Peoplecare Health Insurance

Premium Hospital $500 (Gold) & Comprehensive Extras

Name: Premium Hospital $500 (Gold) & Comprehensive Extras
Brand: Peoplecare Health Insurance
Price: 786.82 AUD

$786.82 / month

(Before Rebate, Discount & Loading)

Available in QLD

1800 808 690 Sponsor link

Go to site Sponsor link

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 & dependants (3 or more people, only 2 of whom are adults).

Children (0 - 17), non-classified* dependant (18 - 20) and students (21 - 30). Disabled dependant person: Participants in the National Disability Insurance Scheme(NDIS) are considered persons with a disability. Insurers may have a broader definition of persons with a disability. Check with the insurer for details. *Non-classified dependant: Non-Classified Dependant Person shall mean a person who is: (i) Aged between 18 and 20 (inclusive); and (ii) Who does not have a Partner

Policy ID: LHM/J12/QLYM2P

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 $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

No waiting period applies for hospital treatment resulting from an accident.

For further information about this policy see: https://www.peoplecare.com.au/siteassets/documents/cd/oms/premium-hospital-gold---250-500-excess--comprehensive-extras.pdf

Extras Cover

By using Peoplecare's 'preferred providers' you may have lower out of pocket costs on Dental and Optical treatments and have access to more 'no gap' treatments. A list of 'preferred providers' is available from Peoplecare. See https://peoplecare.com.au/Members/Providers/Other-health-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

$435 per person up to $870 per policy

combined limit for acupuncture, dietetics/dietary advice, podiatry & remedial massage

sub-limits apply

Initial visit: $35
Subsequent visit: $25

Ante-natal/Post-natal classes 2

$150 per person

Initial visit: 80% of charge
Subsequent visit: 80% of charge

Blood glucose monitors 2

$200 per person

sub-limits apply

Per monitor: $200

Chiropractic 2

$550 per person up to $1,100 per policy

combined limit for chiropractic & osteopathy

sub-limits apply

Initial visit: $45
Subsequent visit: $25

Dietetics/dietary advice 2

$435 per person up to $870 per policy

combined limit for acupuncture, dietetics/dietary advice, podiatry & remedial massage

sub-limits apply

Initial visit: $35
Subsequent visit: $25

Endodontic 2

No annual limit

Filling of one root canal: $110

Exercise physiology 2

$550 per person up to $1,100 per policy

combined limit for exercise physiology, eye therapy (orthoptics), occupational therapy, physiotherapy & other services

Initial visit: $40
Subsequent visit: $30

Eye therapy (orthoptics) 2

$550 per person up to $1,100 per policy

combined limit for exercise physiology, eye therapy (orthoptics), occupational therapy, physiotherapy & other services

Initial visit: $40
Subsequent visit: $30

General dental 2

No annual limit

sub-limits apply

Fluoride treatment: $26
Scale & clean: $60
Surgical tooth extraction: $120
Periodic oral examination: $31

Health management / Healthy lifestyle 6

$150 per person up to $300 per policy

Health management: 100% of charge

Hearing aids 24

$1,500 per person

Hearing aid: 80% of charge

Home nursing 2

$1,000 per person

Initial visit: $45
Subsequent visit: $45

Major dental 12

$2,650 per person

sub-limits apply

Full crown veneered: $750

Non PBS pharmaceuticals 2

$500 per person up to $1,000 per policy

combined limit for non pbs pharmaceuticals & vaccinations

sub-limits apply

Per eligible prescription: $65

Occupational therapy 2

$550 per person up to $1,100 per policy

combined limit for exercise physiology, eye therapy (orthoptics), occupational therapy, physiotherapy & other services

Initial visit: $60
Subsequent visit: $35

Optical 6

$300 per person

Multi-focal lenses & frames: $300
Single vision lenses & frames: $300

Orthodontic 12

$2,100 per person

$2,100 lifetime limit

Braces for upper & lower teeth, including removal plus fitting of retainer: $2100

Orthotics (podiatric orthoses) 2

$250 per person up to $500 per policy

sub-limits apply

Orthotics supply & fit: 80% of charge

Osteopathy 2

$550 per person up to $1,100 per policy

combined limit for chiropractic & osteopathy

Initial visit: $45
Subsequent visit: $25

Physiotherapy 2

$550 per person up to $1,100 per policy

combined limit for exercise physiology, eye therapy (orthoptics), occupational therapy, physiotherapy & other services

sub-limits apply

Initial visit: $50
Subsequent visit: $30

Podiatry 2

$435 per person up to $870 per policy

combined limit for acupuncture, dietetics/dietary advice, podiatry & remedial massage

sub-limits apply

Initial visit: $35
Subsequent visit: $25

Psychology 2

$500 per person up to $650 per policy

sub-limits apply

Initial visit: $120
Subsequent visit: $60

Remedial massage 2

$435 per person up to $870 per policy

combined limit for acupuncture, dietetics/dietary advice, podiatry & remedial massage

sub-limits apply

Initial visit: $35
Subsequent visit: $25

Speech therapy 2

$800 per person

Initial visit: 80% of charge
Subsequent visit: 80% of charge

Vaccinations 2

$500 per person up to $1,000 per policy

combined limit for non pbs pharmaceuticals & vaccinations

Per service: $65

Acupuncture

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$435 per person up to $870 per policy}

