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nib Health Funds Ltd.

Mid Plus - Silver Plus $250 Excess

$304.55 / month

(Before Rebate, Discount & Loading)

Available in TAS

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 provides accident cover - check with insurer for details.
This policy does not provide benefits for travel or accommodation outside of hospital.

Policy ID: NIB/J22/T0500S 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)

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

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

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 of $250 per admission. This is limited to a maximum of $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://my.nib.com.au/product-collateral/8

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/J22/T0500S Source: Private Health Information Statement (PHIS)

Extras Cover

This policy includes General treatment (Extras) cover for

Note, for treatments marked with * : * 65 % back up to your annual limit once maximum PBS amount has been deducted.

Treatment & waiting period (months)

Benefit limits per 12 months unless otherwise stated

Examples of maximum benefits

Acupuncture

$200 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, remedial massage & other services

Initial visit: 65% of charge
Subsequent visit: 65% of charge

Chinese medicine

$200 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, remedial massage & other services

Initial visit: 65% of charge
Subsequent visit: 65% of charge

Chiropractic

$350 per policy

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

Initial visit: 65% of charge
Subsequent visit: 65% of charge

Dietetics/dietary advice

$200 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, remedial massage & other services

Initial visit: 65% of charge
Subsequent visit: 65% of charge

Endodontic

$600 per policy

combined limit for endodontic & major dental

Filling of one root canal: 65% of charge

Exercise physiology

$350 per policy

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

Initial visit: 65% of charge
Subsequent visit: 65% of charge

General dental

$500 per policy

Fluoride treatment: 65% of charge
Scale & clean: 65% of charge
Periodic oral examination: 65% of charge

Health management / Healthy lifestyle

$150 per policy

Health management: 65% of charge

Major dental

$600 per policy

combined limit for endodontic & major dental

Surgical tooth extraction: 65% of charge
Full crown veneered: 65% of charge

Non PBS pharmaceuticals*

$300 per policy

Per eligible prescription: 65% of charge

Optical

$250 per policy

Multi-focal lenses & frames: 65% of charge
Single vision lenses & frames: 65% of charge

Orthodontic

$300 per policy

$1,500 lifetime limit

Braces for upper & lower teeth, including removal plus fitting of retainer: 65% of charge

Osteopathy

$350 per policy

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

Initial visit: 65% of charge
Subsequent visit: 65% of charge

Physiotherapy

$350 per policy

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

Initial visit: 65% of charge
Subsequent visit: 65% of charge

Psychology

$200 per policy

Initial visit: 65% of charge
Subsequent visit: 65% of charge

Remedial massage

$200 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, remedial massage & other services

sub-limits apply

Initial visit: 65% of charge
Subsequent visit: 65% of charge

Myotherapy: combined limit of $200 with acupuncture, dietary advice, remedial massage and Chinese herbalism. Healthier Lifestyle includes nib approved weight management programs, quit smoking and nicotine replacement, gym memberships, personal training, preventative health tests (service limits apply). Psychology has a sublimit of $150 for Digital Cognitive Behavioural Therapy (CBT).

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

Ante-natal/Post-natal classes

Audiology

Blood glucose monitors

Eye therapy (orthoptics)

Hearing aids

Home nursing

Occupational therapy

Orthotics (podiatric orthoses)

Podiatry

Speech therapy

Vaccinations

Other features of this general treatment cover: 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/8

Ambulance cover

Ambulance cover is provided by the State government for residents of Tasmania. This may include cover whilst interstate, except for South Australia and Queensland where no cover applies. In other states please check with Ambulance Tasmania - https://www.health.tas.gov.au/ambulance/fees_and_accounts.

Other features of this ambulance cover: Emergency ambulance costs are covered by the state government for residents of Tasmania.

For further information about this policy see: https://my.nib.com.au/product-collateral/8

Insurer Details

nib Health Funds Ltd.

Mid Plus - Silver Plus $250 Excess

$304.55 / month

(Before Rebate, Discount & Loading)

Available in TAS

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/J22/T0500S