nib Health Funds Ltd.

Public Hospital Plus Extras - Basic Plus $400 Excess

Name: Public Hospital Plus Extras - Basic Plus $400 Excess
Brand: nib Health Funds Ltd.
Price: 494.95 AUD

$494.95 / month

(Before Rebate, Discount & Loading)

Available in WA

13 14 63 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, an Age-based Discount 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: For nib Policies a person who is not a Policy Holder or Partner and who: is aged under 21 years is not married and does not have a defacto Partner; and includes a Foster Child, legally adopted child or stepchild.

Policy ID: NIB/J18/WDFR2Y

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 of $400 per admission. This is limited to a maximum of $400 per person and $800 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

nib does not have a preferred-provider-network-arrangement, but operates an nib-MediGap scheme aiming to eliminate the 'gap' payments for specialist fees in hospital. When a specialist chooses to participate in MediGap, they agree not to charge an out-of-pocket expense for your procedure. We do this by building a network of specialists who may agree to receive a higher benefit from nib than they would ordinarily receive. In exchange they do not charge nib customers an out-of-pocket expense. Ask your specialist if they'll MediGap for you! Our Going to Hospital Pack provides more ways to reduce out-of-pockets, ask us for your copy.

For further information about this policy see: https://my.nib.com.au/product-collateral/9

Extras Cover

By using our FirstChoice providers, you may have lower out-of-pocket costs on many allied health services. A list of "preferred providers" is available from the health insurer. See https://www.nib.com.au/find-a-provider.

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

$900 per person

combined limit for acupuncture, ante-natal/post-natal classes, chiropractic, exercise physiology, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy & speech therapy

sub-limits apply

Initial visit: $21
Subsequent visit: $11

Ante-natal/Post-natal classes 2

$900 per person

combined limit for acupuncture, ante-natal/post-natal classes, chiropractic, exercise physiology, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy & speech therapy

Initial visit: $11
Subsequent visit: $11

Blood glucose monitors 12

$600 per person

Per monitor: $180

Chinese medicine 2

$170 for single policies, $340 for family groups (combined limit with Chinese Herbalism and Myotherapy)

combined limit for chinese medicine & remedial massage

Initial visit: $19
Subsequent visit: $18

Chiropractic 2

$900 per person

combined limit for acupuncture, ante-natal/post-natal classes, chiropractic, exercise physiology, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy & speech therapy

sub-limits apply

Initial visit: $25
Subsequent visit: $22

Dietetics/dietary advice 2

$250 per policy

Initial visit: $27
Subsequent visit: $25

Endodontic 12

Non-specialty Endodontia: $400; Specialty Endodontia: $450, $1600 per Lifetime; Service Limits Apply

Filling of one root canal: $80

Exercise physiology 2

$900 per person

combined limit for acupuncture, ante-natal/post-natal classes, chiropractic, exercise physiology, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy & speech therapy

Initial visit: $28
Subsequent visit: $26

Eye therapy (orthoptics) 2

$900 per person

combined limit for acupuncture, ante-natal/post-natal classes, chiropractic, exercise physiology, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy & speech therapy

Initial visit: $28
Subsequent visit: $25

General dental 2

General Dental/Major Dental: Multiple Limits, Sub-Limits, Shared Limits and Service Limits Apply; See insurer for details

combined limit for general dental & major dental

Fluoride treatment: $19
Scale & clean: $35
Surgical tooth extraction: $65
Periodic oral examination: $21

Health management / Healthy lifestyle 6

$100 for single policies, $200 for family groups

Health management: 100% of charge

Hearing aids 36

$560 per person

Hearing aid: $560

Home nursing 2

$750 per policy

Initial visit: $72
Subsequent visit: $72

Major dental 12

General Dental/Major Dental: Multiple Limits, Sub-Limits, Shared Limits and Service Limits Apply; See insurer for details

combined limit for general dental & major dental

Full crown veneered: $415

Non PBS pharmaceuticals* 2

$600 per person

Per eligible prescription: $60

Occupational therapy 2

$900 per person

combined limit for acupuncture, ante-natal/post-natal classes, chiropractic, exercise physiology, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy & speech therapy

