healthslips.com.au Policy Information

Astute Simplicity Health

Astute Silver Plus Hospital 500 and Astute Wellbeing Extras

Corporate Policy

$555.00 / 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 or an insurer discount. Check with your insurer for details.

This policy covers: Two adults (and no-one else).

Corporate policy: Employees and customers of Astute Financial

Policy ID: SLM/J13D/NDES20

Source: Private Health Information Statement (PHIS)

Hospital Cover

  • 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.
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
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
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 on admission. This is limited to a maximum of $500 per person and $1000 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

Half excess applies to day surgery up to maximum product excess. Ambulance subscriptions are claimable up to an annual premium, where there is no state based Ambulance scheme or levy. Unmarried dependants covered until they turn 23 and single F/T students covered until they turn 25.

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

$300 per person

combined limit for acupuncture, chinese medicine & remedial massage

sub-limits apply

  • Initial visit: $32
  • Subsequent visit: $28
Ante-natal/Post-natal classes 2

$350 per person

combined limit for ante-natal/post-natal classes, exercise physiology, eye therapy (orthoptics) & physiotherapy

sub-limits apply

  • Initial visit: 60% of charge
  • Subsequent visit: 60% of charge
Audiology 2

$350 per person

combined limit for audiology, dietetics/dietary advice, home nursing & occupational therapy

sub-limits apply

  • Initial visit: 60% of charge
Chinese medicine 2

$300 per person

combined limit for acupuncture, chinese medicine & remedial massage

sub-limits apply

  • Initial visit: $32
  • Subsequent visit: $28
Chiropractic 2

$350 per person

combined limit for chiropractic & osteopathy

sub-limits apply

  • Initial visit: $38
  • Subsequent visit: $27
Dietetics/dietary advice 2

$350 per person

combined limit for audiology, dietetics/dietary advice, home nursing & occupational therapy

sub-limits apply

  • Initial visit: $40
  • Subsequent visit: $30
Endodontic 12

$500 per person

combined limit for endodontic & major dental

sub-limits apply

  • Filling of one root canal: 60% of charge
Exercise physiology 2

$350 per person

combined limit for ante-natal/post-natal classes, exercise physiology, eye therapy (orthoptics) & physiotherapy

sub-limits apply

  • Initial visit: 60% of charge
  • Subsequent visit: 60% of charge
Eye therapy (orthoptics) 2

$350 per person

combined limit for ante-natal/post-natal classes, exercise physiology, eye therapy (orthoptics) & physiotherapy

sub-limits apply

  • Initial visit: $43
  • Subsequent visit: $33
General dental* 2

$750 per person

  • Fluoride treatment: 60% of charge
  • Scale & clean: 60% of charge
  • Surgical tooth extraction: 60% of charge
  • Periodic oral examination: 60% of charge
Home nursing 2

$350 per person

combined limit for audiology, dietetics/dietary advice, home nursing & occupational therapy

sub-limits apply

  • Initial visit: $50
  • Subsequent visit: $50
Major dental 12

$500 per person

combined limit for endodontic & major dental

sub-limits apply

  • Full crown veneered: 60% of charge
Non PBS pharmaceuticals 2

$300 per person

  • Per eligible prescription: 60% of charge
Occupational therapy 2

$350 per person

combined limit for audiology, dietetics/dietary advice, home nursing & occupational therapy

sub-limits apply

  • Initial visit: $55
  • Subsequent visit: $40
Optical 6

$200 per person

  • Multi-focal lenses & frames: $200
  • Single vision lenses & frames: $200
Osteopathy 2

$350 per person

combined limit for chiropractic & osteopathy

sub-limits apply

  • Initial visit: $43
  • Subsequent visit: $40
Physiotherapy 2

$350 per person

combined limit for ante-natal/post-natal classes, exercise physiology, eye therapy (orthoptics) & physiotherapy

sub-limits apply

  • Initial visit: $53
  • Subsequent visit: $47
Podiatry 2

$200 per person

  • Initial visit: $40
  • Subsequent visit: $33
Psychology 12

Benefits payable towards counselling services - Initial consultation $60/subsequent consultation $45 included in $400 Psychology Limit.

  • Initial visit: $110
  • Subsequent visit: $75
Remedial massage 2

$300 per person

combined limit for acupuncture, chinese medicine & remedial massage

sub-limits apply

  • Initial visit: $32
  • Subsequent visit: $28

Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $32}

{Subsequent visit: $28}

Ante-natal/Post-natal classes

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

{combined limit for ante-natal/post-natal classes, exercise physiology, eye therapy (orthoptics) & physiotherapy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Audiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

{combined limit for audiology, dietetics/dietary advice, home nursing & occupational therapy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: 60% of charge}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $32}

{Subsequent visit: $28}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

{combined limit for chiropractic & osteopathy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $38}

{Subsequent visit: $27}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

{combined limit for audiology, dietetics/dietary advice, home nursing & occupational therapy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $30}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for endodontic & major dental}

{sub-limits apply}

Examples of maximum benefits

{Filling of one root canal: 60% of charge}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

{combined limit for ante-natal/post-natal classes, exercise physiology, eye therapy (orthoptics) & physiotherapy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

{combined limit for ante-natal/post-natal classes, exercise physiology, eye therapy (orthoptics) & physiotherapy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $43}

{Subsequent visit: $33}

General dental*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$750 per person}

Examples of maximum benefits

{Fluoride treatment: 60% of charge}

{Scale & clean: 60% of charge}

{Surgical tooth extraction: 60% of charge}

{Periodic oral examination: 60% of charge}

Home nursing

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

{combined limit for audiology, dietetics/dietary advice, home nursing & occupational therapy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $50}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for endodontic & major dental}

{sub-limits apply}

Examples of maximum benefits

{Full crown veneered: 60% of charge}

Non PBS pharmaceuticals

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

Examples of maximum benefits

{Per eligible prescription: 60% of charge}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

{combined limit for audiology, dietetics/dietary advice, home nursing & occupational therapy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $55}

{Subsequent visit: $40}

Optical

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

{Multi-focal lenses & frames: $200}

{Single vision lenses & frames: $200}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

{combined limit for chiropractic & osteopathy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $43}

{Subsequent visit: $40}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

{combined limit for ante-natal/post-natal classes, exercise physiology, eye therapy (orthoptics) & physiotherapy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $53}

{Subsequent visit: $47}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $33}

Psychology

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{Benefits payable towards counselling services - Initial consultation $60/subsequent consultation $45 included in $400 Psychology Limit. }

Examples of maximum benefits

{Initial visit: $110}

{Subsequent visit: $75}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $32}

{Subsequent visit: $28}

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

Blood glucose monitors
Health management / Healthy lifestyle
Hearing aids
Orthodontic
Orthotics (podiatric orthoses)
Speech therapy
Vaccinations

Other features of this general treatment cover: Approved health management programs when Wellbeing Extras is taken with hospital cover. Benefits payable at 60% of fee charged, up to maximum benefit. Diabetes Education & Nutrition benefits included in Dietetics sub-limit.

Ambulance cover

Health Care Concession Card, Pensioner Concession Card, and Commonwealth Seniors Health Card holders are entitled to free ambulance transport services. If you are not eligible for a concession and want to be covered, you can purchase insurance from a private health fund.

For further information about this policy see: https://www.stlukes.com.au/forms-brochures?tag=Information+sheet

Insurer Details

Astute Simplicity Health

Astute Silver Plus Hospital 500 and Astute Wellbeing Extras

Corporate Policy

$555.00 / month

(Before Rebate, Discount & Loading)

Available in NSW & ACT

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/SLM/J13D/NDES20

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