healthslips.com.au Policy Information

HBF Health Limited

Prime Package Silver Plus $250/$500 Excess & Ambulance Care

$888.00 / month

(Before Rebate, Discount & Loading)

Available in VIC

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: Non-classified Dependant A person who meets all of the following criteria: a. is aged 18 to 20 (inclusive); and b. does not have a partner (a person in a marital or de facto relationship with the Non-classified Dependant)

Policy ID: HBF/J3M/VBUFQ2Y

Source: Private Health Information Statement (PHIS)

Hospital Cover

  • This policy exempts you from the Medicare Levy Surcharge.
  • This policy does not provide accident cover.
  • This policy does not provide benefits for travel or accommodation outside of hospital.
Covered
Restricted Cover
Not Covered
This policy includes cover for
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)
Rehabilitation
Skin
Sleep studies
Tonsils, adenoids and grommets
Weight loss surgery

This policy does not include cover for

Assisted reproductive services
Pregnancy and birth

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 $250 per admission. This is limited to a maximum of $250 per person and $500 per policy per year.

Excess payments do not apply to hospital admissions for dependants.

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

For agreed services, you are fully covered for accommodation in a shared or private room in an HBF Member Plus hospital. Ambulance Care covers you for the times when you need non-urgent ambulance.

Extras Cover

HBF members have hundreds of participating optical stores nationally to choose from with access to a range of fully covered glasses. See http://www.hbf.com.au/health-insurance/find-a-provider.

This policy includes General treatment (Extras) cover for

Treatment & waiting period (months)
Benefit limits per 12 months unless otherwise stated
Examples of maximum benefits
Blood glucose monitors 12
  • Per monitor: $200
Chiropractic 2

$1,000 per person

combined limit for chiropractic, osteopathy & physiotherapy

  • Initial visit: $37
  • Subsequent visit: $30
Dietetics/dietary advice 2

$240 per person

  • Initial visit: $33
  • Subsequent visit: $17
Endodontic 12

$3,500 per person

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

sub-limits apply

  • Filling of one root canal: $150
Eye therapy (orthoptics) 2

$600 per person

combined limit for eye therapy (orthoptics), occupational therapy & speech therapy

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

$3,500 per person

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

  • Fluoride treatment: $21.25
  • Scale & clean: $83.3
  • Surgical tooth extraction: $132.3
  • Periodic oral examination: $42.5
Health management / Healthy lifestyle 2

$250 per person

sub-limits apply

  • Health management: 70% of charge
Hearing aids 12

$1000 per person every 3 calendar years

  • Hearing aid: 100% of charge
Major dental 12

$3,500 per person

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

sub-limits apply

  • Full crown veneered: $780
Non PBS pharmaceuticals* 2

$200 per person

  • Per eligible prescription: $200
Occupational therapy 2

$600 per person

combined limit for eye therapy (orthoptics), occupational therapy & speech therapy

  • Initial visit: $45
  • Subsequent visit: $25
Optical 2

$204 per person

sub-limits apply

  • Multi-focal lenses & frames: $160
  • Single vision lenses & frames: $120
Orthodontic* 12

$3,500 per person

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

sub-limits apply

  • Braces for upper & lower teeth, including removal plus fitting of retainer: $2500
Orthotics (podiatric orthoses) 12

$240 per person

  • Orthotics supply & fit: $240
Osteopathy 2

$1,000 per person

combined limit for chiropractic, osteopathy & physiotherapy

  • Initial visit: $37
  • Subsequent visit: $30
Physiotherapy 2

$1,000 per person

combined limit for chiropractic, osteopathy & physiotherapy

  • Initial visit: $37
  • Subsequent visit: $30
Podiatry 2
  • Initial visit: $26
  • Subsequent visit: $20
Psychology 2

$720 per person

  • Initial visit: $44
  • Subsequent visit: $44
Speech therapy 2

$600 per person

combined limit for eye therapy (orthoptics), occupational therapy & speech therapy