{combined limit for acupuncture, dietetics/dietary advice, podiatry & remedial massage}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $25}

Ante-natal/Post-natal classes

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$150 per person}

Examples of maximum benefits

{Initial visit: 80% of charge}

{Subsequent visit: 80% of charge}

Blood glucose monitors

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

{sub-limits apply}

Examples of maximum benefits

{Per monitor: $200}

Chiropractic

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$550 per person up to $1,100 per policy}

{combined limit for chiropractic & osteopathy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $25}

Dietetics/dietary advice

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$435 per person up to $870 per policy}

{combined limit for acupuncture, dietetics/dietary advice, podiatry & remedial massage}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $25}

Endodontic

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{No annual limit}

Examples of maximum benefits

{Filling of one root canal: $110}

Exercise physiology

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$550 per person up to $1,100 per policy}

{combined limit for exercise physiology, eye therapy (orthoptics), occupational therapy, physiotherapy & other services}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $30}

Eye therapy (orthoptics)

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$550 per person up to $1,100 per policy}

{combined limit for exercise physiology, eye therapy (orthoptics), occupational therapy, physiotherapy & other services}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $30}

General dental

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{No annual limit}

{sub-limits apply}

Examples of maximum benefits

{Fluoride treatment: $26}

{Scale & clean: $60}

{Surgical tooth extraction: $120}

{Periodic oral examination: $31}

Health management / Healthy lifestyle

Waiting period: 6 months

Benefit limits per 12 months unless otherwise stated

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

Examples of maximum benefits

{Health management: 100% of charge}

Hearing aids

Waiting period: 24 months

Benefit limits per 12 months unless otherwise stated

{$1,500 per person}

Examples of maximum benefits

{Hearing aid: 80% of charge}

Home nursing

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $45}

Major dental

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$2,650 per person}

{sub-limits apply}

Examples of maximum benefits

{Full crown veneered: $750}

Non PBS pharmaceuticals

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person up to $1,000 per policy}

{combined limit for non pbs pharmaceuticals & vaccinations}

{sub-limits apply}

Examples of maximum benefits

{Per eligible prescription: $65}

Occupational therapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$550 per person up to $1,100 per policy}

{combined limit for exercise physiology, eye therapy (orthoptics), occupational therapy, physiotherapy & other services}

Examples of maximum benefits

{Initial visit: $60}

{Subsequent visit: $35}

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

{$2,100 per person}

{$2,100 lifetime limit}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: $2100}

Orthotics (podiatric orthoses)

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$250 per person up to $500 per policy}

{sub-limits apply}

Examples of maximum benefits

{Orthotics supply & fit: 80% of charge}

Osteopathy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$550 per person up to $1,100 per policy}

{combined limit for chiropractic & osteopathy}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $25}

Physiotherapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$550 per person up to $1,100 per policy}

{combined limit for exercise physiology, eye therapy (orthoptics), occupational therapy, physiotherapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $30}

Podiatry

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$435 per person up to $870 per policy}

{combined limit for acupuncture, dietetics/dietary advice, podiatry & remedial massage}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $25}

Psychology

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person up to $650 per policy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $120}

{Subsequent visit: $60}

Remedial massage

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$435 per person up to $870 per policy}

{combined limit for acupuncture, dietetics/dietary advice, podiatry & remedial massage}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $25}

Speech therapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

Examples of maximum benefits

{Initial visit: 80% of charge}

{Subsequent visit: 80% of charge}

Vaccinations

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person up to $1,000 per policy}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per service: $65}

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

Audiology

Chinese medicine

For further information about this policy see: https://www.peoplecare.com.au/siteassets/documents/cd/oms/premium-hospital-gold---250-500-excess--comprehensive-extras.pdf

Ambulance cover

Ambulance cover is provided by the State government for Queensland residents (https://www.ambulance.qld.gov.au). This includes cover whilst interstate.

Other features of this ambulance cover: Queensland residents don’t need to worry about ambulance travel in their states, as it’s free. Queensland residents are also covered by their state when travelling around Australia.

For further information about this policy see: https://www.peoplecare.com.au/health-insurance/hospital-cover/ambulance

Insurer Details

Peoplecare Health Insurance

Premium Hospital $500 (Gold) & Comprehensive Extras

$786.82 / month

(Before Rebate, Discount & Loading)

Available in QLD

1800 808 690 Sponsor link

Go to site Sponsor link

Peoplecare Health Insurance

http://www.peoplecare.com.au

info@peoplecare.com.au

1800 808 690

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/LHM/J12/QLYM2P

Premium Hospital $500 (Gold) & Comprehensive Extras

Policy ID: LHM/J12/QLYM2P

Hospital Cover

Extras Cover

Ambulance cover

Insurer Details

Peoplecare Health Insurance

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