healthslips.com.au Policy Information

Defence Health Limited

ADF Total Package Gold

Restricted Insurer Corporate Policy

$828.18 / month

(Before Rebate, Discount & Loading)

Available in QLD

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: Two adults & dependants, including non-student dependants (3 or more people, only 2 of whom are adults).

Children (0 - 17), non-classified* dependant (18 - 20), students (21 - 30) and non-students (21 to 30), as well as persons with a disability who qualify as a child, non-classified* dependant, student and non-student in these age ranges. *Non-classified dependant: We continue to keep kids covered, no questions asked, until they turn 21.

Restricted insurer: Membership of this insurer is restricted to current or former members of the ADF and the Defence community and their families.

Corporate policy: Permanent ADF and active Reservists, partners and dependent children

Policy ID: AHB/J17/QIQJ2Y

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
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
Dental surgery
Diabetes management (excluding insulin pumps)
Dialysis for chronic kidney failure
Digestive system
Ear, nose and throat
Eye (not cataracts)
Gastrointestinal endoscopy
Gynaecology
Heart and vascular system
Hernia and appendix
Hospital psychiatric services
Implantation of hearing devices
Insulin pumps
Joint reconstructions
Joint replacements
Kidney and bladder
Lung and chest
Male reproductive system
Miscarriage and termination of pregnancy
Pain management
Pain management with device
Palliative care
Plastic and reconstructive surgery (medically necessary)
Podiatric surgery (provided by a registered podiatric surgeon)
Pregnancy and birth
Rehabilitation
Skin
Sleep studies
Tonsils, adenoids and grommets
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: No excess

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
  • 12 months for pregnancy and birth (obstetrics)
  • 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

Includes home nursing, midwifery and a range of health programs. Access Gap available to reduce or eliminate out of pocket medical costs where the treating doctor, specialist, surgeon, anaesthestist, pathologist or radiologist agrees to use it. Go to defencehealth.com.au or call 1800 335 425 for details.

For further information about this policy see: https://www.defencehealth.com.au/

Extras Cover

Visit a network dentist for quality dental care at special member prices. Plus, network optical providers offer no-gap glasses and discounts on other optical purchases up to the optical limit. See https://www.defencehealth.com.au/Health-Insurance/Find-Providers-and-Hospitals.

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

$300 per person

combined limit for acupuncture, health management / healthy lifestyle, remedial massage & other services

  • Initial visit: $31
  • Subsequent visit: $27
Ante-natal/Post-natal classes 2

$1,000 per person

combined limit for ante-natal/post-natal classes, audiology, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, podiatry, psychology & speech therapy

  • Initial visit: $40
  • Subsequent visit: $40
Audiology 2

$1,000 per person

combined limit for ante-natal/post-natal classes, audiology, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, podiatry, psychology & speech therapy

  • Initial visit: $72
  • Subsequent visit: $52
Blood glucose monitors 12

$1,000 per person

combined limit for blood glucose monitors, hearing aids, orthotics (podiatric orthoses) & other services

  • Per monitor: $400
Chiropractic 2

$750 per person

combined limit for chiropractic & osteopathy

  • Initial visit: $47
  • Subsequent visit: $33
Dietetics/dietary advice 2

$1,000 per person

combined limit for ante-natal/post-natal classes, audiology, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, podiatry, psychology & speech therapy

  • Initial visit: $59
  • Subsequent visit: $33
Endodontic 12

$950 per person

combined limit for endodontic & major dental

  • Filling of one root canal: $117.4
Exercise physiology 2

$1,000 per person

combined limit for ante-natal/post-natal classes, audiology, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, podiatry, psychology & speech therapy

  • Initial visit: $30
  • Subsequent visit: $24
Eye therapy (orthoptics) 2

$1,000 per person

combined limit for ante-natal/post-natal classes, audiology, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, podiatry, psychology & speech therapy

  • Initial visit: $65
  • Subsequent visit: $45
General dental 2

No annual limit

  • Fluoride treatment: $21.2
  • Scale & clean: $71.4
  • Periodic oral examination: $37.6
Health management / Healthy lifestyle 2

$300 per person

combined limit for acupuncture, health management / healthy lifestyle, remedial massage & other services

  • Health management: $120
Hearing aids 12

$1,000 per person

combined limit for blood glucose monitors, hearing aids, orthotics (podiatric orthoses) & other services

  • Hearing aid: $1000
Major dental 12

$950 per person

combined limit for endodontic & major dental

  • Surgical tooth extraction: $124.7
  • Full crown veneered: $801.6
Non PBS pharmaceuticals 2

$400 per person

combined limit for non pbs pharmaceuticals, vaccinations & other services

  • Per eligible prescription: $80
Occupational therapy 2

$1,000 per person

combined limit for ante-natal/post-natal classes, audiology, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, podiatry, psychology & speech therapy

  • Initial visit: $85
  • Subsequent visit: $45
Optical 2

$255 per person

  • Multi-focal lenses & frames: 100% of charge
  • Single vision lenses & frames: 100% of charge
Orthodontic 12

$800 per person

  • Braces for upper & lower teeth, including removal plus fitting of retainer: $800
Orthotics (podiatric orthoses) 12

$1,000 per person

combined limit for blood glucose monitors, hearing aids, orthotics (podiatric orthoses) & other services

  • Orthotics supply & fit: $300
Osteopathy 2

$750 per person

combined limit for chiropractic & osteopathy

  • Initial visit: $47
  • Subsequent visit: $33
Physiotherapy 2

$850 per person

  • Initial visit: $59
  • Subsequent visit: $41
Podiatry 2

$1,000 per person

combined limit for ante-natal/post-natal classes, audiology, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, podiatry, psychology & speech therapy