  • Initial visit: $75
  • Subsequent visit: $40

Blood glucose monitors

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

Examples of maximum benefits

{Per monitor: $200}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for chiropractic, osteopathy & physiotherapy}

Examples of maximum benefits

{Initial visit: $37}

{Subsequent visit: $30}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$240 per person}

Examples of maximum benefits

{Initial visit: $33}

{Subsequent visit: $17}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$3,500 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Filling of one root canal: $150}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for eye therapy (orthoptics), occupational therapy & speech therapy}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $45}

General dental

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$3,500 per person}

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

Examples of maximum benefits

{Fluoride treatment: $21.25}

{Scale & clean: $83.3}

{Surgical tooth extraction: $132.3}

{Periodic oral examination: $42.5}

Health management / Healthy lifestyle

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$250 per person}

{sub-limits apply}

Examples of maximum benefits

{Health management: 70% of charge}

Hearing aids

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1000 per person every 3 calendar years}

Examples of maximum benefits

{Hearing aid: 100% of charge}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$3,500 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Full crown veneered: $780}

Non PBS pharmaceuticals*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

{Per eligible prescription: $200}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for eye therapy (orthoptics), occupational therapy & speech therapy}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $25}

Optical

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$204 per person}

{sub-limits apply}

Examples of maximum benefits

{Multi-focal lenses & frames: $160}

{Single vision lenses & frames: $120}

Orthodontic*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$3,500 per person}

{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: $2500}

Orthotics (podiatric orthoses)

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$240 per person}

Examples of maximum benefits

{Orthotics supply & fit: $240}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for chiropractic, osteopathy & physiotherapy}

Examples of maximum benefits

{Initial visit: $37}

{Subsequent visit: $30}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for chiropractic, osteopathy & physiotherapy}

Examples of maximum benefits

{Initial visit: $37}

{Subsequent visit: $30}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

Examples of maximum benefits

{Initial visit: $26}

{Subsequent visit: $20}

Psychology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$720 per person}

Examples of maximum benefits

{Initial visit: $44}

{Subsequent visit: $44}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for eye therapy (orthoptics), occupational therapy & speech therapy}

Examples of maximum benefits

{Initial visit: $75}

{Subsequent visit: $40}

Prime Package Silver Plus also includes cover for: CLINICAL PSYCHOLOGY (waiting period 2 months, $79 initial visit and $44 subsequent visit up to $720 combined with Psychology per person); AIDS TO RECOVERY EQUIPMENT (waiting period 2 months, $50 per person); NON-SURGICALLY IMPLANTED APPLIANCES (waiting period 12 months, benefits vary depending on appliance up to $500 per person, sub-limits apply); NEBULISER (waiting period 12 months, $108 per person up to 1 appliance every 3 years. **Note: Health Management/Healthy Lifestyle – initial visit for Strength for Life is $35 up to combined limit listed.

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

Acupuncture
Ante-natal/Post-natal classes
Audiology
Chinese medicine
Exercise physiology
Home nursing
Remedial massage
Vaccinations

Ambulance cover

In VIC this policy provides:

Emergency: Unlimited with a waiting period of 7 days.

Non-emergency: Unlimited transport with a waiting period of 30 days.

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

Other features of this ambulance cover: Emergency ambulance provides full cover for emergency treatment and urgent ambulance transport (by road) within Australia by a State Government ambulance provider or an HBF approved ambulance provider. Non-emergency ambulance services include transport from home to the hospital and transfers between hospitals. Services not covered include air ambulance services, transport between a public hospital to your home and transport not provided in an ambulance.

For further information about this policy see: http://www.hbf.com.au/health-insurance/ambulance-cover.html

Insurer Details

HBF Health Limited

Prime Package Silver Plus $250/$500 Excess & Ambulance Care

$888.00 / month

(Before Rebate, Discount & Loading)

Available in VIC

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/HBF/J3M/VBUFQ2Y

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