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nib Health Funds Ltd.

Premier 85% - Gold $400 Excess

Corporate Policy

$1,067.47 / month

(Before Rebate, Discount & Loading)

Available in NSW & ACT

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, 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: For nib Policies a person who is not a Policy Holder or Partner and who: is aged under 21 years is not married and does not have a defacto Partner; and includes a Foster Child, legally adopted child or stepchild.

Corporate policy: This cover is available to select nib corporate groups.

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: NIB/J17/NDIB2Y Source: Private Health Information Statement (PHIS)

Hospital Cover

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 $400 per admission. This is limited to a maximum of $400 per person and $800 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
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

Our Going to Hospital Pack provides more ways to reduce out-of-pockets, ask us for your copy.

For further information about this policy see: https://my.nib.com.au/product-collateral/27

By using our FirstChoice providers, you may have lower out-of-pocket costs on many allied health services. A list of "preferred providers" is available from the health insurer. See https://www.nib.com.au/find-a-provider.

Policy ID: NIB/J17/NDIB2Y Source: Private Health Information Statement (PHIS)

Extras Cover

This policy includes General treatment (Extras) cover for

Note, for treatments marked with * : Benefit paid after current PBS patient contribution deducted

Treatment & waiting period (months)

Benefit limits per 12 months unless otherwise stated

Examples of maximum benefits

Acupuncture

$170 per single policy $340 per couple/family policy

combined limit for acupuncture, chinese medicine & remedial massage

Initial visit: 85% of charge
Subsequent visit: 85% of charge

Ante-natal/Post-natal classes

$700 per person

combined limit for ante-natal/post-natal classes, exercise physiology & physiotherapy

Initial visit: 85% of charge
Subsequent visit: 85% of charge

Blood glucose monitors

$500 per person

combined limit for blood glucose monitors, orthotics (podiatric orthoses) & other services

Per monitor: 85% of charge

Chinese medicine

$170 per single policy $340 per couple/family policy

combined limit for acupuncture, chinese medicine & remedial massage

Initial visit: 85% of charge
Subsequent visit: 85% of charge

Chiropractic

$300 per person

combined limit for chiropractic & osteopathy

Initial visit: 85% of charge
Subsequent visit: 85% of charge

Dietetics/dietary advice

$200 per person

Initial visit: 85% of charge
Subsequent visit: 85% of charge

Endodontic

General dental/Oral surgery/Restorative services $500 Endodontia/Periodontia $500 Prosthetic dental - crowns and bridges/dentures $750; Service Limits Apply

combined limit for endodontic, general dental & major dental

Filling of one root canal: 85% of charge

Exercise physiology

$700 per person

combined limit for ante-natal/post-natal classes, exercise physiology & physiotherapy

Initial visit: 85% of charge
Subsequent visit: 85% of charge

Eye therapy (orthoptics)

$200 per person

Initial visit: 85% of charge
Subsequent visit: 85% of charge

General dental

General dental/Oral surgery/Restorative services $500 Endodontia/Periodontia $500 Prosthetic dental - crowns and bridges/dentures $750; Service Limits Apply

combined limit for endodontic, general dental & major dental

Fluoride treatment: 85% of charge
Scale & clean: 85% of charge
Surgical tooth extraction: 85% of charge
Periodic oral examination: 85% of charge

Health management / Healthy lifestyle

$100 per single policy $200 per couple/family policy

Health management: 100% of charge

Hearing aids

$650 per person

Hearing aid: 85% of charge

Home nursing

$500 per person

Initial visit: 85% of charge
Subsequent visit: 85% of charge

Major dental

General dental/Oral surgery/Restorative services $500 Endodontia/Periodontia $500 Prosthetic dental - crowns and bridges/dentures $750; Service Limits Apply

combined limit for endodontic, general dental & major dental

Full crown veneered: 85% of charge

Non PBS pharmaceuticals*

$600 per person

Per eligible prescription: 85% of charge

Occupational therapy

$200 per person

Initial visit: 85% of charge
Subsequent visit: 85% of charge

Optical

$225 per person

Multi-focal lenses & frames: 85% of charge
Single vision lenses & frames: 85% of charge

Orthodontic

$500 per person

Braces for upper & lower teeth, including removal plus fitting of retainer: 85% of charge

Orthotics (podiatric orthoses)

$500 per person

combined limit for blood glucose monitors, orthotics (podiatric orthoses) & other services

Orthotics supply & fit: 85% of charge

Osteopathy

$300 per person

combined limit for chiropractic & osteopathy

Initial visit: 85% of charge
Subsequent visit: 85% of charge

Physiotherapy

$700 per person

combined limit for ante-natal/post-natal classes, exercise physiology & physiotherapy

Initial visit: 85% of charge
Subsequent visit: 85% of charge

Podiatry

$250 per person

Initial visit: 85% of charge
Subsequent visit: 85% of charge

Psychology

$300 per person

Initial visit: 85% of charge
Subsequent visit: 85% of charge

Remedial massage

$170 per single policy $340 per couple/family policy

combined limit for acupuncture, chinese medicine & remedial massage

Initial visit: 85% of charge
Subsequent visit: 85% of charge

Speech therapy

$200 per person

Initial visit: 85% of charge
Subsequent visit: 85% of charge

Artificial aids / Orthotics / Speech processor ($500 limit per person per calendar year) e.g. spacer, peak flow meter, nebuliser, blood glucose monitor, Irlen lens (service limits apply). Myotherapy: combined with acupuncture, remedial massage and Chinese herbalism. Healthier Lifestyle includes nib approved weight management, quit smoking and health management programs (gym memberships) and more. Waiting periods for dental treatment range between 2 and 12 months. No Benefit for Post-natal classes Psychology has a sublimit of $150 for Digital Cognitive Behavioural Therapy (CBT).

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

Audiology

Vaccinations

Other features of this general treatment cover: Comprehensive hospital cover with a range of Extras with benefits up to 85%. Of course, you can see your choice of provider, but by choosing a FirstChoice provider, you may have less to pay towards the cost of your treatment. We’ve created the FirstChoice network to help you access quality healthcare and a better deal for you and your family. We’ve locked in lower costs with our FirstChoice providers, so you can enjoy competitive treatment fees when you visit the dentist or a discount the next time you claim for glasses.

For further information about this policy see: https://my.nib.com.au/product-collateral/27

Ambulance cover

In NSW & ACT 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: All our health covers include unlimited emergency ambulance (1 day waiting period on all emergency ambulance). Emergency ambulance is when you need immediate transport by a State or Territory ambulance to get to a hospital or other facility for urgent medical treatment. No annual limits for emergency ambulance apply.

For further information about this policy see: https://my.nib.com.au/product-collateral/27

Insurer Details

nib Health Funds Ltd.

Premier 85% - Gold $400 Excess

Corporate Policy

$1,067.47 / month

(Before Rebate, Discount & Loading)

Available in NSW & ACT

Call now 13 14 63 Sponsor link

nib Health Funds Ltd.

https://www.nib.com.au

13 14 63

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/NIB/J17/NDIB2Y