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Peoplecare Health Insurance

Silver Plus Essentials Hospital $500 & Standard Extras

$224.03 / 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: Only one person.

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.

Policy ID: LHM/K33/DNVE10 Source: Private Health Information Statement (PHIS)

Hospital Cover

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)

Chemotherapy, radiotherapy and immunotherapy for cancer

Dental surgery

Diabetes management (excluding insulin pumps)

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

Joint reconstructions

Kidney and bladder

Lung and chest

Male reproductive system

Miscarriage and termination of pregnancy

Pain management

Palliative care

Plastic and reconstructive surgery (medically necessary)

Podiatric surgery (provided by a registered podiatric surgeon)

Rehabilitation

Skin

Sleep studies

Tonsils, adenoids and grommets

This policy does not include cover for

Assisted reproductive services

Cataracts

Dialysis for chronic kidney failure

Insulin pumps

Joint replacements

Pain management with device

Pregnancy and birth

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 $500 per person and $500 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.

For further information about this policy see: https://www.peoplecare.com.au/siteassets/documents/cd/oms/silver-plus-essentials-hospital---500-750-excess-standard-extras.pdf

By using Peoplecare's 'preferred providers' you may have lower out of pocket costs on Dental and Optical treatments and have access to more 'no gap' treatments. A list of 'preferred providers' is available from Peoplecare. See https://peoplecare.com.au/Members/Providers/Other-health-providers.

Policy ID: LHM/K33/DNVE10 Source: Private Health Information Statement (PHIS)

Extras Cover

This policy includes General treatment (Extras) cover for

Treatment & waiting period (months)

Benefit limits per 12 months unless otherwise stated

Examples of maximum benefits

Chiropractic

$350 per policy

combined limit for chiropractic & osteopathy

sub-limits apply

Initial visit: $35
Subsequent visit: $25

Exercise physiology

$350 per policy

combined limit for exercise physiology & physiotherapy

sub-limits apply

Initial visit: $35
Subsequent visit: $25

General dental

$500 per policy

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

$100 per policy

Health management: 100% of charge

Non PBS pharmaceuticals

$350 per policy

combined limit for non pbs pharmaceuticals & vaccinations

sub-limits apply

Per eligible prescription: $50

Optical

$150 per policy

Multi-focal lenses & frames: $150
Single vision lenses & frames: $150

Osteopathy

$350 per policy

combined limit for chiropractic & osteopathy

sub-limits apply

Initial visit: $35
Subsequent visit: $25

Physiotherapy

$350 per policy

combined limit for exercise physiology & physiotherapy

sub-limits apply

Initial visit: $35
Subsequent visit: $25

Remedial massage

$170 per policy

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Vaccinations

$350 per policy

combined limit for non pbs pharmaceuticals & vaccinations

sub-limits apply

Per service: $50

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

Acupuncture

Ante-natal/Post-natal classes

Audiology

Blood glucose monitors

Chinese medicine

Dietetics/dietary advice

Endodontic

Eye therapy (orthoptics)

Hearing aids

Home nursing

Major dental

Occupational therapy

Orthodontic

Orthotics (podiatric orthoses)

Podiatry

Psychology

Speech therapy

For further information about this policy see: https://www.peoplecare.com.au/siteassets/documents/cd/oms/silver-plus-essentials-hospital---500-750-excess-standard-extras.pdf

Ambulance cover

In NT this policy provides:

Emergency: Unlimited with a waiting period of 1 day.

Non-emergency: Unlimited transport with a waiting period of 1 day.

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

Other features of this ambulance cover: Unlimited Ambulance covers you Australia wide for land, sea and air transport.

For further information about this policy see: https://www.peoplecare.com.au/health-insurance/hospital-cover/ambulance

Insurer Details

Peoplecare Health Insurance

Silver Plus Essentials Hospital $500 & Standard Extras

$224.03 / month

(Before Rebate, Discount & Loading)

Available in NT

Call now 1800 808 690 Sponsor link

Peoplecare Health Insurance

http://www.peoplecare.com.au

info@peoplecare.com.au

1800 808 690

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/LHM/K33/DNVE10