healthslips.com.au Policy Information

Defence Health Limited

ADF Essentials Package Basic Plus 250

Restricted Insurer Corporate Policy

$136.42 / month

(Before Rebate, Discount & Loading)

Available in SA

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: Only one person.

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, active Reservists and their partners

Policy ID: AHB/J18/SILP10

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
Bone, joint and muscle
Dental surgery
Gastrointestinal endoscopy
Hernia and appendix
Hospital psychiatric services
Joint reconstructions
Palliative care
Rehabilitation
Tonsils, adenoids and grommets

This policy does not include cover for

Assisted reproductive services
Back, neck and spine
Blood
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)
Gynaecology
Heart and vascular system
Implantation of hearing devices
Insulin pumps
Joint replacements
Kidney and bladder
Lung and chest
Male reproductive system
Miscarriage and termination of pregnancy
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 on admission. This is limited to a maximum of $250 per person and $250 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

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.

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

$200 per policy

combined limit for acupuncture, remedial massage & other services

  • Initial visit: $21
  • Subsequent visit: $17
Chiropractic 2

$450 per policy

combined limit for chiropractic, exercise physiology, osteopathy, physiotherapy & vaccinations

  • Initial visit: $37
  • Subsequent visit: $26
Exercise physiology 2

$450 per policy

combined limit for chiropractic, exercise physiology, osteopathy, physiotherapy & vaccinations

  • Initial visit: $20
  • Subsequent visit: $17
General dental* 2

$500 per policy

  • Fluoride treatment: $17.8
  • Scale & clean: $61.8
  • Surgical tooth extraction: $116
  • Periodic oral examination: $32.4
Optical 2

$170 per policy

  • Multi-focal lenses & frames: 100% of charge
  • Single vision lenses & frames: 100% of charge
Osteopathy 2

$450 per policy

combined limit for chiropractic, exercise physiology, osteopathy, physiotherapy & vaccinations

  • Initial visit: $37
  • Subsequent visit: $26
Physiotherapy 2

$450 per policy

combined limit for chiropractic, exercise physiology, osteopathy, physiotherapy & vaccinations

  • Initial visit: $37
  • Subsequent visit: $27
Remedial massage 2

$200 per policy

combined limit for acupuncture, remedial massage & other services

  • Initial visit: $21
  • Subsequent visit: $17
Vaccinations* 2

$450 per policy

combined limit for chiropractic, exercise physiology, osteopathy, physiotherapy & vaccinations

  • Per service: $50

Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

{combined limit for acupuncture, remedial massage & other services}

Examples of maximum benefits

{Initial visit: $21}

{Subsequent visit: $17}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per policy}

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

Examples of maximum benefits

{Initial visit: $37}

{Subsequent visit: $26}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per policy}

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

Examples of maximum benefits

{Initial visit: $20}

{Subsequent visit: $17}

General dental*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

Examples of maximum benefits

{Fluoride treatment: $17.8}

{Scale & clean: $61.8}

{Surgical tooth extraction: $116}

{Periodic oral examination: $32.4}

Optical

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$170 per policy}

Examples of maximum benefits

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

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

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per policy}

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

Examples of maximum benefits

{Initial visit: $37}

{Subsequent visit: $26}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per policy}

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

Examples of maximum benefits

{Initial visit: $37}

{Subsequent visit: $27}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

{combined limit for acupuncture, remedial massage & other services}

Examples of maximum benefits

{Initial visit: $21}

{Subsequent visit: $17}

Vaccinations*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per policy}

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

Examples of maximum benefits

{Per service: $50}

Health and Wellbeing annual limit $200 includes: Acupuncture, Remedial Massage, Myotherapy - initial consultation: $21.00, subsequent consultation: $17.00, Group Physiotherapy - $14.00 per session and Group Exercise Physiology - $9.00 per session.

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

Ante-natal/Post-natal classes
Audiology
Blood glucose monitors
Chinese medicine
Dietetics/dietary advice
Endodontic
Eye therapy (orthoptics)
Health management / Healthy lifestyle
Hearing aids
Home nursing
Major dental
Non PBS pharmaceuticals
Occupational therapy
Orthodontic
Orthotics (podiatric orthoses)
Podiatry
Psychology
Speech therapy

Other features of this general treatment cover: All benefits are per person. Benefits reset on 1 July each year. Details and claim conditions are provided in product guides available at defencehealth.com.au or 1800 335 425.

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

Ambulance cover

In SA this policy provides:

Emergency: Unlimited with a waiting period of 2 months.

Non-emergency: Unlimited transport 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: 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 Essentials Package Basic Plus 250

Restricted Insurer Corporate Policy

$136.42 / month

(Before Rebate, Discount & Loading)

Available in SA

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/J18/SILP10

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