-What's covered? When can I claim? and How much?

Dental Treatment

Includes dental examinations, x-rays, cleaning/polishing performed by a Dentist, Oral Surgeon or Dental Hygienist. Includes fillings and teeth extraction (excluding wisdom teeth) performed by a Dentist or Oral Surgeon. Includes periodontic and endodontic treatment.

Crowns, dental implants and dentures are not included. Veneers, gold fillings or other forms of cosmetic dentistry are not included. Orthodontic treatment is not included (refer Orthodontic Benefit).

Waiting period: 6 months

Benefit maximum: 50% up to $350

Medical, Specialists and Tests

Prescription medicines and laboratory tests ($20 per item limit), GP visits, Specialist consultations and diagnostic tests including: X-rays, Ultrasound (not obstetric), mammograms, prostate checks, and skin checks. Mole Mapping is included. Ambulance fees. Travel/consultations, Flu vaccinations and other vaccinations are included (subject to a Sub-limit of 50% reimbursement of actual costs incurred up to $100 per Calendar Year).

Waiting period: 3 months

Benefit maximum: 50% up to $1000

Complementary Medical 

Physiotherapy, chiropractic, osteopathy, podiatry, acupuncture, naturopathy, homeopathy, psychology, psychotherapy, counselling, drug and alcohol therapy, dietitian and nutritionist consultations, lymphoedema therapy, allergy testing and chelation therapy, audiology, occupational therapy, speech-language therapy, infertility/sterilisation.

Waiting period: 3 months

Benefit maximum: 50% up to $500

Medical Appliance 

Specified items prescribed by a GP, Specialist or Hospital. Includes: hearing aids, prosthesis (not related to surgery), toric and irlen lenses, aids for the control of diabetes or lung disease, Epipens, CPAP Machine/Mask, compression stockings/sleeves, specially made footwear (excluding inserts for shoes provided by a podiatrist), baby monitor or any equipment for the disabled.

Waiting period: 3 months

Benefit maximum: 50% up to $400

Hospital Treatment 

A contribution towards the cost of private hospital treatment. Includes surgeon’s fee, anaesthetist’s fee and private hospital charges. 

HealthCarePlus approved Hospital Cover policy excess reimbursement: excludes oral surgery.

Waiting period: 3 months

Benefit maximum: 50% up to $1000 (^) & $500 maximum applies for excess reimbursement

Orthodontic Treatment 

A contribution towards the cost of orthodontic consultations and treatment for Insured Children.

Waiting period: 12 months

Benefit maximum: 30% up to $750 per child ($1500 maximum for the duration of the subscriber’s membership)

Optical

Optometrist eye examinations, prescription glasses and contact lenses. 

Waiting period: 6 months

Benefit maximum: 50% up to $350

Birth Grant 

A lump sum payment for each live child born to a Subscriber or their partner; or for each child adopted by a Subscriber or their partner.

Waiting period: 12 months

Benefit maximum: $200

Sick Leave Without Pay

Where the Subscriber is required to take sick leave without pay due to illness.

Waiting period: 12 months

Benefit maximum: $50 per week plus $5 per insured child up to $60 per week, for a maximum of 26 weeks.

Major Diagnostic Imaging 

A contribution towards the cost of CT scans, MRI scans and Angiograms.

Waiting period: 6 months

Benefit maximum: 50% up to $600

Bereavement Grant

A lump sum payment on the death of an Insured Adult or Child (including still birth).

Waiting period: 3 months

Benefit maximum: $1000