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Health Partners

Basic Hospital Plus $500 Excess with Combined Active Family Extras

$219.83 / month

(Before Rebate, Discount & Loading)

Available in SA

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.

Policy ID: SPS/C49/SJTQ10

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
Dental surgery
Gastrointestinal endoscopy
Gynaecology
Hernia and appendix
Hospital psychiatric services
Joint reconstructions
Male reproductive system
Miscarriage and termination of pregnancy
Palliative care
Rehabilitation
Tonsils, adenoids and grommets
This policy does not include 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
Diabetes management (excluding insulin pumps)
Dialysis for chronic kidney failure
Digestive system
Ear, nose and throat
Eye (not cataracts)
Heart and vascular system
Implantation of hearing devices
Insulin pumps
Joint replacements
Kidney and bladder
Lung and chest
Pain management
Pain management with device
Plastic and reconstructive surgery (medically necessary)
Podiatric surgery (provided by a registered podiatric surgeon)
Pregnancy and birth
Skin
Sleep studies
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 person and $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
  • 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

Accident Cover provides you with protection for all excluded clinical categories on your policy. Meaning, you will receive the highest level of cover if you require treatment as a result of an accident (as defined by Health Partners). T&Cs apply. Members can also access a range of discounts, refer to the ‘Member Discount’ page at healthpartners.com.au.

Extras Cover

Health Partners Providers covering Dental, Optical, Physio and Pharmacy. Health Partners Providers offer you more such as 100% back on 2 dental check-ups, a bonus optical limit, and a Pharmacy benefits. T&Cs apply. See https://www.healthpartners.com.au/members/providers/.

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 policy

combined limit for acupuncture, chinese medicine & remedial massage

  • Initial visit: $30
  • Subsequent visit: $30
Chinese medicine 2

$200 per policy

combined limit for acupuncture, chinese medicine & remedial massage

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

$1,000 per policy

combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry

  • Initial visit: $40
  • Subsequent visit: $35
Dietetics/dietary advice 2

$500 per policy

combined limit for dietetics/dietary advice, health management / healthy lifestyle, occupational therapy, psychology & speech therapy

  • Initial visit: $40
  • Subsequent visit: $30
Endodontic* 12

$1,000 per policy

combined limit for endodontic & major dental

  • Filling of one root canal: $220.35
Exercise physiology 2

$1,000 per policy

combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry

  • Initial visit: $40
  • Subsequent visit: $35
Eye therapy (orthoptics) 2

$1,000 per policy

combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry

  • Initial visit: $35
  • Subsequent visit: $30
General dental* 2

No annual limit

  • Fluoride treatment: $26
  • Scale & clean: $93.6
  • Surgical tooth extraction: $271.7
  • Periodic oral examination: $43.55
Health management / Healthy lifestyle 2

$500 per policy

combined limit for dietetics/dietary advice, health management / healthy lifestyle, occupational therapy, psychology & speech therapy

  • Health management: 70% of charge
Major dental* 12

$1,000 per policy

combined limit for endodontic & major dental

  • Full crown veneered: $1000
Non PBS pharmaceuticals* 2

$400 per policy

combined limit for non pbs pharmaceuticals & vaccinations

  • Per eligible prescription: $0
Occupational therapy 2

$500 per policy

combined limit for dietetics/dietary advice, health management / healthy lifestyle, occupational therapy, psychology & speech therapy

  • Initial visit: $40
  • Subsequent visit: $30
Optical* 2

$200 per policy

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

$1,500 lifetime limit

sub-limits apply

  • Braces for upper & lower teeth, including removal plus fitting of retainer: 70% of charge
Orthotics (podiatric orthoses) 12

$1,000 per policy

combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry

  • Orthotics supply & fit: 70% of charge
Osteopathy 2

$1,000 per policy

combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry

  • Initial visit: $40
  • Subsequent visit: $35
Physiotherapy* 2

$1,000 per policy

combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry

  • Initial visit: $40
  • Subsequent visit: $35
Podiatry 2

$1,000 per policy

combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry

  • Initial visit: $35
  • Subsequent visit: $30
Psychology 2

$500 per policy

combined limit for dietetics/dietary advice, health management / healthy lifestyle, occupational therapy, psychology & speech therapy

