Peoplecare Health Insurance

Premium Hospital $150 (Gold) & Value Extras

Name: Premium Hospital $150 (Gold) & Value Extras
Brand: Peoplecare Health Insurance
Price: 364.71 AUD

$364.71 / month

(Before Rebate, Discount & Loading)

Available in TAS

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: Only one person.

Policy ID: LHM/J20/THNO10

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 $150 per person and $150 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---150-excess--value-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

$350 per policy

combined limit for acupuncture, podiatry & remedial massage

sub-limits apply

Initial visit: $35
Subsequent visit: $25

Chiropractic 2

$450 per policy

combined limit for chiropractic & osteopathy

sub-limits apply

Initial visit: $45
Subsequent visit: $25

Endodontic 2

$550 per policy

combined limit for endodontic & general dental

Filling of one root canal: 75% of charge

Exercise physiology 2

$450 per policy

combined limit for exercise physiology, physiotherapy & other services

sub-limits apply

Initial visit: $40
Subsequent visit: $30

General dental 2

$550 per policy

combined limit for endodontic & general dental

Fluoride treatment: 75% of charge
Scale & clean: 75% of charge
Surgical tooth extraction: 75% of charge
Periodic oral examination: 75% of charge

Health management / Healthy lifestyle 6

$125 per policy

Health management: 100% of charge

Non PBS pharmaceuticals 2

$500 per policy

combined limit for non pbs pharmaceuticals & vaccinations

sub-limits apply

Per eligible prescription: $50

Optical 6

$180 per policy

Multi-focal lenses & frames: $180
Single vision lenses & frames: $180

Osteopathy 2

$450 per policy

combined limit for chiropractic & osteopathy

sub-limits apply

Initial visit: $45
Subsequent visit: $25

Physiotherapy 2

$450 per policy

combined limit for exercise physiology, physiotherapy & other services

sub-limits apply

Initial visit: $50
Subsequent visit: $30

Podiatry 2

$350 per policy

combined limit for acupuncture, podiatry & remedial massage

sub-limits apply

Initial visit: $35
Subsequent visit: $25

Remedial massage 2

$350 per policy

combined limit for acupuncture, podiatry & remedial massage

sub-limits apply

Initial visit: $35
Subsequent visit: $25

Vaccinations 2

$500 per policy

combined limit for non pbs pharmaceuticals & vaccinations

sub-limits apply

Per service: $50

Acupuncture

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$350 per policy}

{combined limit for acupuncture, podiatry & remedial massage}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $25}

Chiropractic

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$450 per policy}

{combined limit for chiropractic & osteopathy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $25}

Endodontic

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$550 per policy}

{combined limit for endodontic & general dental}

Examples of maximum benefits

{Filling of one root canal: 75% of charge}

Exercise physiology

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$450 per policy}

{combined limit for exercise physiology, physiotherapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $30}

General dental

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$550 per policy}

{combined limit for endodontic & general dental}

Examples of maximum benefits

{Fluoride treatment: 75% of charge}

{Scale & clean: 75% of charge}

{Surgical tooth extraction: 75% of charge}

{Periodic oral examination: 75% of charge}

Health management / Healthy lifestyle

Waiting period: 6 months

Benefit limits per 12 months unless otherwise stated

{$125 per policy}

Examples of maximum benefits

{Health management: 100% of charge}

Non PBS pharmaceuticals

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for non pbs pharmaceuticals & vaccinations}

{sub-limits apply}

Examples of maximum benefits

{Per eligible prescription: $50}

Optical

Waiting period: 6 months

Benefit limits per 12 months unless otherwise stated

{$180 per policy}

Examples of maximum benefits

{Multi-focal lenses & frames: $180}

{Single vision lenses & frames: $180}

Osteopathy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$450 per policy}

{combined limit for chiropractic & osteopathy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $25}

Physiotherapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$450 per policy}

{combined limit for exercise physiology, 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

{$350 per policy}

{combined limit for acupuncture, podiatry & remedial massage}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $25}

Remedial massage

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$350 per policy}

{combined limit for acupuncture, podiatry & remedial massage}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $25}

Vaccinations

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for non pbs pharmaceuticals & vaccinations}

{sub-limits apply}

Examples of maximum benefits

{Per service: $50}

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

Ante-natal/Post-natal classes

Audiology

Blood glucose monitors

Chinese medicine

Dietetics/dietary advice

Eye therapy (orthoptics)

Hearing aids

Home nursing

Major dental

Occupational therapy

Orthodontic

Orthotics (podiatric orthoses)

Psychology

Speech therapy

For further information about this policy see: https://www.peoplecare.com.au/siteassets/documents/CD/oms/premium-hospital-gold---150-excess--value-extras.pdf

Ambulance cover

Ambulance cover is provided by the State government for residents of Tasmania. This may include cover whilst interstate, except for South Australia and Queensland where no cover applies. In other states please check with Ambulance Tasmania - https://www.health.tas.gov.au/ambulance/fees_and_accounts.

Other features of this ambulance cover: Tasmanian residents don’t need to worry about ambulance travel in their state, as it’s free.  This cover will include Ambulance transport whilst on the mainland for land, sea & air.

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

Insurer Details

Peoplecare Health Insurance

Premium Hospital $150 (Gold) & Value Extras

$364.71 / month

(Before Rebate, Discount & Loading)

Available in TAS

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/J20/THNO10

Premium Hospital $150 (Gold) & Value Extras

Policy ID: LHM/J20/THNO10

Hospital Cover

Extras Cover

Ambulance cover

Insurer Details

Peoplecare Health Insurance

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