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nib Health Funds Ltd.

Premier - Gold $500 Excess

Corporate Policy

$597.37 / 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: Only one person.

Corporate policy: This cover is available to select nib corporate groups.

Policy ID: NIB/J26A/V0500S

Source: Private Health Information Statement (PHIS)

Hospital Cover

  • This policy exempts you from the Medicare Levy Surcharge.
  • This policy provides accident cover - check with insurer for details.
  • 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 $500 per admission. This is limited to a maximum of $500 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

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/15

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

$300 per policy

combined limit for acupuncture, chinese medicine, remedial massage & other services

  • Initial visit: 85% of charge
  • Subsequent visit: 85% of charge
Ante-natal/Post-natal classes 2

$450 per policy

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, speech therapy & other services

  • Initial visit: 85% of charge
  • Subsequent visit: 85% of charge
Blood glucose monitors 12

$800 per policy

combined limit for blood glucose monitors, hearing aids, orthotics (podiatric orthoses) & other services

  • Per monitor: 85% of charge
Chinese medicine 2

$300 per policy

combined limit for acupuncture, chinese medicine, remedial massage & other services

  • Initial visit: 85% of charge
  • Subsequent visit: 85% of charge
Chiropractic 2

$650 per policy

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

  • Initial visit: 85% of charge
  • Subsequent visit: 85% of charge
Dietetics/dietary advice 2

$450 per policy

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, speech therapy & other services

  • Initial visit: 85% of charge
  • Subsequent visit: 85% of charge
Endodontic 12

$1,300 per policy

combined limit for endodontic & major dental

  • Filling of one root canal: 85% of charge
Exercise physiology 2

$650 per policy

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

  • Initial visit: 85% of charge
  • Subsequent visit: 85% of charge
Eye therapy (orthoptics) 2

$450 per policy

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, speech therapy & other services

  • Initial visit: 85% of charge
  • Subsequent visit: 85% of charge
General dental 2

$700 per policy

  • Fluoride treatment: 85% of charge
  • Scale & clean: 85% of charge
  • Periodic oral examination: 85% of charge
Health management / Healthy lifestyle 6

$250 per policy

  • Health management: 85% of charge
Hearing aids 36

$800 per policy

combined limit for blood glucose monitors, hearing aids, orthotics (podiatric orthoses) & other services

sub-limits apply

  • Hearing aid: 85% of charge
Home nursing 2

$450 per policy

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, speech therapy & other services

  • Initial visit: 85% of charge
  • Subsequent visit: 85% of charge
Major dental 12

$1,300 per policy

combined limit for endodontic & major dental

  • Surgical tooth extraction: 85% of charge
  • Full crown veneered: 85% of charge
Non PBS pharmaceuticals* 2

$500 per policy

  • Per eligible prescription: 85% of charge
Occupational therapy 2

$450 per policy

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, speech therapy & other services

  • Initial visit: 85% of charge
  • Subsequent visit: 85% of charge
Optical 6

$400 per policy

  • Multi-focal lenses & frames: 85% of charge
  • Single vision lenses & frames: 85% of charge
Orthodontic 12

$500 per policy

$2,800 lifetime limit

  • Braces for upper & lower teeth, including removal plus fitting of retainer: 85% of charge
Orthotics (podiatric orthoses) 2

$800 per policy

combined limit for blood glucose monitors, hearing aids, orthotics (podiatric orthoses) & other services

  • Orthotics supply & fit: 85% of charge
Osteopathy 2

$650 per policy

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

  • Initial visit: 85% of charge
  • Subsequent visit: 85% of charge
Physiotherapy 2

$650 per policy

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

  • Initial visit: 85% of charge
  • Subsequent visit: 85% of charge
Podiatry 2

$450 per policy

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, speech therapy & other services

  • Initial visit: 85% of charge
  • Subsequent visit: 85% of charge
Psychology 2

$300 per policy

  • Initial visit: 85% of charge
  • Subsequent visit: 85% of charge
Remedial massage 2

$300 per policy

combined limit for acupuncture, chinese medicine, remedial massage & other services

  • Initial visit: 85% of charge
  • Subsequent visit: 85% of charge
Speech therapy 2

$450 per policy

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, speech therapy & other services

  • Initial visit: 85% of charge
  • Subsequent visit: 85% of charge
Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per policy}

{combined limit for acupuncture, chinese medicine, remedial massage & other services}

Examples of maximum benefits

{Initial visit: 85% of charge}

{Subsequent visit: 85% of charge}

Ante-natal/Post-natal classes

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per policy}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, speech therapy & other services}

Examples of maximum benefits

{Initial visit: 85% of charge}

{Subsequent visit: 85% of charge}

Blood glucose monitors

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$800 per policy}

{combined limit for blood glucose monitors, hearing aids, orthotics (podiatric orthoses) & other services}

Examples of maximum benefits

{Per monitor: 85% of charge}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per policy}

{combined limit for acupuncture, chinese medicine, remedial massage & other services}

