Health Partners

Basic Hospital Plus $500 Excess with Flex Extras: Teeth Pro / Eyes

Name: Basic Hospital Plus $500 Excess with Flex Extras: Teeth Pro / Eyes
Brand: Health Partners
Price: 278.94 AUD

$278.94 / 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 (and no-one else).

Policy ID: SPS/C87/DMZX20

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 $500 per admission. This is limited to a maximum of $500 per person and $1000 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

Endodontic* 12

$1,000 per person

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

Filling of one root canal: 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

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

Optical* 2

$200 per person

Multi-focal lenses & frames: 60% of charge
Single vision lenses & frames: 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

Vaccinations* 2

$200 per person

combined limit for non pbs pharmaceuticals & vaccinations

Per service: $0

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}

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}

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}

Optical*

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

{Multi-focal lenses & frames: 60% of charge}

{Single vision lenses & frames: 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}

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 a bonus $100 on your Optical Limit. Also get 60% back on dental and optical 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

Acupuncture

Ante-natal/Post-natal classes

Audiology

Blood glucose monitors

Chinese medicine

Chiropractic

Dietetics/dietary advice

Exercise physiology

Eye therapy (orthoptics)

Health management / Healthy lifestyle

Hearing aids

Home nursing

Occupational therapy

Orthotics (podiatric orthoses)

Osteopathy

Physiotherapy

Podiatry

Psychology

Remedial massage

Speech therapy

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 $500 Excess with Flex Extras: Teeth Pro / Eyes

$278.94 / month

(Before Rebate, Discount & Loading)

Available in NT

Health Partners

http://www.healthpartners.com.au

ask@healthpartners.com.au

1300 113 113

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/C87/DMZX20

Basic Hospital Plus $500 Excess with Flex Extras: Teeth Pro / Eyes

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Basic Hospital Plus $500 Excess with Flex Extras: Teeth Pro / Eyes