healthslips.com.au Policy Information

Medibank Private Limited

Silver Plus Settled Families Comprehensive

$652.30 / month

(Before Rebate, Discount & Loading)

Available in WA

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 & dependants (3 or more people, only 2 of whom are adults).

Children (0 - 17), non-classified* dependant (18 - 20) and students (21 - 30), as well as persons with a disability who qualify as a child, non-classified* dependant and student in these age ranges. *Non-classified dependant: Medibank considers a child dependant to be aged up to 21.

Policy ID: MBP/J26/WDPB2D

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 provides benefits for travel or accommodation outside of hospital - check with insurer for details.
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
Insulin pumps
Joint reconstructions
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

This policy does not include cover for

Assisted reproductive services
Cataracts
Dialysis for chronic kidney failure
Joint replacements
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 of $250 per admission. This is limited to a maximum of $250 per person 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

This cover has Accident Cover Boost. You’ll have access to all clinical categories included in Gold level hospital cover where you require hospital treatment as a result of injuries sustained in an Accident that occurred after joining your cover. Please see Member Guide for more information.

Extras Cover

At Members' Choice extras providers you may get more for your cover. This includes 100% back on a dental check up, scale and clean each year and great optical deals. See https://www.medibank.com.au/health-insurance/find-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
Acupuncture 2

$500 per person

combined limit for acupuncture, blood glucose monitors, chinese medicine, dietetics/dietary advice, exercise physiology, orthotics (podiatric orthoses), podiatry, psychology, speech therapy & other services

  • Initial visit: $40.9
  • Subsequent visit: $33.4
Blood glucose monitors 24

$500 per person

combined limit for acupuncture, blood glucose monitors, chinese medicine, dietetics/dietary advice, exercise physiology, orthotics (podiatric orthoses), podiatry, psychology, speech therapy & other services

  • Per monitor: 100% of charge
Chinese medicine 2

$500 per person

combined limit for acupuncture, blood glucose monitors, chinese medicine, dietetics/dietary advice, exercise physiology, orthotics (podiatric orthoses), podiatry, psychology, speech therapy & other services

  • Initial visit: $21.5
  • Subsequent visit: $21.5
Chiropractic 2

$400 per person

combined limit for chiropractic & osteopathy

  • Initial visit: $48.6
  • Subsequent visit: $33.5
Dietetics/dietary advice 2

$500 per person

combined limit for acupuncture, blood glucose monitors, chinese medicine, dietetics/dietary advice, exercise physiology, orthotics (podiatric orthoses), podiatry, psychology, speech therapy & other services

  • Initial visit: $47.3
  • Subsequent visit: $26.2
Endodontic 12

$800 per person

combined limit for endodontic & major dental

  • Filling of one root canal: $126.5
Exercise physiology* 2

$500 per person

combined limit for acupuncture, blood glucose monitors, chinese medicine, dietetics/dietary advice, exercise physiology, orthotics (podiatric orthoses), podiatry, psychology, speech therapy & other services

  • Initial visit: $21.5
  • Subsequent visit: $12
General dental* 2

No annual limit

  • Fluoride treatment: $15.5
  • Scale & clean: $51.2
  • Surgical tooth extraction: $106.5
  • Periodic oral examination: $27
Major dental 12

$800 per person

combined limit for endodontic & major dental

  • Full crown veneered: $700.8
Optical 6

$250 per person

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

$800 per person

$2,400 lifetime limit

  • Braces for upper & lower teeth, including removal plus fitting of retainer: 100% of charge
Orthotics (podiatric orthoses) 2

$500 per person

combined limit for acupuncture, blood glucose monitors, chinese medicine, dietetics/dietary advice, exercise physiology, orthotics (podiatric orthoses), podiatry, psychology, speech therapy & other services

  • Orthotics supply & fit: 70% of charge
Osteopathy 2

$400 per person

combined limit for chiropractic & osteopathy

  • Initial visit: $48.6
  • Subsequent visit: $33.5
Physiotherapy 2

$600 per person

  • Initial visit: $47.3
  • Subsequent visit: $40.7
Podiatry 2

$500 per person

combined limit for acupuncture, blood glucose monitors, chinese medicine, dietetics/dietary advice, exercise physiology, orthotics (podiatric orthoses), podiatry, psychology, speech therapy & other services

  • Initial visit: $41.5
  • Subsequent visit: $31.2
Psychology 0

$500 per person

combined limit for acupuncture, blood glucose monitors, chinese medicine, dietetics/dietary advice, exercise physiology, orthotics (podiatric orthoses), podiatry, psychology, speech therapy & other services

  • Initial visit: $128.52
  • Subsequent visit: $106.44
Remedial massage 2

$200 per person

  • Initial visit: $44.3
  • Subsequent visit: $29.9
Speech therapy 2

$500 per person

combined limit for acupuncture, blood glucose monitors, chinese medicine, dietetics/dietary advice, exercise physiology, orthotics (podiatric orthoses), podiatry, psychology, speech therapy & other services

