healthslips.com.au Policy Information

Astute Simplicity Health

Astute Gold Hospital 500 and Astute Extras Protect

Corporate Policy

$633.15 / month

(Before Rebate, Discount & Loading)

Available in SA

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

Children (0 - 17), non-classified* dependant (18 - 22) and students (23 - 24), as well as persons with a disability who qualify as a child, non-classified* dependant and student in these age ranges. *Non-classified dependant: Dependent under the age of 23.

Corporate policy: Employees and customers of Astute Financial

Policy ID: SLM/J8B/SAPS1D

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
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 on admission. This is limited to a maximum of $500 per person and $500 per policy per year.

Excess payments do not apply to hospital admissions for dependants and day surgery.

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

Ambulance subscriptions are claimable up to an annual premium, where there is no state-based Ambulance scheme or levy.

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

Combined limit of $500 per person for chiropractic/osteopathy, acupuncture and other services. $400 sub-limit applies per person, per service.

combined limit for acupuncture, chinese medicine, chiropractic, osteopathy & remedial massage

  • Initial visit: $35
  • Subsequent visit: $30
Ante-natal/Post-natal classes 2

$850 per person

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

sub-limits apply

  • Initial visit: $49
  • Subsequent visit: $49
Audiology 2
  • Initial visit: $50
  • Subsequent visit: $40
Blood glucose monitors 12

Overall limit of $1000 per person applies to Health Appliances & Aids**. $200 sub-limit applies to foot orthotics.

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

  • Per monitor: $200
Chinese medicine 2

Combined limit of $500 per person for chiropractic/osteopathy, acupuncture and other services. $400 sub-limit applies per person, per service.

combined limit for acupuncture, chinese medicine, chiropractic, osteopathy & remedial massage

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

Combined limit of $500 per person for chiropractic/osteopathy, acupuncture and other services. $400 sub-limit applies per person, per service.

combined limit for acupuncture, chinese medicine, chiropractic, osteopathy & remedial massage

  • Initial visit: $41
  • Subsequent visit: $30
Dietetics/dietary advice 2

$1,000 per person

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

sub-limits apply

  • Initial visit: $75
  • Subsequent visit: $45
Endodontic 12

$1,500 per person

combined limit for endodontic & major dental

sub-limits apply

  • Filling of one root canal: $180
Exercise physiology 2

$850 per person

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

sub-limits apply

  • Initial visit: $53
  • Subsequent visit: $40
Eye therapy (orthoptics) 2

$1,000 per person

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

sub-limits apply

  • Initial visit: $65
  • Subsequent visit: $38
General dental* 2

$1,000 per person

  • Fluoride treatment: $36
  • Scale & clean: 100% of charge
  • Surgical tooth extraction: $180
  • Periodic oral examination: 100% of charge
Hearing aids 36
  • Hearing aid: $1000
Home nursing 2

$500 per person

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

$1,500 per person

combined limit for endodontic & major dental

sub-limits apply

  • Full crown veneered: $810
Non PBS pharmaceuticals 2

$600 per person

  • Per eligible prescription: $70
Occupational therapy 2

$1,000 per person

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

  • Initial visit: $80
  • Subsequent visit: $55
Optical 6

$300 per person

  • Multi-focal lenses & frames: $300
  • Single vision lenses & frames: $300
Orthodontic 12

$1,000 per person

$2,800 lifetime limit

  • Braces for upper & lower teeth, including removal plus fitting of retainer: 100% of charge
Orthotics (podiatric orthoses) 2

Overall limit of $1000 per person applies to Health Appliances & Aids**. $200 sub-limit applies to foot orthotics.

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

  • Orthotics supply & fit: 90% of charge
Osteopathy 2

Combined limit of $500 per person for chiropractic/osteopathy, acupuncture and other services. $400 sub-limit applies per person, per service.

combined limit for acupuncture, chinese medicine, chiropractic, osteopathy & remedial massage

  • Initial visit: $57
  • Subsequent visit: $45
Physiotherapy 2

$850 per person

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

sub-limits apply

  • Initial visit: $57
  • Subsequent visit: $49
Podiatry 2

$1,000 per person

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

  • Initial visit: $47
  • Subsequent visit: $38
Psychology 12

Benefits payable towards counselling services - Initial consultation $80/subsequent consultation $70 included in $600 Psychology Limit

  • Initial visit: $145
  • Subsequent visit: $110
Remedial massage 2

Combined limit of $500 per person for chiropractic/osteopathy, acupuncture and other services. $400 sub-limit applies per person, per service.

