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nib Health Funds Ltd.

Young at Heart Mid - Silver Plus $750 Excess

$423.04 / 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: One adult & dependants (2 or more people, only one of whom is an adult).

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: 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.

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/J28/DPDR1D 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)

Cataracts

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

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)

Rehabilitation

Skin

Sleep studies

Tonsils, adenoids and grommets

This policy does not include cover for

Assisted reproductive services

Dialysis for chronic kidney failure

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 $750 per admission. This is limited to a maximum of $750 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/11

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/J28/DPDR1D 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

Blood glucose monitors

$400 per person

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

Per monitor: 65% of charge

Chiropractic

$300 per person

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

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

Dietetics/dietary advice

$200 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry & speech therapy

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

Endodontic

$700 per person

combined limit for endodontic & major dental

Filling of one root canal: 65% of charge

Exercise physiology

$300 per person

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

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

Eye therapy (orthoptics)

$200 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry & speech therapy

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

General dental

$500 per person

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

Hearing aids

$400 per person

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

Hearing aid: 65% of charge

Home nursing

$200 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry & speech therapy

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

Major dental

$700 per person

combined limit for endodontic & major dental

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

Non PBS pharmaceuticals*

$400 per person

Per eligible prescription: 65% of charge

Occupational therapy

$200 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry & speech therapy

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

Optical

$250 per person

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

Orthotics (podiatric orthoses)

$400 per person

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

Orthotics supply & fit: 65% of charge

Osteopathy

$300 per person

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

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

Physiotherapy

$300 per person

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

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

Podiatry

$200 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry & speech therapy

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

Speech therapy

$200 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry & speech therapy

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

Other Therapies ($200) includes dietary advice, eye therapy, home nursing, occupational therapy, podiatry and speech pathology. Hearing aids / Artificial aids / Orthotics ($400) includes e.g. spacer, peak flow meter, nebuliser, blood glucose monitor, Irlen lens (service limits apply).

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

Acupuncture

Ante-natal/Post-natal classes

Audiology

Chinese medicine

Health management / Healthy lifestyle

Orthodontic

Psychology

Remedial massage

Vaccinations

Other features of this general treatment cover: For customers looking for a medium level of cover, tailored for them when they reach a certain time in their life. 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/11

Ambulance cover

In NT 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/11

Insurer Details

nib Health Funds Ltd.

Young at Heart Mid - Silver Plus $750 Excess

$423.04 / month

(Before Rebate, Discount & Loading)

Available in NT

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/J28/DPDR1D