  • Initial visit: $47
  • Subsequent visit: $33
Psychology 2

$1,000 per person

combined limit for ante-natal/post-natal classes, audiology, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, podiatry, psychology & speech therapy

  • Initial visit: $102
  • Subsequent visit: $77
Remedial massage 2

$300 per person

combined limit for acupuncture, health management / healthy lifestyle, remedial massage & other services

  • Initial visit: $31
  • Subsequent visit: $27
Speech therapy 2

$1,000 per person

combined limit for ante-natal/post-natal classes, audiology, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, podiatry, psychology & speech therapy

  • Initial visit: $107
  • Subsequent visit: $52
Vaccinations 2

$400 per person

combined limit for non pbs pharmaceuticals, vaccinations & other services

  • Per service: $80

Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

{combined limit for acupuncture, health management / healthy lifestyle, remedial massage & other services}

Examples of maximum benefits

{Initial visit: $31}

{Subsequent visit: $27}

Ante-natal/Post-natal classes

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for ante-natal/post-natal classes, audiology, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, podiatry, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $40}

Audiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for ante-natal/post-natal classes, audiology, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, podiatry, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: $72}

{Subsequent visit: $52}

Blood glucose monitors

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for blood glucose monitors, hearing aids, orthotics (podiatric orthoses) & other services}

Examples of maximum benefits

{Per monitor: $400}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$750 per person}

{combined limit for chiropractic & osteopathy}

Examples of maximum benefits

{Initial visit: $47}

{Subsequent visit: $33}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for ante-natal/post-natal classes, audiology, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, podiatry, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: $59}

{Subsequent visit: $33}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$950 per person}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Filling of one root canal: $117.4}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for ante-natal/post-natal classes, audiology, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, podiatry, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $24}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for ante-natal/post-natal classes, audiology, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, podiatry, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: $65}

{Subsequent visit: $45}

General dental

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{No annual limit}

Examples of maximum benefits

{Fluoride treatment: $21.2}

{Scale & clean: $71.4}

{Periodic oral examination: $37.6}

Health management / Healthy lifestyle

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

{combined limit for acupuncture, health management / healthy lifestyle, remedial massage & other services}

Examples of maximum benefits

{Health management: $120}

Hearing aids

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for blood glucose monitors, hearing aids, orthotics (podiatric orthoses) & other services}

Examples of maximum benefits

{Hearing aid: $1000}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$950 per person}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Surgical tooth extraction: $124.7}

{Full crown veneered: $801.6}

Non PBS pharmaceuticals

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for non pbs pharmaceuticals, vaccinations & other services}

Examples of maximum benefits

{Per eligible prescription: $80}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for ante-natal/post-natal classes, audiology, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, podiatry, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: $85}

{Subsequent visit: $45}

Optical

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$255 per person}

Examples of maximum benefits

{Multi-focal lenses & frames: 100% of charge}

{Single vision lenses & frames: 100% of charge}

Orthodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: $800}

Orthotics (podiatric orthoses)

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for blood glucose monitors, hearing aids, orthotics (podiatric orthoses) & other services}

Examples of maximum benefits

{Orthotics supply & fit: $300}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$750 per person}

{combined limit for chiropractic & osteopathy}

Examples of maximum benefits

{Initial visit: $47}

{Subsequent visit: $33}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$850 per person}

Examples of maximum benefits

{Initial visit: $59}

{Subsequent visit: $41}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for ante-natal/post-natal classes, audiology, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, podiatry, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: $47}

{Subsequent visit: $33}

Psychology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for ante-natal/post-natal classes, audiology, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, podiatry, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: $102}

{Subsequent visit: $77}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

{combined limit for acupuncture, health management / healthy lifestyle, remedial massage & other services}

Examples of maximum benefits

{Initial visit: $31}

{Subsequent visit: $27}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for ante-natal/post-natal classes, audiology, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, podiatry, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: $107}

{Subsequent visit: $52}

Vaccinations

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for non pbs pharmaceuticals, vaccinations & other services}

Examples of maximum benefits

{Per service: $80}

Health and Wellbeing annual limit $300 includes: Acupuncture, Remedial Massage, Myotherapy - initial consultation: $31.00, subsequent consultation: $27.00, Group Physiotherapy - $20.00 per session, Group Exercise Physiology $14.00 per session and Health Management. Also includes cover for Laser Refractive Eye Surgery - annual limit: $1,000 every two financial years; School Accident - annual limit: $600. Health appliances limit also includes: Orthopaedic Shoes – sub-limit: $300; Nebuliser – sub-limit: $300 every three financial years; Spacer – sub-limit: $300.

This policy does not include General treatment (Extras) cover for

Chinese medicine
Home nursing

Other features of this general treatment cover: No lifetime limit on orthodontics. All benefits are per person. Benefits reset on 1 July each year. Details and claim conditions are in product guides available at defencehealth.com.au

For further information about this policy see: https://www.defencehealth.com.au/

Ambulance cover

Ambulance cover is provided by the State government for Queensland residents (https://www.ambulance.qld.gov.au). This includes cover whilst interstate.

Other features of this ambulance cover: Comprehensive cover for ambulance services by state-appointed ambulance providers across Australia. This includes emergency services, non-emergency dispatch, mobile intensive care and air and sea ambulance services. Non-emergency services are those that are classed as clinically necessary; for example, you need to be monitored by a paramedic during transport. Patient transfer services and transport services by Patient Transport vehicles are not ambulance services and are not claimable.

For further information about this policy see: https://www.defencehealth.com.au/

Insurer Details

Defence Health Limited

ADF Total Package Gold

Restricted Insurer Corporate Policy

$828.18 / month

(Before Rebate, Discount & Loading)

Available in QLD

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/AHB/J17/QIQJ2Y

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