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Police Health

Gold Combined

Restricted Insurer

$1054.22 / month

(Before Rebate, Discount & Loading)

Available in NSW & ACT

You may be entitled to an Australian Government Rebate on the above premium. Your premium may also include a Lifetime Health Cover Loading 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 - 31) and non-students (21 to 24). Disabled dependant person: Participants in the National Disability Insurance Scheme(NDIS) are considered persons with a disability. Insurers may have a broader definition of persons with a disability. Check with the insurer for details. *Non-classified dependant: Police Health covers children on a family or single parent family policy up to, but not including, their 21st birthday, provided the children are not married or in a de-facto relationship.

Restricted insurer: Membership of this insurer is restricted to Members of Australia’s police community, and their families.

Policy ID: SPE/J1/NAIB2P

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 provides benefits for travel or accommodation outside of hospital - check with insurer for details.
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: No excess

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

This policy supports greater choice in hospital and service provider – covering a large number of contracted hospitals, and also meeting reasonable fees charged by non-contracted hospitals. Benefits for a number of treatments that fall outside the mandated clinical categories are included, such as; Travel and Accommodation, Hospital at Home, Home Nursing, Aids & Appliances (such as CPAP Machines), Nourish baby, lactation consultants and antenatal education. Eligible members can also gain access to chronic disease management programs including; Type 2 Diabetes, Cancer Support, Osteoarthritis and Coronary Heart Disease.

For further information about this policy see: https://policehealth.com.au/gold-combined

Extras Cover

Benefits are payable at any provider (as long as they are registered and recognised by us) giving members ultimate freedom of choice.

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 person (Rollover benefit applies) (combined limit chiropractic, acupuncture, remedial massage, chinese medicine, osteopathy & other services)

combined limit for acupuncture, chinese medicine, chiropractic, osteopathy & remedial massage

  • Initial visit: $87.4
  • Subsequent visit: $74.5
Blood glucose monitors 12

$250 per person

  • Per monitor: 80% of charge
Chinese medicine* 2

$700 per person (Rollover benefit applies) (combined limit chiropractic, acupuncture, remedial massage, chinese medicine, osteopathy & other services)

combined limit for acupuncture, chinese medicine, chiropractic, osteopathy & remedial massage

  • Initial visit: $30
  • Subsequent visit: $30
Chiropractic* 2

$700 per person (Rollover benefit applies) (combined limit chiropractic, acupuncture, remedial massage, chinese medicine, osteopathy & other services)

combined limit for acupuncture, chinese medicine, chiropractic, osteopathy & remedial massage

  • Initial visit: $88.7
  • Subsequent visit: $57
Dietetics/dietary advice* 2

$600 per person (Rollover benefit applies)

  • Initial visit: $171.2
  • Subsequent visit: $92.8
Endodontic* 2

No annual limit

  • Filling of one root canal: $248.4
Exercise physiology* 2

$850 per person (Rollover benefit applies) (combined limit physiotherapy & exercise physiology)

combined limit for exercise physiology & physiotherapy

  • Initial visit: $89.2
  • Subsequent visit: $67.1
Eye therapy (orthoptics)* 2

$600 per person (Rollover benefit applies)

  • Initial visit: $55.2
  • Subsequent visit: $46
General dental 2

No annual limit (Some service limits apply)

  • Fluoride treatment: $34.5
  • Scale & clean: $113.1
  • Surgical tooth extraction: $266.8
  • Periodic oral examination: $56.6
Hearing aids 12

$1,200 per person

  • Hearing aid: 80% of charge
Home nursing 2

20 days per episode, 65 days per year

  • Initial visit: $75
  • Subsequent visit: $75
Major dental* 12

$1,500 per person (Rollover benefit applies)

  • Full crown veneered: $1781.8
Non PBS pharmaceuticals* 2

$600 per person (Rollover benefit applies) (combined limit for non pbs pharmaceuticals & vaccinations)

combined limit for non pbs pharmaceuticals & vaccinations

  • Per eligible prescription: $60
Occupational therapy* 2

$600 per person (Rollover benefit applies)

  • Initial visit: $165.6
  • Subsequent visit: $146.4
Optical* 2

$350 per person (Rollover benefit applies)

  • Multi-focal lenses & frames: $404.4
  • Single vision lenses & frames: $289.4
Orthodontic 12

