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Extras Cover

With Basic65, up to your annual cap, you'll get 65% of the fee back from the provider of your choice every time you see them. That's your choice of provider, not ours.

Hospital Cover

If you go into hospital we cover you for things that healthier people are more likely to use, like: accidents, removal of tonsils, adenoids, wisdom teeth and the appendix; arthroscopies and colonoscopies; shoulder and back surgery; and knee reconstructions. So nothing too serious, as you would expect if you're in already good health.

Limitations on Hospital Services

Psychiatric, rehabilitation and surgical podiatry services are only covered to a minimum level. For these services coverage is only enough to be treated as a private patient in a public hospital, not a private hospital.

Exclusions

This product will not cover you for pregnancy, heart related services, joint replacements, cataract removal nor some other treatments that fit and active people are less likely to use.

Ambulance cover

We will pay for medically necessary ambulance transport.

Hospital Excess

So you can lower the cost of your premiums, we give you a choice of two excess amounts: $500 or $250 apply per person for each hospital admission, but there is an annual cap to limit your expense. There is no excess with Extras or ambulance.

Waiting periods

All health insurance providers impose waiting periods. Ours are:

• 2 months - All services including psychiatric, rehabilitation, and palliative care, except the ones listed below
• 12 months - orthodontics, major dental, and any pre-existing conditions

If you are joining us from another health insurer, any waiting periods that you have already served will be recognised so that you don't have to serve them again. Waiting periods may apply for services not covered with your previous fund.

Restricted items

For these services only limited benefits are payable. Benefits are only enough to be treated as a private patient in a public hospital, not a private hospital.

Further details

This is only a summary of the product's features. View the Basic65 Features Guide for more information.

You should read this summary together with the health.com.au Policy Guide

Out of pocket expenses, otherwise known as gap fees.

Gap fees can be applied by hospitals and or medical practitioners (for their medical services).

Hospitals

We have an agreement with nearly every private hospital in Australia. However, if you go to a hospital that we don't have an agreement with you're likely to have out of pocket expenses that are not covered by the policy.

Medical services

Our Access Gap Cover scheme allows you to reduce or eliminate your out of pocket expenses. On a case by case basis medical practitioners can decide if they will participate in our scheme. Almost 9 out of 10 medical services under the Access Gap Cover scheme have no out of pocket expenses. If your medical practitioner chooses not to participate then health.com.au is only able, by law, to pay 25% of the Medicare Benefits Schedule (MBS) fee. Medicare pays 75% of the MBS fee. However medical practitioners are able to charge what they like. If your bill is more than the MBS fee you'll have to pay the difference.

Extras Cover

With Basic75, up to your annual cap, you'll get 75% of the fee back from the provider of your choice every time you see them. That's your choice of provider, not ours.

Hospital Cover

If you go into hospital we cover you for things that healthier people are more likely to use, like: accidents, removal of tonsils, adenoids, wisdom teeth and the appendix; arthroscopies and colonoscopies; shoulder and back surgery; and knee reconstructions. So nothing too serious, as you would expect if you're in already good health.

Limitations on Hospital Services

Psychiatric, rehabilitation and surgical podiatry services are only covered to a minimum level. For these services coverage is only enough to be treated as a private patient in a public hospital, not a private hospital.

Exclusions

This product will not cover you for pregnancy, heart related services, joint replacements, cataract removal nor some other treatments that fit and active people are less likely to use.

Ambulance cover

We will pay for medically necessary ambulance transport.

Hospital Excess

So you can lower the cost of your premiums, we give you a choice of two excess amounts: $500 or $250 apply per person for each hospital admission, but there is an annual cap to limit your expense. There is no excess with Extras or ambulance.

Waiting Periods

All health insurance providers impose waiting periods on both Hospital and Extras. Ours are:

• 2 months - All services including psychiatric, rehabilitation, and palliative care, except the ones listed below
• 12 months - orthodontics, major dental, and any pre-existing conditions

Restricted items

For these services only limited benefits are payable. Benefits are only enough to be treated as a private patient in a public hospital, not a private hospital.

Further details

This is only a summary of the product's features. View the Basic75 Features Guide for more information.

You should read this summary together with the health.com.au Policy Guide

Out of pocket expenses, otherwise known as gap fees.

Gap fees can be applied by hospitals and or medical practitioners (for their medical services).

Hospitals

We have an agreement with nearly every private hospital in Australia. However, if you go to a hospital that we don't have an agreement with you're likely to have out of pocket expenses that are not covered by the policy.

Medical services

Our Access Gap Cover scheme allows you to reduce or eliminate your out of pocket expenses. On a case by case basis medical practitioners can decide if they will participate in our scheme. Almost 9 out of 10 medical services under the Access Gap Cover scheme have no out of pocket expenses. If your medical practitioner chooses not to participate then health.com.au is only able, by law, to pay 25% of the Medicare Benefits Schedule (MBS) fee. Medicare pays 75% of the MBS fee. However medical practitioners are able to charge what they like. If your bill is more than the MBS fee you'll have to pay the difference.

Extras Cover

With Basic85, up to your annual cap, you'll get 85% of the fee back from the provider of your choice every time you see them. That's your choice of provider, not ours.

Hospital Cover

If you go into hospital we cover you for things that healthier people are more likely to use, like: accidents, removal of tonsils, adenoids, wisdom teeth and the appendix; arthroscopies and colonoscopies; shoulder and back surgery; and knee reconstructions. So nothing too serious, as you would expect if you're in already good health.

Limitations on Hospital Services

Psychiatric, rehabilitation and surgical podiatry services are only covered to a minimum level. For these services coverage is only enough to be treated as a private patient in a public hospital, not a private hospital.

Exclusions

This product will not cover you for pregnancy, heart related services, joint replacements, cataract removal nor some other treatments that fit and active people are less likely to use.

Ambulance cover

We will pay for medically necessary ambulance transport.

Hospital Excess

So you can lower the cost of your premiums, we give you a choice of two excess amounts: $500 or $250 apply per person for each hospital admission, but there is an annual cap to limit your expense. There is no excess with Extras or ambulance.

Waiting Periods

All health insurance providers impose waiting periods on both Hospital and Extras. Ours are:

• 2 months - All services including psychiatric, rehabilitation, and palliative care, except the ones listed below
• 12 months - orthodontics, major dental, and any pre-existing conditions

Restricted items

For these services only limited benefits are payable. Benefits are only enough to be treated as a private patient in a public hospital, not a private hospital.

Further details

This is only a summary of the product's features. View the Basic85 Features Guide for more information.

You should read this summary together with the health.com.au Policy Guide

Out of pocket expenses, otherwise known as gap fees.

Gap fees can be applied by hospitals and or medical practitioners (for their medical services).

Hospitals

We have an agreement with nearly every private hospital in Australia. However, if you go to a hospital that we don't have an agreement with you're likely to have out of pocket expenses that are not covered by the policy.

Medical services

Our Access Gap Cover scheme allows you to reduce or eliminate your out of pocket expenses. On a case by case basis medical practitioners can decide if they will participate in our scheme. Almost 9 out of 10 medical services under the Access Gap Cover scheme have no out of pocket expenses. If your medical practitioner chooses not to participate then health.com.au is only able, by law, to pay 25% of the Medicare Benefits Schedule (MBS) fee. Medicare pays 75% of the MBS fee. However medical practitioners are able to charge what they like. If your bill is more than the MBS fee you'll have to pay the difference.