: 60% of charge
Remedial massage 2

$200 per person

combined limit for acupuncture, chinese medicine & remedial massage

  • Initial visit: 60% of charge
  • Subsequent visit: 60% of charge
Speech therapy 2

$200 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), health management / healthy lifestyle, occupational therapy, podiatry, psychology & speech therapy

  • Initial visit: 60% of charge
  • Subsequent visit: 60% of charge
Vaccinations* 2

$200 per person

combined limit for non pbs pharmaceuticals & vaccinations

  • Per service: $0
Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

{combined limit for acupuncture, chinese medicine & remedial massage}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

{combined limit for acupuncture, chinese medicine & remedial massage}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

{combined limit for dietetics/dietary advice, eye therapy (orthoptics), health management / healthy lifestyle, occupational therapy, podiatry, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Endodontic*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for endodontic, general dental, major dental & orthodontic}

Examples of maximum benefits

{Filling of one root canal: 60% of charge}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

{combined limit for dietetics/dietary advice, eye therapy (orthoptics), health management / healthy lifestyle, occupational therapy, podiatry, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

General dental*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for endodontic, general dental, major dental & orthodontic}

Examples of maximum benefits

{Fluoride treatment: 60% of charge}

{Scale & clean: 60% of charge}

{Surgical tooth extraction: 60% of charge}

{Periodic oral examination: 60% of charge}

Health management / Healthy lifestyle

Waiting period:  0 month

Benefit limits per 12 months unless otherwise stated

{$200 per person}

{combined limit for dietetics/dietary advice, eye therapy (orthoptics), health management / healthy lifestyle, occupational therapy, podiatry, psychology & speech therapy}

Examples of maximum benefits

{Health management: 60% of charge}

Major dental*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for endodontic, general dental, major dental & orthodontic}

Examples of maximum benefits

{Full crown veneered: 60% of charge}

Non PBS pharmaceuticals*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per eligible prescription: $0}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

{combined limit for dietetics/dietary advice, eye therapy (orthoptics), health management / healthy lifestyle, occupational therapy, podiatry, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Orthodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{$1,800 lifetime limit}

{combined limit for endodontic, general dental, major dental & orthodontic}

{sub-limits apply}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: 60% of charge}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Physiotherapy*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

{combined limit for dietetics/dietary advice, eye therapy (orthoptics), health management / healthy lifestyle, occupational therapy, podiatry, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Psychology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

{combined limit for dietetics/dietary advice, eye therapy (orthoptics), health management / healthy lifestyle, occupational therapy, podiatry, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

{combined limit for acupuncture, chinese medicine & remedial massage}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

{combined limit for dietetics/dietary advice, eye therapy (orthoptics), health management / healthy lifestyle, occupational therapy, podiatry, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Vaccinations*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per service: $0}

In South Australia, get more from your cover with Health Partners providers, like 100% back on 2 dental check-ups (including x-rays) and 100% back on your first physio visit each year. Also get 60% back on dental and physio services up to your limits, at Health Partners and other recognised providers. Plus, save 20% on most full-price non-prescription items at over 50 pharmacies across SA, which include participating Priceline and TerryWhite Chemmart stores. T&Cs apply.

This policy does not include General treatment (Extras) cover for
Ante-natal/Post-natal classes
Audiology
Blood glucose monitors
Hearing aids
Home nursing
Optical
Orthotics (podiatric orthoses)

Other features of this general treatment cover: Flex Extras gives you the flexibility to choose the cover that suits your needs. If your needs change or you’re not using a selected option, you can remove or change it at any time to find the right mix for you. T&Cs apply. Waiting periods, exclusions, limits and conditions may apply.

Ambulance cover

In NT this policy provides:

Emergency: Unlimited with a waiting period of 2 months.

Call-out fees: Will be paid for each attendance, including emergency treatment without transport to hospital.

Other features of this ambulance cover: Australia wide unlimited emergency ambulance as defined by Health Partners, is for an unplanned event where there is a serious threat to your health, as a result of an accident, serious medical event or trauma, and immediate medical treatment is needed. Transport costs are covered from the place where you are initially treated, to the nearest hospital that can provide necessary emergency medical treatment. This includes treatment where no transport is provided. It also includes transport between hospitals only where required emergency care could not be provided at the transferring hospital. See Health Partners Member Guide for Terms & Conditions.

For further information about this policy see: https://www.healthpartners.com.au/health-insurance/understanding-private-health-insurance/

Insurer Details

Health Partners

Basic Hospital Plus $750 Excess with Flex Extras: Teeth Pro / Body / Wellness

$318.80 / month

(Before Rebate, Discount & Loading)

Available in NT

Disclaimer: This document is not a Private Health Information Statement (PHIS), and it is not intended to replace that document. The details contained in the healthslips.com.au Policy Information was provided by the insurer to the Australian Government. It is intended as general information. It may not take into account your circumstances. For further information contact the insurer. Information used is Licensed from the Commonwealth of Australia under a Creative Commons 3.0 licence.Private Health Information Statement is available from the Private Health Insurance Ombudsman website at https://privatehealth.gov.au/dynamic/Premium/PHIS/SPS/C75/DMWY2D

Basic Hospital Plus $750 Excess with Flex Extras: Teeth Pro / Body / Wellness

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