$1,500 per person

$3,000 lifetime limit

  • Braces for upper & lower teeth, including removal plus fitting of retainer: 80% of charge
Orthotics (podiatric orthoses)* 2

$700 per person (Rollover benefit applies) (combined limit podiatry & orthotics (podiatric orthoses))

combined limit for orthotics (podiatric orthoses) & podiatry

  • Orthotics supply & fit: $414
Osteopathy* 2

$700 per person (Rollover benefit applies) (combined limit chiropractic, acupuncture, remedial massage, chinese medicine, osteopathy & other services)

combined limit for acupuncture, chinese medicine, chiropractic, osteopathy & remedial massage

  • Initial visit: $103
  • Subsequent visit: $86.1
Physiotherapy* 2

$850 per person (Rollover benefit applies) (combined limit physiotherapy & exercise physiology)

combined limit for exercise physiology & physiotherapy

  • Initial visit: $128
  • Subsequent visit: $106.8
Podiatry* 2

$700 per person (Rollover benefit applies) (combined limit podiatry & orthotics (podiatric orthoses))

combined limit for orthotics (podiatric orthoses) & podiatry

  • Initial visit: $75
  • Subsequent visit: $62.5
Psychology* 2

$850 per person (Rollover benefit applies) (combined limit psychology & other services)

  • Initial visit: $237.3
  • Subsequent visit: $237.3
Remedial massage* 2

$700 per person (Rollover benefit applies) (combined limit chiropractic, acupuncture, remedial massage, chinese medicine, osteopathy & other services)

combined limit for acupuncture, chinese medicine, chiropractic, osteopathy & remedial massage

  • Initial visit: $30
  • Subsequent visit: $30
Speech therapy* 2

$850 per person (Rollover benefit applies)

  • Initial visit: $194.4
  • Subsequent visit: $171.6
Vaccinations* 2

$600 per person (Rollover benefit applies) (combined limit for non pbs pharmaceuticals & vaccinations)

combined limit for non pbs pharmaceuticals & vaccinations

  • Per service: $60
Acupuncture*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per person (Rollover benefit applies) (combined limit chiropractic, acupuncture, remedial massage, chinese medicine, osteopathy & other services)}

{combined limit for acupuncture, chinese medicine, chiropractic, osteopathy & remedial massage}

Examples of maximum benefits

{Initial visit: $87.4}

{Subsequent visit: $74.5}

Blood glucose monitors

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$250 per person}

Examples of maximum benefits

{Per monitor: 80% of charge}

Chinese medicine*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per person (Rollover benefit applies) (combined limit chiropractic, acupuncture, remedial massage, chinese medicine, osteopathy & other services)}

{combined limit for acupuncture, chinese medicine, chiropractic, osteopathy & remedial massage}

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $30}

Chiropractic*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per person (Rollover benefit applies) (combined limit chiropractic, acupuncture, remedial massage, chinese medicine, osteopathy & other services)}

{combined limit for acupuncture, chinese medicine, chiropractic, osteopathy & remedial massage}

Examples of maximum benefits

{Initial visit: $88.7}

{Subsequent visit: $57}

Dietetics/dietary advice*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person (Rollover benefit applies)}

Examples of maximum benefits

{Initial visit: $171.2}

{Subsequent visit: $92.8}

Endodontic*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{No annual limit}

Examples of maximum benefits

{Filling of one root canal: $248.4}

Exercise physiology*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$850 per person (Rollover benefit applies) (combined limit physiotherapy & exercise physiology)}

{combined limit for exercise physiology & physiotherapy}

Examples of maximum benefits

{Initial visit: $89.2}

{Subsequent visit: $67.1}

Eye therapy (orthoptics)*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person (Rollover benefit applies)}

Examples of maximum benefits

{Initial visit: $55.2}

{Subsequent visit: $46}

General dental

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{No annual limit (Some service limits apply)}

Examples of maximum benefits

{Fluoride treatment: $34.5}

{Scale & clean: $113.1}

{Surgical tooth extraction: $266.8}

{Periodic oral examination: $56.6}

Hearing aids

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,200 per person}

Examples of maximum benefits

{Hearing aid: 80% of charge}

Home nursing

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{20 days per episode, 65 days per year}

Examples of maximum benefits

{Initial visit: $75}

{Subsequent visit: $75}

Major dental*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,500 per person (Rollover benefit applies)}

