healthslips.com.au Policy Information

Health Partners

Gold Hospital Advantage $750 Excess with Combined Best Extras

$1333.93 / 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 - 31) and non-students (21 to 31), 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: Non-classified dependant means a person who is aged between 18 and 20 (inclusive), is not married or living in a de facto relationship, and is a child of the policyholder or child of the policyholder's partner. References to Child Dependant include Non-Classified Dependant.

Policy ID: SPS/C36/NGRI2Y

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 of $750 per admission. This is limited to a maximum of $750 per person and $1500 per policy per year.

Excess payments do not apply to hospital admissions for dependants.

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

Health Partners Support Programs: Hospital to Home; includes Hospital Guide, Hospital in the Home and Rehab in the Home. Health Management Programs; Health Coaching. Benefits directly related to an admission and medically necessary: PBS approved prescriptions - 100% benefit & unlimited, Aids for recovery benefit 75% with $100 limit, non-surgically implanted medical devices and human tissue products benefit 75% with $150 limit. Members can also access a range of discounts, refer to the ‘Member Discount’ page at healthpartners.com.au.

For further information about this policy see: https://www.healthpartners.com.au/health-insurance

Extras Cover

Health Partners operates a preferred provider scheme available only in South Australia. See https://www.healthpartners.com.au/members/providers/.

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

  • Initial visit: $35
  • Subsequent visit: $35
Blood glucose monitors 12

$600 per person

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

sub-limits apply

  • Per monitor: 90% of charge
Chinese medicine 2

$300 per person

combined limit for acupuncture, chinese medicine & remedial massage

  • Initial visit: $35
  • Subsequent visit: $35
Chiropractic 2

$1,300 per person

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

  • Initial visit: $50
  • Subsequent visit: $40
Dietetics/dietary advice 2

$750 per person

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

  • Initial visit: $50
  • Subsequent visit: $50
Endodontic* 12

$1,300 per person

combined limit for endodontic & major dental

  • Filling of one root canal: 80% of charge
Exercise physiology 2

$1,300 per person

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

  • Initial visit: $50
  • Subsequent visit: $40
Eye therapy (orthoptics) 2

$750 per person

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

  • Initial visit: $50
  • Subsequent visit: $50
General dental* 2

No annual limit

  • Fluoride treatment: 80% of charge
  • Scale & clean: 80% of charge
  • Surgical tooth extraction: 80% of charge
  • Periodic oral examination: 80% of charge
Health management / Healthy lifestyle 2

$200 per person

  • Health management: 90% of charge
Hearing aids 12

$600 per person

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

sub-limits apply

  • Hearing aid: 90% of charge
Major dental* 12

$1,300 per person

combined limit for endodontic & major dental

  • Full crown veneered: 80% of charge
Non PBS pharmaceuticals* 2

$600 per person

combined limit for non pbs pharmaceuticals & vaccinations

  • Per eligible prescription: $0
Occupational therapy 2

$750 per person

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

  • Initial visit: $75
  • Subsequent visit: $75
Optical* 2

$300 per person

sub-limits apply

  • Multi-focal lenses & frames: 100% of charge
  • Single vision lenses & frames: 100% of charge
Orthodontic 12

$2,800 lifetime limit

sub-limits apply

  • Braces for upper & lower teeth, including removal plus fitting of retainer: 100% of charge
Orthotics (podiatric orthoses) 12

$600 per person

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

sub-limits apply

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

$1,300 per person

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

  • Initial visit: $50
  • Subsequent visit: $40
Physiotherapy* 2

$1,300 per person

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

sub-limits apply

  • Initial visit: $50
  • Subsequent visit: $40
Podiatry 2

$750 per person

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

  • Initial visit: $50
  • Subsequent visit: $50
Psychology 2

$750 per person

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

  • Initial visit: $100
  • Subsequent visit: $100
Remedial massage 2

$300 per person

combined limit for acupuncture, chinese medicine & remedial massage

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

$750 per person

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

  • Initial visit: $75
  • Subsequent visit: $75
Vaccinations* 2

$600 per person

combined limit for non pbs pharmaceuticals & vaccinations

  • Per service: $0

Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

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

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $35}

Blood glucose monitors

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Per monitor: 90% 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}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $35}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,300 per person}

{combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $40}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$750 per person}

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

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $50}

Endodontic*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,300 per person}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Filling of one root canal: 80% of charge}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,300 per person}

{combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $40}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$750 per person}

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

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $50}

General dental*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{No annual limit}

Examples of maximum benefits

{Fluoride treatment: 80% of charge}

{Scale & clean: 80% of charge}

{Surgical tooth extraction: 80% of charge}

{Periodic oral examination: 80% of charge}

Health management / Healthy lifestyle

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

{Health management: 90% of charge}

Hearing aids

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Hearing aid: 90% of charge}

Major dental*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,300 per person}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Full crown veneered: 80% of charge}

Non PBS pharmaceuticals*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per eligible prescription: $0}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$750 per person}

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

Examples of maximum benefits

{Initial visit: $75}

{Subsequent visit: $75}

Optical*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

{sub-limits apply}

Examples of maximum benefits

{Multi-focal lenses & frames: 100% of charge}

{Single vision lenses & frames: 100% of charge}

Orthodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$2,800 lifetime limit}

{sub-limits apply}

Examples of maximum benefits

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

Orthotics (podiatric orthoses)

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Orthotics supply & fit: 90% of charge}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,300 per person}

{combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $40}

Physiotherapy*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,300 per person}

{combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $40}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$750 per person}

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

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $50}

Psychology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$750 per person}

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

Examples of maximum benefits

{Initial visit: $100}

{Subsequent visit: $100}

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}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $35}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$750 per person}

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

Examples of maximum benefits

{Initial visit: $75}

{Subsequent visit: $75}

Vaccinations*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per service: $0}

In South Australia, get more from your cover by using Health Partners Dental and Optical practices – like 100% back on 2 x dental check-ups (including x-rays) and a mouthguard. Plus, 90% benefit on other general and major dental services, up to your limits. At Health Partners Optical, you get 100% back on your optical limit, and an unlimited 40% benefit once you have reached your limit. 100% back on your optical limit is also available at other recognised optical providers, sub-limit applies. At our participating physios get 100% back on 2 physio visits and 90% thereafter, up to your limit. Save 20% every day on full-price, non-prescription products at over 50 pharmacies across South Australia, which include participating Priceline and TerryWhite Chemmart stores. T&Cs apply.

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

Ante-natal/Post-natal classes
Audiology
Home nursing

Other features of this general treatment cover: Combined limits create flexibility for you to use your limit on what's important to you. Acupuncture and Remedial Massage limits can also be used for other natural therapies, such as Chinese herbalism, myofascial release, therapeutic massage, Swedish massage, myotherapy & nutritionist. Also combined with the Hearing Aid limit is other appliances such as CPAP Machine, nebuliser & spacer devices. Sub-limits apply. Health Management limits include benefits for bowel screening, diabetes membership, weight management, post-natal lactation consultation and gym & fitness benefit (when medically necessary). T&Cs apply.

For further information about this policy see: https://www.healthpartners.com.au/health-insurance

Ambulance cover

In NSW & ACT this policy provides:

Emergency: Unlimited with no waiting period.

Call-out fees: Will not be paid.

For further information about this policy see: https://www.healthpartners.com.au/health-insurance/understanding-private-health-insurance/

Insurer Details

Health Partners

Gold Hospital Advantage $750 Excess with Combined Best Extras

$1333.93 / 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/SPS/C36/NGRI2Y

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