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nib Health Funds Ltd.

Executive R - Gold $400 Excess

Corporate Policy

$500.05 / 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: Only one person.

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

Policy ID: NIB/J4/TNUL10

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 $400 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: http://my.nib.com.au/product-collateral/25

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

$700 per policy

combined limit for acupuncture, chiropractic, dietetics/dietary advice, osteopathy, remedial massage & other services

  • Initial visit: 100% of charge
  • Subsequent visit: 100% of charge
Ante-natal/Post-natal classes 2

$700 per policy

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

  • Initial visit: 100% of charge
  • Subsequent visit: 100% of charge
Blood glucose monitors 12

$600 per policy

combined limit for blood glucose monitors, hearing aids & other services

  • Per monitor: 100% of charge
Chiropractic 2

$700 per policy

combined limit for acupuncture, chiropractic, dietetics/dietary advice, osteopathy, remedial massage & other services

  • Initial visit: 100% of charge
  • Subsequent visit: 100% of charge
Dietetics/dietary advice 2

$700 per policy

combined limit for acupuncture, chiropractic, dietetics/dietary advice, osteopathy, remedial massage & other services

  • Initial visit: 100% of charge
  • Subsequent visit: 100% of charge
Endodontic 12

$1,500 per policy

combined limit for endodontic, general dental, major dental & orthodontic

  • Filling of one root canal: 80% of charge
Exercise physiology 2

$700 per policy

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

  • Initial visit: 100% of charge
  • Subsequent visit: 100% of charge
Eye therapy (orthoptics) 2

$700 per policy

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

  • Initial visit: 100% of charge
  • Subsequent visit: 100% of charge
General dental 2

$1,500 per policy

combined limit for endodontic, general dental, major dental & orthodontic

  • Fluoride treatment: 100% of charge
  • Scale & clean: 100% of charge
  • Surgical tooth extraction: 80% of charge
  • Periodic oral examination: 100% of charge
Hearing aids 36

$600 per policy

combined limit for blood glucose monitors, hearing aids & other services

  • Hearing aid: 100% of charge
Home nursing 2

$1,000 per policy

  • Initial visit: 100% of charge
  • Subsequent visit: 100% of charge
Major dental 12

$1,500 per policy

combined limit for endodontic, general dental, major dental & orthodontic

  • Full crown veneered: 65% of charge
Non PBS pharmaceuticals* 2

$500 per policy

  • Per eligible prescription: 100% of charge
Occupational therapy 2

$700 per policy

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

  • Initial visit: 100% of charge
  • Subsequent visit: 100% of charge
Optical 6

$200 per policy

  • Multi-focal lenses & frames: 100% of charge
  • Single vision lenses & frames: 100% of charge
Orthodontic 12

$1,500 per policy

combined limit for endodontic, general dental, major dental & orthodontic

  • Braces for upper & lower teeth, including removal plus fitting of retainer: 65% of charge
Orthotics (podiatric orthoses) 2

$200 per policy

  • Orthotics supply & fit: 100% of charge
Osteopathy 2

$700 per policy

combined limit for acupuncture, chiropractic, dietetics/dietary advice, osteopathy, remedial massage & other services

  • Initial visit: 100% of charge
  • Subsequent visit: 100% of charge
Physiotherapy 2

$700 per policy

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

  • Initial visit: 100% of charge
  • Subsequent visit: 100% of charge
Podiatry 2

$200 per policy

  • Initial visit: 100% of charge
  • Subsequent visit: 100% of charge
Remedial massage 2

$700 per policy

combined limit for acupuncture, chiropractic, dietetics/dietary advice, osteopathy, remedial massage & other services

  • Initial visit: 100% of charge
  • Subsequent visit: 100% of charge
Speech therapy 2

$700 per policy

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

  • Initial visit: 100% of charge
  • Subsequent visit: 100% of charge
Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per policy}