  • Initial visit: $78
  • Subsequent visit: $37.1

Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for acupuncture, blood glucose monitors, chinese medicine, dietetics/dietary advice, exercise physiology, orthotics (podiatric orthoses), podiatry, psychology, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $40.9}

{Subsequent visit: $33.4}

Blood glucose monitors

Waiting period:  24 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for acupuncture, blood glucose monitors, chinese medicine, dietetics/dietary advice, exercise physiology, orthotics (podiatric orthoses), podiatry, psychology, speech therapy & other services}

Examples of maximum benefits

{Per monitor: 100% of charge}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for acupuncture, blood glucose monitors, chinese medicine, dietetics/dietary advice, exercise physiology, orthotics (podiatric orthoses), podiatry, psychology, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $21.5}

{Subsequent visit: $21.5}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for chiropractic & osteopathy}

Examples of maximum benefits

{Initial visit: $48.6}

{Subsequent visit: $33.5}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for acupuncture, blood glucose monitors, chinese medicine, dietetics/dietary advice, exercise physiology, orthotics (podiatric orthoses), podiatry, psychology, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $47.3}

{Subsequent visit: $26.2}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Filling of one root canal: $126.5}

Exercise physiology*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for acupuncture, blood glucose monitors, chinese medicine, dietetics/dietary advice, exercise physiology, orthotics (podiatric orthoses), podiatry, psychology, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $21.5}

{Subsequent visit: $12}

General dental*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{No annual limit}

Examples of maximum benefits

{Fluoride treatment: $15.5}

{Scale & clean: $51.2}

{Surgical tooth extraction: $106.5}

{Periodic oral examination: $27}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Full crown veneered: $700.8}

Optical

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$250 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}

{$2,400 lifetime limit}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: 100% of charge}

Orthotics (podiatric orthoses)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for acupuncture, blood glucose monitors, chinese medicine, dietetics/dietary advice, exercise physiology, orthotics (podiatric orthoses), podiatry, psychology, speech therapy & other services}

Examples of maximum benefits

{Orthotics supply & fit: 70% of charge}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for chiropractic & osteopathy}

Examples of maximum benefits

{Initial visit: $48.6}

{Subsequent visit: $33.5}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

Examples of maximum benefits

{Initial visit: $47.3}

{Subsequent visit: $40.7}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for acupuncture, blood glucose monitors, chinese medicine, dietetics/dietary advice, exercise physiology, orthotics (podiatric orthoses), podiatry, psychology, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $41.5}

{Subsequent visit: $31.2}

Psychology

Waiting period:  0 month

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for acupuncture, blood glucose monitors, chinese medicine, dietetics/dietary advice, exercise physiology, orthotics (podiatric orthoses), podiatry, psychology, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $128.52}

{Subsequent visit: $106.44}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

{Initial visit: $44.3}

{Subsequent visit: $29.9}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for acupuncture, blood glucose monitors, chinese medicine, dietetics/dietary advice, exercise physiology, orthotics (podiatric orthoses), podiatry, psychology, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $78}

{Subsequent visit: $37.1}

Health appliances and external prostheses 2mth waiting period, Breathing appliances 12 mth waiting period, Blood pressure monitor 24 mth waiting period, Health subscriptions 2mth waiting period, Health screening tests 2mth waiting periods, fixed benefits, sublimits and benefit replacement periods apply share combined annual limit with Podiatry (contact Medibank for further information). – Private hospital accident and emergency fees, 2mth waiting period applies to child and student dependants only, annual limit $250. – MembershipBonus, 6 mth waiting period, starts at $100 per membership per year. - Counselling (no waiting period) shares an annual limit with Psychology. Please contact Medibank for more information.

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

Ante-natal/Post-natal classes
Audiology
Eye therapy (orthoptics)
Health management / Healthy lifestyle
Hearing aids
Home nursing
Non PBS pharmaceuticals
Occupational therapy
Vaccinations

Other features of this general treatment cover: Cover for extras services that older families are more likely to need such as orthodontics. Plus on some extras services we increase the amount you can claim back each year to a maximum of 5 years. You'll also get a $100 annual membership bonus to use towards your extras and other approved services.

Ambulance cover

In WA this policy provides:

Emergency: Unlimited 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: Cover for an ambulance when you require immediate professional attention and you need to be transported to hospital or other approved facility and your medical condition is such that you cannot be transported any other way, or where an ambulance is called but transport is not needed. Cover for air ambulance where pre-approval has been obtained from Medibank. In all cases the ambulance provider must be Medibank approved. Please contact Medibank for further details.

Insurer Details

Medibank Private Limited

Silver Plus Settled Families Comprehensive

$652.30 / month

(Before Rebate, Discount & Loading)

Available in WA

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/MBP/J26/WDPB2D

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