combined limit for acupuncture, chinese medicine, chiropractic, osteopathy & remedial massage

  • Initial visit: $35
  • Subsequent visit: $30
Speech therapy 2

$1,000 per person

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

sub-limits apply

  • Initial visit: $120
  • Subsequent visit: $67

Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{Combined limit of $500 per person for chiropractic/osteopathy, acupuncture and other services. $400 sub-limit applies per person, per service.}

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

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $30}

Ante-natal/Post-natal classes

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$850 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $49}

{Subsequent visit: $49}

Audiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $40}

Blood glucose monitors

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{Overall limit of $1000 per person applies to Health Appliances & Aids**. $200 sub-limit applies to foot orthotics.}

{combined limit for blood glucose monitors & orthotics (podiatric orthoses)}

Examples of maximum benefits

{Per monitor: $200}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{Combined limit of $500 per person for chiropractic/osteopathy, acupuncture and other services. $400 sub-limit applies per person, per service.}

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

Examples of maximum benefits

{Initial visit: $32}

{Subsequent visit: $28}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{Combined limit of $500 per person for chiropractic/osteopathy, acupuncture and other services. $400 sub-limit applies per person, per service.}

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

Examples of maximum benefits

{Initial visit: $41}

{Subsequent visit: $30}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $75}

{Subsequent visit: $45}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,500 per person}

{combined limit for endodontic & major dental}

{sub-limits apply}

Examples of maximum benefits

{Filling of one root canal: $180}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$850 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $53}

{Subsequent visit: $40}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $65}

{Subsequent visit: $38}

General dental*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

Examples of maximum benefits

{Fluoride treatment: $36}

{Scale & clean: 100% of charge}

{Surgical tooth extraction: $180}

{Periodic oral examination: 100% of charge}

Hearing aids

Waiting period:  36 months

Benefit limits per 12 months unless otherwise stated

Examples of maximum benefits

{Hearing aid: $1000}

Home nursing

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $50}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,500 per person}

{combined limit for endodontic & major dental}

{sub-limits apply}

Examples of maximum benefits

{Full crown veneered: $810}

Non PBS pharmaceuticals

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

Examples of maximum benefits

{Per eligible prescription: $70}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

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

Examples of maximum benefits

{Initial visit: $80}

{Subsequent visit: $55}

Optical

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

Examples of maximum benefits

{Multi-focal lenses & frames: $300}

{Single vision lenses & frames: $300}

Orthodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{$2,800 lifetime limit}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: 100% of charge}

Orthotics (podiatric orthoses)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{Overall limit of $1000 per person applies to Health Appliances & Aids**. $200 sub-limit applies to foot orthotics.}

{combined limit for blood glucose monitors & orthotics (podiatric orthoses)}

Examples of maximum benefits

{Orthotics supply & fit: 90% of charge}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{Combined limit of $500 per person for chiropractic/osteopathy, acupuncture and other services. $400 sub-limit applies per person, per service.}

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

Examples of maximum benefits

{Initial visit: $57}

{Subsequent visit: $45}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$850 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $57}

{Subsequent visit: $49}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

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

Examples of maximum benefits

{Initial visit: $47}

{Subsequent visit: $38}

Psychology

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{Benefits payable towards counselling services - Initial consultation $80/subsequent consultation $70 included in $600 Psychology Limit}

Examples of maximum benefits

{Initial visit: $145}

{Subsequent visit: $110}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{Combined limit of $500 per person for chiropractic/osteopathy, acupuncture and other services. $400 sub-limit applies per person, per service.}

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

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $30}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $120}

{Subsequent visit: $67}

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

Health management / Healthy lifestyle
Vaccinations

Other features of this general treatment cover: Orthodontic limit included in annual Major Dental limit. Diabetes Education & Nutrition benefits included in Dietetics sub-limit. Approved health management programs when Extras Protect is taken with hospital cover. Member rewards apply after 5 years continuous membership. **Limits apply to individual Health Appliances & Aids.

Ambulance cover

South Australia has a subscription service to cover ambulance within the state, with an additional fee to cover interstate travel (http://www.saambulance.com.au/ProductsServices/AmbulanceCover.aspx).

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

Insurer Details

Astute Simplicity Health

Astute Gold Hospital 500 and Astute Extras Protect

Corporate Policy

$633.15 / month

(Before Rebate, Discount & Loading)

Available in SA

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/J8B/SAPS1D

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