Initial visit: $29
Subsequent visit: $28

Optical 6

$200 per person

Multi-focal lenses & frames: $190
Single vision lenses & frames: $140

Orthodontic 12

Non-specialty Orthodontia: $350, $1050 per Lifetime; Specialty Orthodontia: $350, increasing by $100 per calendar year to $2400 per Lifetime

Braces for upper & lower teeth, including removal plus fitting of retainer: 100% of charge

Orthotics (podiatric orthoses) 2

$200 per policy

Orthotics supply & fit: $100

Osteopathy 2

$900 per person

combined limit for acupuncture, ante-natal/post-natal classes, chiropractic, exercise physiology, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy & speech therapy

Initial visit: $25
Subsequent visit: $23

Physiotherapy 2

$900 per person

combined limit for acupuncture, ante-natal/post-natal classes, chiropractic, exercise physiology, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy & speech therapy

Initial visit: $28
Subsequent visit: $26

Podiatry 2

$220 per person

Initial visit: $25
Subsequent visit: $21

Psychology 2

$300 per person

Initial visit: $45
Subsequent visit: $40

Remedial massage 2

$170 for single policies, $340 for family groups (combined limit with Chinese Herbalism and Myotherapy)

combined limit for chinese medicine & remedial massage

Initial visit: $19
Subsequent visit: $18

Speech therapy 2

$900 per person

combined limit for acupuncture, ante-natal/post-natal classes, chiropractic, exercise physiology, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy & speech therapy

Initial visit: $29
Subsequent visit: $27

Vaccinations 2

$100 per policy

Per service: $16

Acupuncture

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

{combined limit for acupuncture, ante-natal/post-natal classes, chiropractic, exercise physiology, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy & speech therapy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $21}

{Subsequent visit: $11}

Ante-natal/Post-natal classes

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

{combined limit for acupuncture, ante-natal/post-natal classes, chiropractic, exercise physiology, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy & speech therapy}

Examples of maximum benefits

{Initial visit: $11}

{Subsequent visit: $11}

Blood glucose monitors

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

Examples of maximum benefits

{Per monitor: $180}

Chinese medicine

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$170 for single policies, $340 for family groups (combined limit with Chinese Herbalism and Myotherapy)}

{combined limit for chinese medicine & remedial massage}

Examples of maximum benefits

{Initial visit: $19}

{Subsequent visit: $18}

Chiropractic

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

{combined limit for acupuncture, ante-natal/post-natal classes, chiropractic, exercise physiology, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy & speech therapy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $25}

{Subsequent visit: $22}

Dietetics/dietary advice

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$250 per policy}

Examples of maximum benefits

{Initial visit: $27}

{Subsequent visit: $25}

Endodontic

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{Non-specialty Endodontia: $400; Specialty Endodontia: $450, $1600 per Lifetime; Service Limits Apply}

Examples of maximum benefits

{Filling of one root canal: $80}

Exercise physiology

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

{combined limit for acupuncture, ante-natal/post-natal classes, chiropractic, exercise physiology, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy & speech therapy}

Examples of maximum benefits

{Initial visit: $28}

{Subsequent visit: $26}

Eye therapy (orthoptics)

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

{combined limit for acupuncture, ante-natal/post-natal classes, chiropractic, exercise physiology, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy & speech therapy}

Examples of maximum benefits

{Initial visit: $28}

{Subsequent visit: $25}

General dental

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{General Dental/Major Dental: Multiple Limits, Sub-Limits, Shared Limits and Service Limits Apply; See insurer for details}

{combined limit for general dental & major dental}

Examples of maximum benefits

{Fluoride treatment: $19}

{Scale & clean: $35}

{Surgical tooth extraction: $65}

{Periodic oral examination: $21}

Health management / Healthy lifestyle

Waiting period: 6 months

Benefit limits per 12 months unless otherwise stated

{$100 for single policies, $200 for family groups}

Examples of maximum benefits

{Health management: 100% of charge}

Hearing aids

Waiting period: 36 months

Benefit limits per 12 months unless otherwise stated

{$560 per person}

Examples of maximum benefits

{Hearing aid: $560}

Home nursing

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$750 per policy}

Examples of maximum benefits

{Initial visit: $72}

{Subsequent visit: $72}

Major dental

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{General Dental/Major Dental: Multiple Limits, Sub-Limits, Shared Limits and Service Limits Apply; See insurer for details}

