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Peoplecare Health Insurance

Silver Plus Essentials Hospital $750 & High Extras

$602.52 / month

(Before Rebate, Discount & Loading)

Available in VIC

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

Children (0 - 17), non-classified* dependant (18 - 20) and students (21 - 30), as well as persons with a disability who qualify as a child, non-classified* dependant and 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/K28/VOJH2D

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
Back, neck and spine
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
Heart and vascular system
Hernia and appendix
Hospital psychiatric services
Implantation of hearing devices
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
Cataracts
Dialysis for chronic kidney failure
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 $750 per person and $1500 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

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/silver-plus-essentials-hospital---500-750-excess-high-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 person up to $700 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, remedial massage & other services

  • Initial visit: $45
  • Subsequent visit: $45
Ante-natal/Post-natal classes 2

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

combined limit for ante-natal/post-natal classes, blood glucose monitors, home nursing, orthotics (podiatric orthoses) & other services

  • Initial visit: 70% of charge
  • Subsequent visit: 70% of charge
Blood glucose monitors 2

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

combined limit for ante-natal/post-natal classes, blood glucose monitors, home nursing, orthotics (podiatric orthoses) & other services

  • Per monitor: 70% of charge
Chinese medicine 2

$350 per person up to $700 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, remedial massage & other services

  • Initial visit: $45
  • Subsequent visit: $45
Chiropractic 2

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

combined limit for chiropractic & osteopathy

  • Initial visit: $50
  • Subsequent visit: $50
Dietetics/dietary advice 2

$350 per person up to $700 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, remedial massage & other services

  • Initial visit: $45
  • Subsequent visit: $45
Endodontic 12

$1,000 per person

combined limit for endodontic & major dental

  • Filling of one root canal: 70% of charge
Exercise physiology 2

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

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

  • Initial visit: 70% of charge
  • Subsequent visit: 70% of charge
Eye therapy (orthoptics) 2

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

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

  • Initial visit: $51
  • Subsequent visit: $41
General dental 2

$1,000 per person

  • Fluoride treatment: 70% of charge
  • Scale & clean: 70% of charge
  • Surgical tooth extraction: 70% of charge
  • Periodic oral examination: 70% of charge
Health management / Healthy lifestyle 6

$200 per person up to $400 per policy

  • Health management: 70% of charge
Hearing aids 24

$1,000 per person

  • Hearing aid: 70% of charge
Home nursing 2

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

combined limit for ante-natal/post-natal classes, blood glucose monitors, home nursing, orthotics (podiatric orthoses) & other services

  • Initial visit: 70% of charge
  • Subsequent visit: 70% of charge
Major dental 12

$1,000 per person

combined limit for endodontic & major dental

  • Full crown veneered: 70% of charge
Non PBS pharmaceuticals 2

$400 per person up to $800 per policy

combined limit for non pbs pharmaceuticals & vaccinations

sub-limits apply

  • Per eligible prescription: $70
Occupational therapy 2

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

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

  • Initial visit: $51
  • Subsequent visit: $41
Optical 6

$250 per person

  • Multi-focal lenses & frames: $250
  • Single vision lenses & frames: $250
Orthodontic 12

$800 per person

$2,400 lifetime limit

  • Braces for upper & lower teeth, including removal plus fitting of retainer: 70% of charge
Orthotics (podiatric orthoses) 2

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

combined limit for ante-natal/post-natal classes, blood glucose monitors, home nursing, orthotics (podiatric orthoses) & other services

sub-limits apply

  • Orthotics supply & fit: $150
Osteopathy 2

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

combined limit for chiropractic & osteopathy

  • Initial visit: $50
  • Subsequent visit: $50
Physiotherapy 2

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

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

  • Initial visit: $51
  • Subsequent visit: $51
Podiatry 2

$400 per person up to $800 per policy

  • Initial visit: $45
  • Subsequent visit: $35
Psychology 2

$400 per person up to $800 per policy

  • Initial visit: $90
  • Subsequent visit: $70
Remedial massage 2

$350 per person up to $700 per policy

combined limit for acupuncture, chinese medicine, dietetics/dietary advice, remedial massage & other services

