nib Health Funds Ltd.

Young at Heart Top - Silver Plus $500 Excess

Name: Young at Heart Top - Silver Plus $500 Excess
Brand: nib Health Funds Ltd.
Price: 1067.42 AUD

$1067.42 / month

(Before Rebate, Discount & Loading)

Available in TAS

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/J27/TPFK2Y

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

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)

Rehabilitation

Skin

Sleep studies

Tonsils, adenoids and grommets

Weight loss surgery

This policy does not include cover for

Assisted reproductive services

Pregnancy and birth

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 $1000 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.

For further information about this policy see: https://my.nib.com.au/product-collateral/12

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

$250 per person

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

Initial visit: 75% of charge
Subsequent visit: 75% of charge

Blood glucose monitors 12

$1,000 per person

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

Per monitor: 75% of charge

Chinese medicine 2

$250 per person

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

Initial visit: 75% of charge
Subsequent visit: 75% of charge

Chiropractic 2

$500 per person

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

Initial visit: 75% of charge
Subsequent visit: 75% of charge

Dietetics/dietary advice 2

$400 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry & speech therapy

Initial visit: 75% of charge
Subsequent visit: 75% of charge

Endodontic 12

$1,200 per person

combined limit for endodontic & major dental

Filling of one root canal: 75% of charge

Exercise physiology 2

$500 per person

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

Initial visit: 75% of charge
Subsequent visit: 75% of charge

Eye therapy (orthoptics) 2

$400 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry & speech therapy

Initial visit: 75% of charge
Subsequent visit: 75% of charge

General dental 2

$700 per person

Fluoride treatment: 75% of charge
Scale & clean: 75% of charge
Periodic oral examination: 75% of charge

Health management / Healthy lifestyle 6

$150 per person

Health management: 75% of charge

Hearing aids 36

$1,000 per person

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

Hearing aid: 75% of charge

Home nursing 2

$400 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry & speech therapy

Initial visit: 75% of charge
Subsequent visit: 75% of charge

Major dental 12

$1,200 per person

combined limit for endodontic & major dental

Surgical tooth extraction: 75% of charge
Full crown veneered: 75% of charge

Non PBS pharmaceuticals* 2

$600 per person

Per eligible prescription: 75% of charge

Occupational therapy 2

$400 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry & speech therapy

Initial visit: 75% of charge
Subsequent visit: 75% of charge

Optical 6

$350 per person

Multi-focal lenses & frames: 75% of charge
Single vision lenses & frames: 75% of charge

Orthotics (podiatric orthoses) 2

$1,000 per person

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

Orthotics supply & fit: 75% of charge

Osteopathy 2

$500 per person

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

Initial visit: 75% of charge
Subsequent visit: 75% of charge

Physiotherapy 2

$500 per person

combined limit for chiropractic, exercise physiology, osteopathy & physiotherapy

Initial visit: 75% of charge
Subsequent visit: 75% of charge

Podiatry 2

$400 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry & speech therapy

Initial visit: 75% of charge
Subsequent visit: 75% of charge

Remedial massage 2

$250 per person

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

sub-limits apply

Initial visit: 75% of charge
Subsequent visit: 75% of charge

Speech therapy 2

$400 per person

combined limit for dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry & speech therapy

Initial visit: 75% of charge
Subsequent visit: 75% of charge

Acupuncture

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$250 per person}

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

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Blood glucose monitors

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

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

Examples of maximum benefits

{Per monitor: 75% of charge}

Chinese medicine

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$250 per person}

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

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Chiropractic

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

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

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Dietetics/dietary advice

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry & speech therapy}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Endodontic

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$1,200 per person}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Filling of one root canal: 75% of charge}

Exercise physiology

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

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

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Eye therapy (orthoptics)

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry & speech therapy}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

General dental

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$700 per person}

Examples of maximum benefits

{Fluoride treatment: 75% of charge}

{Scale & clean: 75% of charge}

{Periodic oral examination: 75% of charge}

Health management / Healthy lifestyle

Waiting period: 6 months

Benefit limits per 12 months unless otherwise stated

{$150 per person}

Examples of maximum benefits

{Health management: 75% of charge}

Hearing aids

Waiting period: 36 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

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

Examples of maximum benefits

{Hearing aid: 75% of charge}

Home nursing

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry & speech therapy}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Major dental

Waiting period: 12 months

Benefit limits per 12 months unless otherwise stated

{$1,200 per person}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Surgical tooth extraction: 75% of charge}

{Full crown veneered: 75% of charge}

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: 75% of charge}

Occupational therapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry & speech therapy}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Optical

Waiting period: 6 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

Examples of maximum benefits

{Multi-focal lenses & frames: 75% of charge}

{Single vision lenses & frames: 75% of charge}

Orthotics (podiatric orthoses)

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

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

Examples of maximum benefits

{Orthotics supply & fit: 75% of charge}

Osteopathy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

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

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Physiotherapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

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

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Podiatry

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry & speech therapy}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Remedial massage

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$250 per person}

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

{sub-limits apply}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Speech therapy

Waiting period: 2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy, podiatry & speech therapy}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Other Therapies ($400) includes dietary advice, eye therapy, home nursing, occupational therapy, podiatry and speech pathology. Hearing aids / Artificial aids / Orthotics ($1,000) includes e.g. spacer, peak flow meter, nebuliser, blood glucose monitor, Irlen lens (service limits apply). 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) and more (service limits apply).

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

Ante-natal/Post-natal classes

Audiology

Orthodontic

Psychology

Vaccinations

Other features of this general treatment cover: For customers looking for a high level of cover, tailored for them when they reached a certain time in their life. 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/12

Ambulance cover

Ambulance cover is provided by the State government for residents of Tasmania. This may include cover whilst interstate, except for South Australia and Queensland where no cover applies. In other states please check with Ambulance Tasmania - https://www.health.tas.gov.au/ambulance/fees_and_accounts.

Other features of this ambulance cover: Emergency ambulance costs are covered by the state government for residents of Tasmania.

For further information about this policy see: https://my.nib.com.au/product-collateral/12

Insurer Details

nib Health Funds Ltd.

Young at Heart Top - Silver Plus $500 Excess

$1067.42 / month

(Before Rebate, Discount & Loading)

Available in TAS

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/J27/TPFK2Y

Young at Heart Top - Silver Plus $500 Excess

Policy ID: NIB/J27/TPFK2Y

Hospital Cover

Extras Cover

Ambulance cover

Insurer Details

nib Health Funds Ltd.

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