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Peoplecare Health Insurance

Premium Hospital $0 (Gold) & Standard Extras

$940.52 / month

(Before Rebate, Discount & Loading)

Available in SA

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, including non-student dependants (3 or more people, only 2 of whom are adults).

Children (0 - 17), non-classified* dependant (18 - 20), students (21 - 30) and non-students (21 to 30), 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 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/J8/SGPP2Y

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: No excess

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---no-excess--standard-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
Chiropractic 2

$350 per person up to $700 per policy

combined limit for chiropractic & osteopathy

sub-limits apply

  • Initial visit: $35
  • Subsequent visit: $25
Exercise physiology 2

$350 per person up to $700 per policy

combined limit for exercise physiology & physiotherapy

sub-limits apply

  • Initial visit: $35
  • Subsequent visit: $25
General dental 2

$500 per person

  • Fluoride treatment: 60% of charge
  • Scale & clean: 60% of charge
  • Surgical tooth extraction: 60% of charge
  • Periodic oral examination: 60% of charge
Health management / Healthy lifestyle 6

$100 per person up to $200 per policy

  • Health management: 100% of charge
Non PBS pharmaceuticals 2

$350 per person up to $700 per policy

combined limit for non pbs pharmaceuticals & vaccinations

sub-limits apply

  • Per eligible prescription: $50
Optical 6

$150 per person

  • Multi-focal lenses & frames: $150
  • Single vision lenses & frames: $150
Osteopathy 2

$350 per person up to $700 per policy

combined limit for chiropractic & osteopathy

sub-limits apply

  • Initial visit: $35
  • Subsequent visit: $25
Physiotherapy 2

$350 per person up to $700 per policy

combined limit for exercise physiology & physiotherapy

sub-limits apply

  • Initial visit: $35
  • Subsequent visit: $25
Remedial massage 2

$170 per person up to $340 per policy

  • Initial visit: 60% of charge
  • Subsequent visit: 60% of charge
Vaccinations 2

$350 per person up to $700 per policy

combined limit for non pbs pharmaceuticals & vaccinations

sub-limits apply

  • Per service: $50
Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person up to $700 per policy}

{combined limit for chiropractic & osteopathy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $25}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person up to $700 per policy}

{combined limit for exercise physiology & physiotherapy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $25}

General dental

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

Examples of maximum benefits

{Fluoride treatment: 60% of charge}

{Scale & clean: 60% of charge}

{Surgical tooth extraction: 60% of charge}

{Periodic oral examination: 60% of charge}

Health management / Healthy lifestyle

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$100 per person up to $200 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

{$350 per person up to $700 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

{$150 per person}

Examples of maximum benefits

{Multi-focal lenses & frames: $150}

{Single vision lenses & frames: $150}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person up to $700 per policy}

{combined limit for chiropractic & osteopathy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $25}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person up to $700 per policy}

{combined limit for exercise physiology & physiotherapy}

{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

{$170 per person up to $340 per policy}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Vaccinations

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person up to $700 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
Acupuncture
Ante-natal/Post-natal classes
Audiology
Blood glucose monitors
Chinese medicine
Dietetics/dietary advice
Endodontic
Eye therapy (orthoptics)
Hearing aids
Home nursing
Major dental
Occupational therapy
Orthodontic
Orthotics (podiatric orthoses)
Podiatry
Psychology
Speech therapy

For further information about this policy see: https://www.peoplecare.com.au/siteassets/documents/CD/oms/premium-hospital-gold---no-excess--standard-extras.pdf

Ambulance cover

In SA this policy provides:

Emergency: Unlimited with a waiting period of 1 day.

Non-emergency: Unlimited transport with a waiting period of 1 day.

Call-out fees: Will be paid for each attendance, including emergency treatment without transport to hospital.

Other features of this ambulance cover: Unlimited Ambulance covers you Australia wide for land, sea and air transport.

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

Insurer Details

Peoplecare Health Insurance

Premium Hospital $0 (Gold) & Standard Extras

$940.52 / month

(Before Rebate, Discount & Loading)

Available in SA

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/J8/SGPP2Y

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