  • Initial visit: $45
  • Subsequent visit: $45
Speech therapy 2

$400 per person up to $800 per policy

  • Initial visit: 70% of charge
  • Subsequent visit: 70% of charge
Vaccinations 2

$400 per person up to $800 per policy

combined limit for non pbs pharmaceuticals & vaccinations

sub-limits apply

  • Per service: $70
Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

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

{combined limit for acupuncture, chinese medicine, dietetics/dietary advice, remedial massage & other services}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $45}

Ante-natal/Post-natal classes

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

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

{combined limit for ante-natal/post-natal classes, blood glucose monitors, home nursing, orthotics (podiatric orthoses) & other services}

Examples of maximum benefits

{Initial visit: 70% of charge}

{Subsequent visit: 70% of charge}

Blood glucose monitors

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

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

{combined limit for ante-natal/post-natal classes, blood glucose monitors, home nursing, orthotics (podiatric orthoses) & other services}

Examples of maximum benefits

{Per monitor: 70% of charge}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

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

{combined limit for acupuncture, chinese medicine, dietetics/dietary advice, remedial massage & other services}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $45}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

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

{combined limit for chiropractic & osteopathy}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $50}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

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

{combined limit for acupuncture, chinese medicine, dietetics/dietary advice, remedial massage & other services}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $45}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Filling of one root canal: 70% of charge}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

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

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

Examples of maximum benefits

{Initial visit: 70% of charge}

{Subsequent visit: 70% of charge}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

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

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

Examples of maximum benefits

{Initial visit: $51}

{Subsequent visit: $41}

General dental

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

Examples of maximum benefits

{Fluoride treatment: 70% of charge}

{Scale & clean: 70% of charge}

{Surgical tooth extraction: 70% of charge}

{Periodic oral examination: 70% of charge}

Health management / Healthy lifestyle

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$200 per person up to $400 per policy}

Examples of maximum benefits

{Health management: 70% of charge}

Hearing aids

Waiting period:  24 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

Examples of maximum benefits

{Hearing aid: 70% of charge}

Home nursing

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

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

{combined limit for ante-natal/post-natal classes, blood glucose monitors, home nursing, orthotics (podiatric orthoses) & other services}

Examples of maximum benefits

{Initial visit: 70% of charge}

{Subsequent visit: 70% of charge}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Full crown veneered: 70% of charge}

Non PBS pharmaceuticals

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

{combined limit for non pbs pharmaceuticals & vaccinations}

{sub-limits apply}

Examples of maximum benefits

{Per eligible prescription: $70}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

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

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

Examples of maximum benefits

{Initial visit: $51}

{Subsequent visit: $41}

Optical

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$250 per person}

Examples of maximum benefits

{Multi-focal lenses & frames: $250}

{Single vision lenses & frames: $250}

Orthodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

{$2,400 lifetime limit}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: 70% of charge}

Orthotics (podiatric orthoses)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

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

{combined limit for ante-natal/post-natal classes, blood glucose monitors, home nursing, orthotics (podiatric orthoses) & other services}

{sub-limits apply}

Examples of maximum benefits

{Orthotics supply & fit: $150}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

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

{combined limit for chiropractic & osteopathy}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $50}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

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

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

Examples of maximum benefits

{Initial visit: $51}

{Subsequent visit: $51}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $35}

Psychology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

Examples of maximum benefits

{Initial visit: $90}

{Subsequent visit: $70}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

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

{combined limit for acupuncture, chinese medicine, dietetics/dietary advice, remedial massage & other services}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $45}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

Examples of maximum benefits

{Initial visit: 70% of charge}

{Subsequent visit: 70% of charge}

Vaccinations

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

{combined limit for non pbs pharmaceuticals & vaccinations}

{sub-limits apply}

Examples of maximum benefits

{Per service: $70}

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

Other features of this general treatment cover: Orthotics limited to 1 appliance every 2 financial years.

For further information about this policy see: https://www.peoplecare.com.au/siteassets/documents/cd/oms/silver-plus-essentials-hospital---500-750-excess-high-extras.pdf

Ambulance cover

In VIC 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

Silver Plus Essentials Hospital $750 & High Extras

$602.52 / month

(Before Rebate, Discount & Loading)

Available in VIC

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/K28/VOJH2D

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