  • Initial visit: $75
  • Subsequent visit: $75
Remedial massage 2

$200 per policy

combined limit for acupuncture, chinese medicine & remedial massage

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

$500 per policy

combined limit for dietetics/dietary advice, health management / healthy lifestyle, occupational therapy, psychology & speech therapy

  • Initial visit: $40
  • Subsequent visit: $30
Vaccinations* 2

$400 per policy

combined limit for non pbs pharmaceuticals & vaccinations

  • Per service: $0
Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

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

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $30}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

{combined limit for acupuncture, chinese medicine & 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

{$1,000 per policy}

{combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $35}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for dietetics/dietary advice, health management / healthy lifestyle, occupational therapy, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $30}

Endodontic*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Filling of one root canal: $220.35}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $35}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $30}

General dental*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{No annual limit}

Examples of maximum benefits

{Fluoride treatment: $26}

{Scale & clean: $93.6}

{Surgical tooth extraction: $271.7}

{Periodic oral examination: $43.55}

Health management / Healthy lifestyle

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for dietetics/dietary advice, health management / healthy lifestyle, occupational therapy, psychology & speech therapy}

Examples of maximum benefits

{Health management: 70% of charge}

Major dental*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Full crown veneered: $1000}

Non PBS pharmaceuticals*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per eligible prescription: $0}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for dietetics/dietary advice, health management / healthy lifestyle, occupational therapy, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $30}

Optical*

Waiting period:  2 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 lifetime limit}

{sub-limits apply}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: 70% of charge}

Orthotics (podiatric orthoses)

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry}

Examples of maximum benefits

{Orthotics supply & fit: 70% of charge}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $35}

Physiotherapy*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $35}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

{combined limit for chiropractic, exercise physiology, eye therapy (orthoptics), orthotics (podiatric orthoses), osteopathy, physiotherapy & podiatry}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $30}

Psychology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for dietetics/dietary advice, health management / healthy lifestyle, occupational therapy, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: $75}

{Subsequent visit: $75}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per policy}

{combined limit for acupuncture, chinese medicine & 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

{$500 per policy}

{combined limit for dietetics/dietary advice, health management / healthy lifestyle, occupational therapy, psychology & speech therapy}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $30}

Vaccinations*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per policy}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per service: $0}

In South Australia, get more from your cover by using Health Partners Dental and Optical practices - like 100% back on 2x dental check-ups (including x-rays). Plus, 70% benefit on other general and major dental services, up to your limits. At Health Partners Optical, you get 100% back on your optical limit, and an unlimited 40% benefit after you’ve reached your limit. 100% back on your optical limit is also available at other recognised optical providers, sub-limit applies. At our participating physios get 70% back on a physio visit, up to your limit. Save 20% every day on full-price, non-prescription products at over 50 pharmacies across South Australia, which include participating Priceline and TerryWhite Chemmart stores. T&Cs apply.

This policy does not include General treatment (Extras) cover for
Ante-natal/Post-natal classes
Audiology
Blood glucose monitors
Hearing aids
Home nursing

Other features of this general treatment cover: Combined limits create flexibility for you to use your limit on what's important to you. Acupuncture and remedial massage limits also includes other natural therapies, such as Chinese herbalism, myofascial release, therapeutic massage, Swedish massage, myotherapy, nutritionist, yoga, pilates & naturopathy. T&Cs apply.

Ambulance cover

In SA this policy provides:

Emergency: Unlimited with no waiting period.

Call-out fees: Will not be paid.

For further information about this policy see: https://www.healthpartners.com.au/health-insurance/understanding-private-health-insurance/

Insurer Details

Health Partners

Basic Hospital Plus $500 Excess with Combined Active Family Extras

$219.83 / month

(Before Rebate, Discount & Loading)

Available in SA

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/SPS/C49/SJTQ10

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