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$110.14*
30 day cooling off period
Join now with peace of mind
30 day cooling off period
Join now with peace of mind
From
$110.14*
$ after April 1
$110.14*
Minimum direct debit period
/ Fortnightly
30 day cooling off period
Join now with peace of mind
* Assumes a 4% discount for direct debit and 0% aged based discount. Any rebate and Lifetime Health Cover loading listed above has been factored into the price. Price includes cover for non-student dependants aged 23 and over.Price excludes cover for non-student dependants aged 23 and over.
Lockton Unions & Associations Health Plan customers discount has been applied.
Hospital cover benefits
-
Cover for most clinical categories including heart and vascular, joint replacements and rehabilitation
-
Additional benefits such as ambulance, hospital substitution programs, preventative health and health programs
-
Lower cost cover in exchange for paying an excess and daily co-payments if you need to use your hospital cover
-
Excess and co-payments are waived for dependants
Extras cover benefits
-
Benefits claimed as No Gap Dental do not count towards your yearly limit Cover for a wide range of dental including general dental, root canals, surgical extractions, crowns, bridges and dentures
-
Physiotherapy, chiropractic, optical, remedial massage, podiatry and a range of additional benefits including health aids and emergency ambulance
Value Hospital (Silver Plus) with $100 daily co-payment cover
Inclusions
Waiting period
For example: psychoses such as schizophrenia, mood disorders such as depression, eating disorders and addiction therapy.
Also includes two ambulance attendances per person per calendar year, where you are not taken to hospital.
For example: sciatica, prolapsed or herniated disc, spinal disc replacement and spine curvature disorders such as scoliosis, kyphosis and lordosis.
Joint replacements are listed separately under joint replacements.
Joint fusions are listed separately under bone, joint and muscle.
Spinal cord conditions are listed separately under brain and nervous system.
Management of back pain is listed separately under pain management. Pain management that requires a device is listed separately under pain management with device.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: blood clotting disorders and bone marrow transplants.
Treatment for cancers of the blood is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: carpal tunnel, fractures, hand surgery, joint fusion, bone spurs, osteomyelitis and bone cancer.
Chest surgery is listed separately under lung and chest.
Spinal cord conditions are listed separately under brain and nervous system.
Spinal column conditions are listed separately under back, neck and spine.
Joint reconstructions are listed separately under joint reconstructions.
Joint replacements are listed separately under joint replacements.
Podiatric surgery performed by a registered podiatric surgeon is listed separately under podiatric surgery (provided by a registered podiatric surgeon).
Management of back pain is listed separately under pain management. Pain management that requires a device is listed separately under pain management with device.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: stroke, brain or spinal cord tumours, head injuries, epilepsy and Parkinson's disease.
Treatment of spinal column (back bone) conditions is listed separately under back, neck and spine.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: breast lesions, breast tumours, asymmetry due to breast cancer surgery, and gynecomastia.
This clinical category does not require benefits to be paid for cosmetic breast surgery that is not medically necessary.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
Surgical treatment of cancer is listed separately under each body system.
For example: surgery to remove wisdom teeth, and dental implant surgery.
For example: stabilisation of hypo- or hyper- glycaemia, contour problems due to insulin injections.
Treatment for diabetes-related conditions is listed separately under each body system affected. For example, treatment for diabetes-related eye conditions is listed separately under eye.
Treatment for ulcers is listed separately under skin.
Provision and replacement of insulin pumps is listed separately under insulin pumps.
For example: oesophageal cancer, irritable bowel syndrome, gall stones and haemorrhoids.
Endoscopy is listed separately under gastrointestinal endoscopy.
Hernia and appendicectomy procedures are listed separately under hernia and appendix.
Bariatric surgery is listed separately under weight loss surgery.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: damaged ear drum, sinus surgery, removal of foreign bodies, stapedectomy and throat cancer.
Tonsils, adenoids and grommets are listed separately under tonsils, adenoids and grommets.
The implantation of a hearing device is listed separately under implantation of hearing devices.
Orthopaedic neck conditions are listed separately under back, neck and spine.
Sleep studies are listed separately under sleep studies.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: retinal detachment, tear duct conditions, eye infections and medically managed trauma to the eye.
Cataract procedures are listed separately under cataracts.
Eyelid procedures are listed separately under plastic and reconstructive surgery.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: colonoscopy, gastroscopy, endoscopic retrograde cholangiopancreatography (ERCP).
