healthslips.com.au Policy Information

Health Partners

Silver Hospital Plus Advantage $500 Excess with Combined Growing Family Extras

$234.13 / 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: Only one person.

Policy ID: SPS/C43/DIWG10

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)
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)
Rehabilitation
Skin
Sleep studies
Tonsils, adenoids and grommets

This policy does not include cover for

Assisted reproductive services
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 $500 per admission. This is limited to a maximum of $500 per person and $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.

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. 12 month waiting period for insulin pumps & hearing devices. Members can also access a range of discounts, refer to the ‘Member Discount’ page at healthpartners.com.au.

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

$200 per policy

combined limit for acupuncture, chinese medicine & remedial massage

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

$300 per policy

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, occupational therapy, psychology & speech therapy

  • Initial visit: 60% of charge
  • Subsequent visit: 60% of charge
Chinese medicine 2

$200 per policy

combined limit for acupuncture, chinese medicine & remedial massage

  • Initial visit: $30
Chiropractic 2

$500 per policy

combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry

  • Initial visit: $40
  • Subsequent visit: $35
Dietetics/dietary advice 2

$300 per policy

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, occupational therapy, psychology & speech therapy

  • Initial visit: $35
  • Subsequent visit: $30
Endodontic* 12

$500 per policy

combined limit for endodontic & major dental

  • Filling of one root canal: $169.5
Exercise physiology 2

$500 per policy

combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry

  • Initial visit: $40
  • Subsequent visit: $35
Eye therapy (orthoptics) 2

$500 per policy

combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry

  • Initial visit: $35
  • Subsequent visit: $30
General dental* 2

$800 per policy

  • Fluoride treatment: $20
  • Scale & clean: $72
  • Surgical tooth extraction: $209
  • Periodic oral examination: $33.5
Major dental* 12

$500 per policy

combined limit for endodontic & major dental

  • Full crown veneered: $884
Non PBS pharmaceuticals* 2

$200 per policy

combined limit for non pbs pharmaceuticals & vaccinations

  • Per eligible prescription: $0
Occupational therapy 2

$300 per policy

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, occupational therapy, psychology & speech therapy

  • Initial visit: $35
  • Subsequent visit: $30
Optical* 2

$200 per policy

  • Multi-focal lenses & frames: 100% of charge
  • Single vision lenses & frames: 100% of charge
Orthotics (podiatric orthoses) 12

$500 per policy

combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry

  • Orthotics supply & fit: 60% of charge
Osteopathy 2

$500 per policy

combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry

  • Initial visit: $40
  • Subsequent visit: $35
Physiotherapy* 2

$500 per policy

combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry

  • Initial visit: $40
  • Subsequent visit: $35
Podiatry 2

$500 per policy

combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry

  • Initial visit: $35
  • Subsequent visit: $30
Psychology 2

$300 per policy

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, occupational therapy, psychology & speech therapy

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

$200 per policy

combined limit for acupuncture, chinese medicine & remedial massage

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

$300 per policy

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, occupational therapy, psychology & speech therapy

  • Initial visit: $35
  • Subsequent visit: $30
Vaccinations* 2

$200 per policy

combined limit for non pbs pharmaceuticals & vaccinations

  • Per service: $0

Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

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

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $30}

Ante-natal/Post-natal classes

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per policy}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, occupational therapy, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

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

Examples of maximum benefits

{Initial visit: $30}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $35}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per policy}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, occupational therapy, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $30}

Endodontic*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Filling of one root canal: $169.5}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $35}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $30}

General dental*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$800 per policy}

Examples of maximum benefits

{Fluoride treatment: $20}

{Scale & clean: $72}

{Surgical tooth extraction: $209}

{Periodic oral examination: $33.5}

Major dental*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Full crown veneered: $884}

Non PBS pharmaceuticals*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

{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

{$300 per policy}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, occupational therapy, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $30}

Optical*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

Examples of maximum benefits

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

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

Orthotics (podiatric orthoses)

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry}

Examples of maximum benefits

{Orthotics supply & fit: 60% of charge}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $35}

Physiotherapy*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $35}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $30}

Psychology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per policy}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, occupational therapy, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: $75}

{Subsequent visit: $75}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

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

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $30}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per policy}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, occupational therapy, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $30}

Vaccinations*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

{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 your dental check-up (including x-rays). Plus, 60% 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 after you’ve 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 60% back on a physio visit, 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

Audiology
Blood glucose monitors
Health management / Healthy lifestyle
Hearing aids
Home nursing
Orthodontic

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 also includes other natural therapies, such as Chinese herbalism, myofascial release, therapeutic massage, Swedish massage, myotherapy & nutritionist. T&Cs apply.

Ambulance cover

In NT 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

Silver Hospital Plus Advantage $500 Excess with Combined Growing Family Extras

$234.13 / month

(Before Rebate, Discount & Loading)

Available in NT

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/C43/DIWG10

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