healthslips.com.au Policy Information

Navy Health Ltd

Premium Gold Hospital 350 & Budget Extras

Restricted Insurer

$348.68 / 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: Dependants only (2 or more people, none of whom is an adult).

Children (0 - 17), non-classified* dependant (18 - 21) and students (22 - 31), as well as persons with a disability who qualify as a child, non-classified* dependant and student in these age ranges. *Non-classified dependant: A non classified dependant is defined by Navy Health as a child, legally adopted child or step-child who is unmarried and who is younger than 21 years of age.

Restricted insurer: Membership of this insurer is restricted to Cover for the ADF community - serving, ex-serving ADF, employees of contractors to ADF and families.

Policy ID: NHB/J13/QDSX0D

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: You will have to pay an excess of $350 per admission. This is limited to a maximum of $350 per person and $350 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
  • 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

Receive up to 100% cover at over 490 private hospitals and day facilities, in addition to all recognised public hospitals across Australia. You also have access to Member Health Support Program for home recovery, as well as unlimited ambulance cover Australia-wide, which means you are not required to take out ambulance cover elsewhere.

Extras Cover

This health insurer does not operate a preferred provider scheme.

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 person up to $400 per policy

combined limit for acupuncture, chinese medicine, exercise physiology & remedial massage

  • Initial visit: $18
  • Subsequent visit: $18
Chinese medicine 2

$200 per person up to $400 per policy

combined limit for acupuncture, chinese medicine, exercise physiology & remedial massage

  • Initial visit: $18
  • Subsequent visit: $18
Chiropractic 2

$300 per person up to $600 per policy

combined limit for chiropractic, osteopathy & other services

  • Initial visit: $30
  • Subsequent visit: $22
Exercise physiology 2

$200 per person up to $400 per policy

combined limit for acupuncture, chinese medicine, exercise physiology & remedial massage

  • Initial visit: $18
  • Subsequent visit: $18
General dental 2

$500 per person

combined limit for general dental & major dental

  • Fluoride treatment: $15.6
  • Scale & clean: $50
  • Periodic oral examination: $28
Major dental 12

$500 per person

combined limit for general dental & major dental

  • Surgical tooth extraction: $102
Non PBS pharmaceuticals 2

$200 per person

  • Per eligible prescription: $50
Optical 6

$170 per person

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

$300 per person up to $600 per policy

combined limit for chiropractic, osteopathy & other services

  • Initial visit: $30
  • Subsequent visit: $22
Physiotherapy 2

$300 per person

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

$200 per person up to $400 per policy

combined limit for acupuncture, chinese medicine, exercise physiology & remedial massage

  • Initial visit: $18
  • Subsequent visit: $18

Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person up to $400 per policy}

{combined limit for acupuncture, chinese medicine, exercise physiology & remedial massage}

Examples of maximum benefits

{Initial visit: $18}

{Subsequent visit: $18}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person up to $400 per policy}

{combined limit for acupuncture, chinese medicine, exercise physiology & remedial massage}

Examples of maximum benefits

{Initial visit: $18}

{Subsequent visit: $18}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person up to $600 per policy}

{combined limit for chiropractic, osteopathy & other services}

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $22}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person up to $400 per policy}

{combined limit for acupuncture, chinese medicine, exercise physiology & remedial massage}

Examples of maximum benefits

{Initial visit: $18}

{Subsequent visit: $18}

General dental

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for general dental & major dental}

Examples of maximum benefits

{Fluoride treatment: $15.6}

{Scale & clean: $50}

{Periodic oral examination: $28}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for general dental & major dental}

Examples of maximum benefits

{Surgical tooth extraction: $102}

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: $50}

Optical

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$170 per person}

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

{$300 per person up to $600 per policy}

{combined limit for chiropractic, osteopathy & other services}

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $22}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

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 person up to $400 per policy}

{combined limit for acupuncture, chinese medicine, exercise physiology & remedial massage}

Examples of maximum benefits

{Initial visit: $18}

{Subsequent visit: $18}

Members can access special offers from any of Navy Health’s preferred optical providers: OPSM, Laubman & Pank, Specsavers, Teachers Eye Care, Eyebenefit and Q Optical Network (QON). General treatment benefit year runs from 1 July to 30 June.

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

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

Other features of this general treatment cover: Telehealth services available for Physiotherapy.

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: We cover 100% of the cost of ambulance services within Australia, provided it is provided by a state based run Ambulance service, by either air/sea or land. We do not provide benefits for privately run patient transport services.

Insurer Details

Navy Health Ltd

Premium Gold Hospital 350 & Budget Extras

Restricted Insurer

$348.68 / 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/NHB/J13/QDSX0D

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