Peoplecare Health Insurance

Premium Hospital $250 (Gold) & Flex Up Extras

Name: Premium Hospital $250 (Gold) & Flex Up Extras
Brand: Peoplecare Health Insurance
Price: 406 AUD

$406.00 / 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: Only one person.

Policy ID: LHM/J88/QOZQ10

Source: Private Health Information Statement (PHIS)

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 $250 per person and $250 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-flex-up-extras.pdf

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

$1,000 per policy

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage

sub-limits apply

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Chinese medicine 2

$1,000 per policy

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage

sub-limits apply

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Chiropractic 2

$1,000 per policy

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Dietetics/dietary advice 2

$1,000 per policy

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage

sub-limits apply

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Endodontic 12

$1,000 per policy

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage

Filling of one root canal: 60% of charge

Exercise physiology 2

$1,000 per policy

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage

Initial visit: 60% of charge
Subsequent visit: 60% of charge

General dental 2

$1,000 per policy

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage

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

$1,000 per policy

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage

sub-limits apply

Health management: 60% of charge

Major dental 12

$1,000 per policy

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage

Full crown veneered: 60% of charge

Occupational therapy 2

$1,000 per policy

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Optical 6

$200 per policy

Multi-focal lenses & frames: $200
Single vision lenses & frames: $200

Osteopathy 2

$1,000 per policy

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Physiotherapy 2

$1,000 per policy

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Psychology 2

$1,000 per policy

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Remedial massage 2

$1,000 per policy

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage

sub-limits apply

Initial visit: 60% of charge
Subsequent visit: 60% of charge

Acupuncture

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage}

{sub-limits apply}

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

{$1,000 per policy}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Chiropractic

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Dietetics/dietary advice

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Endodontic

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage}

Examples of maximum benefits

{Filling of one root canal: 60% of charge}

Exercise physiology

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

General dental

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage}

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

{$1,000 per policy}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage}

{sub-limits apply}

Examples of maximum benefits

{Health management: 60% of charge}

Major dental

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage}

Examples of maximum benefits

{Full crown veneered: 60% of charge}

Occupational therapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Optical

Waiting period: 6 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

Examples of maximum benefits

{Multi-focal lenses & frames: $200}

{Single vision lenses & frames: $200}

Osteopathy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Physiotherapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Psychology

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

Remedial massage

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, endodontic, exercise physiology, general dental, health management / healthy lifestyle, major dental, occupational therapy, osteopathy, physiotherapy, psychology & remedial massage}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: 60% of charge}

{Subsequent visit: 60% of charge}

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

Ante-natal/Post-natal classes

Audiology

Blood glucose monitors

Eye therapy (orthoptics)

Hearing aids

Home nursing

Non PBS pharmaceuticals

Orthodontic

Orthotics (podiatric orthoses)

Podiatry

Speech therapy

Vaccinations

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

Premium Hospital $250 (Gold) & Flex Up Extras

Policy ID: LHM/J88/QOZQ10

Hospital Cover

Extras Cover

Ambulance cover

Insurer Details

Peoplecare Health Insurance

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