Doctors' Health Fund

Smart Starter Bronze Plus $500 Excess & Starter Extras

Name: Smart Starter Bronze Plus $500 Excess & Starter Extras
Brand: Doctors' Health Fund
Price: 452.7 AUD

Restricted Insurer

$452.70 / month

(Before Rebate, Discount & Loading)

Available in VIC

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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 (and no-one else).

Restricted insurer: Membership of this insurer is restricted to Medical and allied health professionals, their families, medical students and AMA employees.

Policy ID: AMA/J13/VAQS20

Source: Private Health Information Statement (PHIS)

This policy exempts you from the Medicare Levy Surcharge.
This policy provides accident cover - check with insurer for details.
This policy provides benefits for travel or accommodation outside of hospital - check with insurer for details.

Covered

Restricted Cover

Not Covered

This policy includes cover for

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

Hernia and appendix

Hospital psychiatric services

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

Back, neck and spine

Cataracts

Dialysis for chronic kidney failure

Heart and vascular system

Implantation of hearing devices

Insulin pumps

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
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

This cover is categorised as Bronze Plus as the services covered exceed the minimum requirements for Bronze level cover. Smart Starter Bronze Plus has Silver inclusions such as lung and chest, blood, medically necessary plastic and reconstructive surgery, dental surgery, and podiatric surgery. It also includes cover for sleep studies which is generally only included in Gold level cover.

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

$150 per person up to $300 per policy

combined limit for acupuncture, health management / healthy lifestyle & other services

Initial visit: 75% of charge
Subsequent visit: 75% of charge

Blood glucose monitors 12

$150 per person

combined limit for blood glucose monitors, non pbs pharmaceuticals & vaccinations

Per monitor: 75% of charge

Dietetics/dietary advice 2

$600 per person

combined limit for dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

Initial visit: $35
Subsequent visit: $30

Exercise physiology 2

$600 per person

combined limit for dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

Initial visit: $25
Subsequent visit: $25

Eye therapy (orthoptics) 2

$600 per person

combined limit for dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

Initial visit: $30
Subsequent visit: $30

General dental* 2

$800 per person

Fluoride treatment: 100% of charge
Scale & clean: 100% of charge
Periodic oral examination: 100% of charge

Health management / Healthy lifestyle 2

$150 per person up to $300 per policy

combined limit for acupuncture, health management / healthy lifestyle & other services

Health management: 75% of charge

Non PBS pharmaceuticals 2

$150 per person

combined limit for blood glucose monitors, non pbs pharmaceuticals & vaccinations

sub-limits apply

Per eligible prescription: 85% of charge

Occupational therapy 2

$600 per person

combined limit for dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

Initial visit: $45
Subsequent visit: $35

Optical* 2

$300 per person

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

Orthotics (podiatric orthoses) 12

$600 per person

combined limit for dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

sub-limits apply

Orthotics supply & fit: $100

Physiotherapy* 2

$600 per person

combined limit for dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

Initial visit: $45
Subsequent visit: $35

Podiatry 2

$600 per person

combined limit for dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

Initial visit: $40
Subsequent visit: $30

Psychology 2

$600 per person

combined limit for dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

Initial visit: $100
Subsequent visit: $100

Remedial massage 2

$600 per person

combined limit for dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

Initial visit: $35
Subsequent visit: $25

Speech therapy 2

$600 per person

combined limit for dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

Initial visit: $45
Subsequent visit: $35

Vaccinations 2

$150 per person

combined limit for blood glucose monitors, non pbs pharmaceuticals & vaccinations

Per service: 85% of charge

Acupuncture*

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$150 per person up to $300 per policy}

{combined limit for acupuncture, health management / healthy lifestyle & other services}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Blood glucose monitors

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$150 per person}

{combined limit for blood glucose monitors, non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per monitor: 75% of charge}

Dietetics/dietary advice

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $30}

Exercise physiology

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $25}

{Subsequent visit: $25}

Eye therapy (orthoptics)

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $30}

General dental*

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

Examples of maximum benefits

{Fluoride treatment: 100% of charge}

{Scale & clean: 100% of charge}

{Periodic oral examination: 100% of charge}

Health management / Healthy lifestyle

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$150 per person up to $300 per policy}

{combined limit for acupuncture, health management / healthy lifestyle & other services}

Examples of maximum benefits

{Health management: 75% of charge}

Non PBS pharmaceuticals

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$150 per person}

{combined limit for blood glucose monitors, non pbs pharmaceuticals & vaccinations}

{sub-limits apply}

Examples of maximum benefits

{Per eligible prescription: 85% of charge}

Occupational therapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $35}

Optical*

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

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

{$600 per person}

{combined limit for dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Orthotics supply & fit: $100}

Physiotherapy*

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $35}

Podiatry

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $30}

Psychology

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $100}

{Subsequent visit: $100}

Remedial massage

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $25}

Speech therapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $35}

Vaccinations

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$150 per person}

{combined limit for blood glucose monitors, non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per service: 85% of charge}

Combined annual limit of $600 for physiotherapy, exercise physiology, dietetics, occupational therapy, speech therapy, mental health services, podiatry, massage and more ($100 per pair for orthotics up to 2 pairs per year). Group physiotherapy and hydrotherapy $15 per session. Pharmacy benefits paid at 85% of charge above the PBS co-payment to a maximum of $20 per prescription (sub-limit applies for weight loss medications).

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

Ante-natal/Post-natal classes

Audiology

Chinese medicine

Chiropractic

Endodontic

Hearing aids

Home nursing

Major dental

Orthodontic

Osteopathy

Other features of this general treatment cover: Affordable entry-level extras cover perfectly suited to young singles and couples. 100% back for one dental checkup per year (50% thereafter) at the provider of your choice. No sub-limits on optical benefits – use the full $300 limit on your choice of contact lenses or frames fitted with prescription lenses. Health management includes services such as acupuncture, weight loss classes and class physiotherapy for the treatment of a specific diagnosed condition.

For further information about this policy see: https://www.doctorshealthfund.com.au/our-health-cover

Smart Starter Bronze Plus $500 Excess & Starter Extras

Policy ID: AMA/J13/VAQS20

Hospital Cover

Extras Cover

Ambulance cover

Insurer Details

Doctors' Health Fund

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