Download Heart Hospital with Basic 75 Extras ($500 excess)

Private Health Insurance Standard Information Statement - Combined Policy
This Statement provides basic information for the purposes of comparison only. For full explanation of this combined
hospital and general treatment policy please contact the health insurer on 1300 199 802 or visit http://www.health.com.au.
HEALTH INSURER: health.com.au
WHO IS COVERED:
One adult
PRODUCT NAME:
Heart Hospital with Basic 75 Extras ($500 MONTHLY PREMIUM: #
$212.98 (before any rebate or loading)
M
EDICARE
L
EVY
S
URCHARGE
:
Exempt
excess)
AVAILABLE FOR:
Residents of Tasmania
# You may be entitled to an Australian Government rebate on this premium. Your premium may include a Lifetime Health Cover loading and/or an insurer discount
depending on your individual circumstances. Check with your insurer for more details.
Hospital Component
The following applies to the hospital component for the Heart Hospital with Basic 75 Extras ($500 excess) policy from health.com.au.
WHAT'S COVERED IF I HAVE
TO GO TO HOSPITAL ?
Hospital treatment, including accommodation as a private patient in a private or public hospital
Doctors' bills in hospital (see below)
(Ambulance is covered by State government)
WHAT SERVICES ARE NOT
COVERED AT ALL ?
(Exclusions)
WHAT SERVICES ARE ONLY
COVERED TO A LIMITED
EXTENT ?
(Restrictions, Benefit Limitation
Periods)
HOW LONG ARE THE WAITING
PERIODS FOR NEW AND
UPGRADING MEMBERS?
WILL I HAVE TO PAY
ANYTHING IF I GO TO
HOSPITAL ?
(Excesses, Co-payments,
Medical/Hospital gaps)
WHAT OTHER FEATURES
DOES THIS POLICY HAVE?
Cataract and eye lens procedures
Pregnancy and birth related services
Assisted reproductive services
Joint replacements ie shoulder, knee, hip and elbow, including revisions
Dialysis for chronic renal failure
Gastric banding and related services
Hospital treatment for which Medicare pays no benefit eg most cosmetic surgery
Other services (see insurer for details)
You are not fully covered for:
Psychiatric services
No benefit limitation periods
2 months for palliative care, rehabilitation and psychiatric treatment
12 months for treatments relating to other pre-existing ailments
2 months for all other treatments
EXCESS: You will have to pay an excess of $500 per admission. This is limited to a maximum of
$500 per year.
EXTRA COST PER DAY (CO-PAYMENTS): No co-payments
DOCTORS' AND HOSPITAL BILLS: Almost 9 out of 10 medical services paid for by this health insurer
in Tasmania have no out-of-pocket expenses. This insurer also has arrangements that may mean
lower out-of-pocket expenses on doctors' bills. You may also have to pay other costs depending
upon:
the doctor(s) chosen
the treatment you are having
the hospital you go to
Before you go to hospital, you should ask your doctor, hospital and health insurer about
any out-of-pocket costs that may apply to you.
Heart Hospital cover is perfect for a family who is done having children, or singles and couples who
want the added safety of cover for cardiac complications. Please note further exclusions include;
Insulin Pumps, Cochlear Implants, Neurostimulators and all Spinal Surgery.
HEA/J91/TDSA10 issued 02 March 2017
www.PrivateHealth.gov.au
General Treatment Component
The following applies to the general treatment component for the Heart Hospital with Basic 75 Extras ($500 excess) policy from health.com.au.
PREFERRED SERVICE PROVIDER ARRANGEMENTS: This health insurer does not operate a preferred provider scheme.
SERVICES
COVER
DENTAL
WAITING PERIOD
(MONTHS)
2
General dental
BENEFIT LIMITS
(PER 12 MONTHS)
$700 per policy
EXAMPLES OF MAXIMUM BENEFITS
Periodic oral examination - 75% of charge
Scale & clean - 75% of charge
Fluoride treatment - 75% of charge
Surgical tooth extraction - 75% of charge
(combined limit for general dental, major
dental, endodontic & orthodontic - Sub-limits Full crown veneered - 75% of charge
apply)
Major dental
12
Orthodontic
12
OPTICAL (eg prescribed
2
$225 per policy
NON PBS PHARMACEUTICALS
-
-
PHYSIOTHERAPY
2
$400 per policy
CHIROPRACTIC
2
PODIATRY
-
-
-
PSYCHOLOGY
-
-
-
ACUPUNCTURE
2
$300 per policy
NATUROPATHY
2
REMEDIAL MASSAGE
2
$225 per policy
HEARING AIDS
-
-
-
-
-
-
Endodontic
12
spectacles / contact lenses)
B LOOD GLUCOSE MONITORS
AMBULANCE
n/a
Filling of one root canal - 75% of charge
Braces for upper & lower teeth, including removal
plus fitting of retainer - 75% of charge
(combined limit for physiotherapy &
chiropractic)
(combined limit for acupuncture &
naturopathy)
Single vision lenses & frames - 75% of charge
Multi-focal lenses & frames - 75% of charge
Initial visit - 75% of charge
Subsequent visit - 75% of charge
Initial visit - 75% of charge
Subsequent visit - 75% of charge
Initial visit - 75% of charge
Subsequent visit - 75% of charge
Initial visit - 75% of charge
Subsequent visit - 75% of charge
Initial visit - 75% of charge
Subsequent visit - 75% of charge
Covered by State government
Osteopathy benefits payable from Physiotherapy and Chiropractic limit.
OTHER FEATURES: Dental sublimit of $350 per person per year is available for Orthodontic treatment. Health maintenance benefits
of up to $150 per person for things like Gym memberships. Benefits are also payable towards Occupational and Speech
therapies. See; https://health.com.au/customers/ for more details
HEA/J91/TDSA10 issued 02 March 2017
www.PrivateHealth.gov.au