Examples of maximum benefits

{Initial visit: 85% of charge}

{Subsequent visit: 85% of charge}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$650 per policy}

{combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy}

Examples of maximum benefits

{Initial visit: 85% of charge}

{Subsequent visit: 85% of charge}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per policy}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, speech therapy & other services}

Examples of maximum benefits

{Initial visit: 85% of charge}

{Subsequent visit: 85% of charge}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,300 per policy}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Filling of one root canal: 85% of charge}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$650 per policy}

{combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy}

Examples of maximum benefits

{Initial visit: 85% of charge}

{Subsequent visit: 85% of charge}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per policy}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, speech therapy & other services}

Examples of maximum benefits

{Initial visit: 85% of charge}

{Subsequent visit: 85% of charge}

General dental

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per policy}

Examples of maximum benefits

{Fluoride treatment: 85% of charge}

{Scale & clean: 85% of charge}

{Periodic oral examination: 85% of charge}

Health management / Healthy lifestyle

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$250 per policy}

Examples of maximum benefits

{Health management: 85% of charge}

Hearing aids

Waiting period:  36 months

Benefit limits per 12 months unless otherwise stated

{$800 per policy}

{combined limit for blood glucose monitors, hearing aids, orthotics (podiatric orthoses) & other services}

{sub-limits apply}

Examples of maximum benefits

{Hearing aid: 85% of charge}

Home nursing

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per policy}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, speech therapy & other services}

Examples of maximum benefits

{Initial visit: 85% of charge}

{Subsequent visit: 85% of charge}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,300 per policy}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Surgical tooth extraction: 85% of charge}

{Full crown veneered: 85% of charge}

Non PBS pharmaceuticals*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

Examples of maximum benefits

{Per eligible prescription: 85% of charge}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per policy}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, speech therapy & other services}

Examples of maximum benefits

{Initial visit: 85% of charge}

{Subsequent visit: 85% of charge}

Optical

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

Examples of maximum benefits

{Multi-focal lenses & frames: 85% of charge}

{Single vision lenses & frames: 85% of charge}

Orthodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{$2,800 lifetime limit}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: 85% of charge}

Orthotics (podiatric orthoses)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$800 per policy}

{combined limit for blood glucose monitors, hearing aids, orthotics (podiatric orthoses) & other services}

Examples of maximum benefits

{Orthotics supply & fit: 85% of charge}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$650 per policy}

{combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy}

Examples of maximum benefits

{Initial visit: 85% of charge}

{Subsequent visit: 85% of charge}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$650 per policy}

{combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy}

Examples of maximum benefits

{Initial visit: 85% of charge}

{Subsequent visit: 85% of charge}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per policy}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, speech therapy & other services}

Examples of maximum benefits

{Initial visit: 85% of charge}

{Subsequent visit: 85% of charge}

Psychology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per policy}

Examples of maximum benefits

{Initial visit: 85% of charge}

{Subsequent visit: 85% of charge}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per policy}

{combined limit for acupuncture, chinese medicine, remedial massage & other services}

Examples of maximum benefits

{Initial visit: 85% of charge}

{Subsequent visit: 85% of charge}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$450 per policy}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry, speech therapy & other services}

Examples of maximum benefits

{Initial visit: 85% of charge}

{Subsequent visit: 85% of charge}

Other Therapies ($450) includes antenatal services, dietary advice, eye therapy, home nursing, occupational therapy, podiatry and speech pathology. Hearing aids / Artificial aids / Orthotics ($800) e.g. spacer, peak flow meter, nebuliser, Irlen lens. Myotherapy: combined limit of $250 with acupuncture, remedial massage and chinese herbalism. Healthier Lifestyle includes nib approved weight management, quit smoking and health management programs (gym, personal trainer). Psychology has a sublimit of $150 for Digital Cognitive Behavioural Therapy (CBT). ---------------------------------------------------------------------------------------------------------------------------------------------------------------- Save on the everyday and more: get access to a range of exciting rewards and discounts on things like groceries, petrol, entertainment, health, wellbeing and more! nib Rewards is our way of helping you live a fun, healthy and rewarding life.

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

Other features of this general treatment cover: nib's highest level hospital cover with Extras paid back as 85% of the cost. Of course, you can see your choice of provider, but by choosing a FirstChoice provider, you may have less to pay towards the cost of your treatment. We’ve created the FirstChoice network to help you access quality healthcare and a better deal for you and your family. We’ve locked in lower costs with our FirstChoice providers, so you can enjoy competitive treatment fees when you visit the dentist or a discount the next time you claim for glasses.

For further information about this policy see: https://my.nib.com.au/product-collateral/15

Ambulance cover

In VIC 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/15

Insurer Details

nib Health Funds Ltd.

Premier - Gold $500 Excess

Corporate Policy

$597.37 / month

(Before Rebate, Discount & Loading)

Available in VIC

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/J26A/V0500S

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