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

Examples of maximum benefits

{Initial visit: 100% of charge}

{Subsequent visit: 100% of charge}

Ante-natal/Post-natal classes

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per policy}

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

Examples of maximum benefits

{Initial visit: 100% of charge}

{Subsequent visit: 100% of charge}

Blood glucose monitors

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$600 per policy}

{combined limit for blood glucose monitors, hearing aids & other services}

Examples of maximum benefits

{Per monitor: 100% of charge}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per policy}

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

Examples of maximum benefits

{Initial visit: 100% of charge}

{Subsequent visit: 100% of charge}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per policy}

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

Examples of maximum benefits

{Initial visit: 100% of charge}

{Subsequent visit: 100% of charge}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,500 per policy}

{combined limit for endodontic, general dental, major dental & orthodontic}

Examples of maximum benefits

{Filling of one root canal: 80% of charge}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per policy}

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

Examples of maximum benefits

{Initial visit: 100% of charge}

{Subsequent visit: 100% of charge}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per policy}

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

Examples of maximum benefits

{Initial visit: 100% of charge}

{Subsequent visit: 100% of charge}

General dental

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,500 per policy}

{combined limit for endodontic, general dental, major dental & orthodontic}

Examples of maximum benefits

{Fluoride treatment: 100% of charge}

{Scale & clean: 100% of charge}

{Surgical tooth extraction: 80% of charge}

{Periodic oral examination: 100% of charge}

Hearing aids

Waiting period:  36 months

Benefit limits per 12 months unless otherwise stated

{$600 per policy}

{combined limit for blood glucose monitors, hearing aids & other services}

Examples of maximum benefits

{Hearing aid: 100% of charge}

Home nursing

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

Examples of maximum benefits

{Initial visit: 100% of charge}

{Subsequent visit: 100% of charge}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,500 per policy}

{combined limit for endodontic, general dental, major dental & orthodontic}

Examples of maximum benefits

{Full crown veneered: 65% 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: 100% of charge}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per policy}

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

Examples of maximum benefits

{Initial visit: 100% of charge}

{Subsequent visit: 100% of charge}

Optical

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

Examples of maximum benefits

{Multi-focal lenses & frames: 100% of charge}

{Single vision lenses & frames: 100% of charge}

Orthodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,500 per policy}

{combined limit for endodontic, general dental, major dental & orthodontic}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: 65% 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% of charge}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per policy}

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

Examples of maximum benefits

{Initial visit: 100% of charge}

{Subsequent visit: 100% of charge}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per policy}

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

Examples of maximum benefits

{Initial visit: 100% of charge}

{Subsequent visit: 100% of charge}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

Examples of maximum benefits

{Initial visit: 100% of charge}

{Subsequent visit: 100% of charge}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per policy}

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

Examples of maximum benefits

{Initial visit: 100% of charge}

{Subsequent visit: 100% of charge}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per policy}

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

Examples of maximum benefits

{Initial visit: 100% of charge}

{Subsequent visit: 100% of charge}

Combined Other Therapies ($700) includes antenatal services (No benefit for post-natal services), exercise physiology, eye therapy, occupational therapy, physiotherapy and speech pathology. Chiropractic / Osteopathy / Natural Therapies ($700) includes acupuncture, chiropractic, dietary advice, osteopathy and remedial massage. hearing aids / Artificial aids ($600) e.g. spacer, peak flow meter, nebuliser, Irlen lens. Orthopaedic shoes/boots ($130)

This policy does not include General treatment (Extras) cover for
Audiology
Chinese medicine
Health management / Healthy lifestyle
Psychology
Vaccinations

Other features of this general treatment cover: Of course you can see your choice of provider, but by choosing an nib First Choice provider, you may have less to pay towards the cost of your treatment. We’ve created the nib First Choice network to help you access quality healthcare when you need it most. These health providers will deliver quality care and value for money and a better deal for you and your family. We’ve locked in lower costs with nib First Choice 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: http://my.nib.com.au/product-collateral/25

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: http://my.nib.com.au/product-collateral/25

Insurer Details

nib Health Funds Ltd.

Executive R - Gold $400 Excess

Corporate Policy

$500.05 / 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/J4/TNUL10

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