{combined limit for general dental & major dental}

Examples of maximum benefits

{Full crown veneered: $415}

Non PBS pharmaceuticals*

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

Examples of maximum benefits

{Per eligible prescription: $60}

Occupational therapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

{combined limit for acupuncture, ante-natal/post-natal classes, chiropractic, exercise physiology, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy & speech therapy}

Examples of maximum benefits

{Initial visit: $29}

{Subsequent visit: $28}

Optical

Waiting period: 6 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

{Multi-focal lenses & frames: $190}

{Single vision lenses & frames: $140}

Orthodontic

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{Non-specialty Orthodontia: $350, $1050 per Lifetime; Specialty Orthodontia: $350, increasing by $100 per calendar year to $2400 per Lifetime}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: 100% of charge}

Orthotics (podiatric orthoses)

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

Examples of maximum benefits

{Orthotics supply & fit: $100}

Osteopathy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

{combined limit for acupuncture, ante-natal/post-natal classes, chiropractic, exercise physiology, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy & speech therapy}

Examples of maximum benefits

{Initial visit: $25}

{Subsequent visit: $23}

Physiotherapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

{combined limit for acupuncture, ante-natal/post-natal classes, chiropractic, exercise physiology, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy & speech therapy}

Examples of maximum benefits

{Initial visit: $28}

{Subsequent visit: $26}

Podiatry

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$220 per person}

Examples of maximum benefits

{Initial visit: $25}

{Subsequent visit: $21}

Psychology

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $40}

Remedial massage

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$170 for single policies, $340 for family groups (combined limit with Chinese Herbalism and Myotherapy)}

{combined limit for chinese medicine & remedial massage}

Examples of maximum benefits

{Initial visit: $19}

{Subsequent visit: $18}

Speech therapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

{combined limit for acupuncture, ante-natal/post-natal classes, chiropractic, exercise physiology, eye therapy (orthoptics), occupational therapy, osteopathy, physiotherapy & speech therapy}

Examples of maximum benefits

{Initial visit: $29}

{Subsequent visit: $27}

Vaccinations

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$100 per policy}

Examples of maximum benefits

{Per service: $16}

Combined Therapies ($900) includes acupuncture, antenatal services, chiropractic, exercise physiology, eye therapy, occupational therapy, osteopathy, physiotherapy and speech pathology. Artificial aids ($600) e.g. spacer, peak flow meter, nebuliser, Irlen lens. Myotherapy: combined limit of $170 with remedial massage and Chinese herbalism. Healthier Lifestyle includes nib approved weight management and quit smoking. Postnatal services are not covered. Psychology has a sublimit of $150 for Digital Cognitive Behavioural Therapy (CBT).

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

Audiology

Other features of this general treatment cover: nib also has policy benefits for a wide range of other services such as shiatsu and nutrition. Then receive up to a 4% discount for payment by direct debit from a cheque or savings account. Please note that limits may apply per policy for artificial aids such as blood glucose monitors.

For further information about this policy see: https://my.nib.com.au/product-collateral/9

Ambulance cover

In WA this policy provides:

Emergency: Unlimited 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: All our health covers include unlimited emergency ambulance (1 day waiting period on all emergency ambulance). Emergency ambulance is when you need immediate transport by a State or Territory ambulance to get to a hospital or other facility for urgent medical treatment. No annual limits for emergency ambulance apply.

For further information about this policy see: https://my.nib.com.au/product-collateral/9

Insurer Details

nib Health Funds Ltd.

Public Hospital Plus Extras - Basic Plus $400 Excess

$494.95 / month

(Before Rebate, Discount & Loading)

Available in WA

13 14 63 Sponsor link

Go to site Sponsor link

nib Health Funds Ltd.

https://www.nib.com.au

13 14 63

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/NIB/J18/WDFR2Y

Public Hospital Plus Extras - Basic Plus $400 Excess

Policy ID: NIB/J18/WDFR2Y

Hospital Cover

Extras Cover

Ambulance cover

Insurer Details

nib Health Funds Ltd.

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