Examples of maximum benefits

{Full crown veneered: $1781.8}

Non PBS pharmaceuticals*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person (Rollover benefit applies) (combined limit for non pbs pharmaceuticals & vaccinations)}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per eligible prescription: $60}

Occupational therapy*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person (Rollover benefit applies)}

Examples of maximum benefits

{Initial visit: $165.6}

{Subsequent visit: $146.4}

Optical*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$350 per person (Rollover benefit applies)}

Examples of maximum benefits

{Multi-focal lenses & frames: $404.4}

{Single vision lenses & frames: $289.4}

Orthodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,500 per person}

{$3,000 lifetime limit}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: 80% of charge}

Orthotics (podiatric orthoses)*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per person (Rollover benefit applies) (combined limit podiatry & orthotics (podiatric orthoses))}

{combined limit for orthotics (podiatric orthoses) & podiatry}

Examples of maximum benefits

{Orthotics supply & fit: $414}

Osteopathy*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per person (Rollover benefit applies) (combined limit chiropractic, acupuncture, remedial massage, chinese medicine, osteopathy & other services)}

{combined limit for acupuncture, chinese medicine, chiropractic, osteopathy & remedial massage}

Examples of maximum benefits

{Initial visit: $103}

{Subsequent visit: $86.1}

Physiotherapy*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$850 per person (Rollover benefit applies) (combined limit physiotherapy & exercise physiology)}

{combined limit for exercise physiology & physiotherapy}

Examples of maximum benefits

{Initial visit: $128}

{Subsequent visit: $106.8}

Podiatry*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per person (Rollover benefit applies) (combined limit podiatry & orthotics (podiatric orthoses))}

{combined limit for orthotics (podiatric orthoses) & podiatry}

Examples of maximum benefits

{Initial visit: $75}

{Subsequent visit: $62.5}

Psychology*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$850 per person (Rollover benefit applies) (combined limit psychology & other services)}

Examples of maximum benefits

{Initial visit: $237.3}

{Subsequent visit: $237.3}

Remedial massage*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per person (Rollover benefit applies) (combined limit chiropractic, acupuncture, remedial massage, chinese medicine, osteopathy & other services)}

{combined limit for acupuncture, chinese medicine, chiropractic, osteopathy & remedial massage}

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $30}

Speech therapy*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$850 per person (Rollover benefit applies)}

Examples of maximum benefits

{Initial visit: $194.4}

{Subsequent visit: $171.6}

Vaccinations*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person (Rollover benefit applies) (combined limit for non pbs pharmaceuticals & vaccinations)}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per service: $60}

Most benefits paid at 80% of charge up to amount shown in benefit examples. Remedial massage & Chinese medicine are a fixed benefit. Pharmaceutical benefit applies after $23 co-payment. Other services covered include, but not limited to: Myotherapy, Counselling, Blood Pressure Monitors, CPAP machines, Nebulisers, TENS machines, Anticoagulation machine. Please call for more information.

This policy does not include General treatment (Extras) cover for
Ante-natal/Post-natal classes
Audiology
Health management / Healthy lifestyle

Other features of this general treatment cover: Includes benefits for Corrective Laser Eye Surgery, available after 3 years membership. Loyalty benefit applies to Corrective Laser Eye Surgery and Hearing Aids after 10 years of continuous cover. Enjoy fast, easy claiming via our app, or simply swipe your membership card at the provider.

For further information about this policy see: https://policehealth.com.au/gold-combined

Ambulance cover

In NSW & ACT this policy provides:

Emergency: Unlimited with a waiting period of 2 months.

Non-emergency: Unlimited transport with a waiting period of 2 months.

Call-out fees: Will be paid for each attendance, including emergency treatment without transport to hospital.

Other features of this ambulance cover: In some instances, Department of Veterans Affairs Gold Card, pension and healthcare card holders may be exempt from paying for ambulance services in their state of residence. Under those arrangements, the relevant scheme is responsible for the cost and Police Health only pay a benefit if the cost isn’t fully covered by the arrangement or scheme.

For further information about this policy see: https://www.policehealth.com.au/information-hub/benefit-guides/ambulance-benefit-guide/

Insurer Details

Police Health

Gold Combined

Restricted Insurer

$1054.22 / month

(Before Rebate, Discount & Loading)

Available in NSW & ACT

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/SPE/J1/NAIB2P

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