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nib Health Funds Ltd.

Hospital Plus - Silver Plus $250 Excess

$841.79 / month

(Before Rebate, Discount & Loading)

Available in TAS

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: One adult & dependants (2 or more people, only one of whom is an adult).

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: 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/J32/TBAU1D

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
This policy does not include cover for
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 $250 per admission. This is limited to a maximum of $1000 per policy per year.

Excess payments do not apply to hospital admissions for dependants.

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.

For further information about this policy see: https://my.nib.com.au/product-collateral/14

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

$200 per person

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

  • Initial visit: 50% of charge
  • Subsequent visit: 50% of charge
Ante-natal/Post-natal classes* 2

$100 per person

  • Initial visit: 100% of charge
  • Subsequent visit: 100% of charge
Chinese medicine 2

$200 per person

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

  • Initial visit: 50% of charge
  • Subsequent visit: 50% of charge
Chiropractic 2

$350 per person

combined limit for chiropractic, exercise physiology, osteopathy, physiotherapy & other services

  • Initial visit: 50% of charge
  • Subsequent visit: 50% of charge
Endodontic 12

$600 per person

combined limit for endodontic & major dental

  • Filling of one root canal: 50% of charge
Exercise physiology 2

$350 per person

combined limit for chiropractic, exercise physiology, osteopathy, physiotherapy & other services

  • Initial visit: 50% of charge
  • Subsequent visit: 50% of charge
General dental 2

$500 per person

  • Fluoride treatment: 50% of charge
  • Scale & clean: 50% of charge
  • Periodic oral examination: 50% of charge
Health management / Healthy lifestyle 2

$150 per person

  • Health management: 50% of charge
Major dental 12

$600 per person

combined limit for endodontic & major dental

  • Surgical tooth extraction: 50% of charge
  • Full crown veneered: 50% of charge
Non PBS pharmaceuticals 2

$200 per person

  • Per eligible prescription: 50% of charge
Optical 6

$250 per person

  • Multi-focal lenses & frames: 50% of charge
  • Single vision lenses & frames: 50% of charge
Orthodontic 12

$200 per person

$1,000 lifetime limit

  • Braces for upper & lower teeth, including removal plus fitting of retainer: 50% of charge
Osteopathy 2

$350 per person

combined limit for chiropractic, exercise physiology, osteopathy, physiotherapy & other services

  • Initial visit: 50% of charge
  • Subsequent visit: 50% of charge
Physiotherapy 2

$350 per person

combined limit for chiropractic, exercise physiology, osteopathy, physiotherapy & other services

  • Initial visit: 50% of charge
  • Subsequent visit: 50% of charge
Remedial massage 2

$200 per person

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

  • Initial visit: 50% of charge
  • Subsequent visit: 50% of charge
Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

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

Examples of maximum benefits

{Initial visit: 50% of charge}

{Subsequent visit: 50% of charge}

Ante-natal/Post-natal classes*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$100 per person}

Examples of maximum benefits

{Initial visit: 100% of charge}

{Subsequent visit: 100% of charge}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

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

Examples of maximum benefits

{Initial visit: 50% of charge}

{Subsequent visit: 50% of charge}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

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

Examples of maximum benefits

{Initial visit: 50% of charge}

{Subsequent visit: 50% of charge}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Filling of one root canal: 50% of charge}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

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

Examples of maximum benefits

{Initial visit: 50% of charge}

{Subsequent visit: 50% of charge}

General dental

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

Examples of maximum benefits

{Fluoride treatment: 50% of charge}

{Scale & clean: 50% of charge}

{Periodic oral examination: 50% of charge}

Health management / Healthy lifestyle

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$150 per person}

Examples of maximum benefits

{Health management: 50% of charge}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Surgical tooth extraction: 50% of charge}

{Full crown veneered: 50% of charge}

Non PBS pharmaceuticals

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

{Per eligible prescription: 50% of charge}

Optical

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$250 per person}

Examples of maximum benefits

{Multi-focal lenses & frames: 50% of charge}

{Single vision lenses & frames: 50% of charge}

Orthodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

{$1,000 lifetime limit}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: 50% of charge}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

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

Examples of maximum benefits

{Initial visit: 50% of charge}

{Subsequent visit: 50% of charge}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person}

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

Examples of maximum benefits

{Initial visit: 50% of charge}

{Subsequent visit: 50% of charge}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

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

Examples of maximum benefits

{Initial visit: 50% of charge}

{Subsequent visit: 50% of charge}

Myotherapy: combined limit of $200 with acupuncture, remedial massage and Chinese herbalism. Healthier Lifestyle includes nib approved weight management, quit smoking and health management programs (gym, personal trainer), preventative health tests.

This policy does not include General treatment (Extras) cover for
Audiology
Blood glucose monitors
Dietetics/dietary advice
Eye therapy (orthoptics)
Hearing aids
Home nursing
Occupational therapy
Orthotics (podiatric orthoses)
Podiatry
Psychology
Speech therapy
Vaccinations

Other features of this general treatment cover: High level of private hospital cover plus a great range of Extras. 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/14

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/14

Insurer Details

nib Health Funds Ltd.

Hospital Plus - Silver Plus $250 Excess

$841.79 / month

(Before Rebate, Discount & Loading)

Available in TAS

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/J32/TBAU1D

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