Non-endoscopic procedures for the digestive system are listed separately under digestive system.
For example: endometriosis, polycystic ovaries, female sterilisation and cervical cancer.
Fertility treatments are listed separately under assisted reproductive services.
Pregnancy and birth-related conditions are listed separately under pregnancy and birth.
Miscarriage or termination of pregnancy is listed separately under miscarriage and termination of pregnancy.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: heart failure and heart attack, monitoring of heart conditions, varicose veins and removal of plaque from arterial walls.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
Digestive conditions are listed separately under digestive system.
Stapedectomy is listed separately under ear, nose and throat.
For example: torn tendons, rotator cuff tears and damaged ligaments.
Joint replacements are listed separately under joint replacements.
Bone fractures are listed separately under bone, joint and muscle.
Procedures to the spinal column are listed separately under back, neck and spine.
Podiatric surgery performed by a registered podiatric surgeon is listed separately under podiatric surgery (provided by a registered podiatric surgeon).
For example: replacement of shoulder, wrist, finger, hip, knee, ankle, or toe joint.
Joint fusions are listed separately under bone, joint and muscle.
Spinal fusions are listed separately under back, neck and spine.
Joint reconstructions are listed separately under joint reconstructions.
Podiatric surgery performed by a registered podiatric surgeon is listed separately under podiatric surgery (provided by a registered podiatric surgeon).
For example: kidney stones, adrenal gland tumour and incontinence.
Dialysis is listed separately under dialysis for chronic kidney failure.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: lung cancer, respiratory disorders such as asthma, pneumonia, and treatment of trauma to the chest.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: male sterilisation, circumcision and prostate cancer.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: treatment of nerve pain and chest pain due to cancer by injection of a nerve block.
Pain management using a device (for example an infusion pump or neurostimulator) is listed separately under Pain management with device.
For example: treatment of nerve pain, back pain, and pain caused by coronary heart disease with a device (for example an infusion pump or neurostimulator).
Treatment of pain that does not require a device is listed separately under pain management.
For example: burns requiring a graft, cleft palate, club foot and angioma.
Plastic surgery that is medically necessary relating to the treatment of a skin-related condition is listed separately under skin.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
- - accommodation; and
- - the cost of a prosthesis as listed in the prostheses list set out in the Private Health Insurance (Prostheses) Rules, as in force from time to time.
Note: Insurers are not required to pay for any other benefits for hospital treatment for this clinical category but may choose to do so.
For example: melanoma, minor wound repair and abscesses.
Removal of excess skin due to weight loss is listed separately under weight loss surgery.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: sleep apnoea and snoring.
More Inclusions
For example: blood clotting disorders and bone marrow transplants.
Treatment for cancers of the blood is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: carpal tunnel, fractures, hand surgery, joint fusion, bone spurs, osteomyelitis and bone cancer.
Chest surgery is listed separately under lung and chest.
Spinal cord conditions are listed separately under brain and nervous system.
Spinal column conditions are listed separately under back, neck and spine.
Joint reconstructions are listed separately under joint reconstructions.
Joint replacements are listed separately under joint replacements.
Podiatric surgery performed by a registered podiatric surgeon is listed separately under podiatric surgery (provided by a registered podiatric surgeon).
Management of back pain is listed separately under pain management. Pain management that requires a device is listed separately under pain management with device.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: stroke, brain or spinal cord tumours, head injuries, epilepsy and Parkinson's disease.
Treatment of spinal column (back bone) conditions is listed separately under back, neck and spine.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: breast lesions, breast tumours, asymmetry due to breast cancer surgery, and gynecomastia.
This clinical category does not require benefits to be paid for cosmetic breast surgery that is not medically necessary.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
Surgical treatment of cancer is listed separately under each body system.
For example: surgery to remove wisdom teeth, and dental implant surgery.
For example: stabilisation of hypo- or hyper- glycaemia, contour problems due to insulin injections.
Treatment for diabetes-related conditions is listed separately under each body system affected. For example, treatment for diabetes-related eye conditions is listed separately under eye.
Treatment for ulcers is listed separately under skin.
Provision and replacement of insulin pumps is listed separately under insulin pumps.
For example: oesophageal cancer, irritable bowel syndrome, gall stones and haemorrhoids.
Endoscopy is listed separately under gastrointestinal endoscopy.
Hernia and appendicectomy procedures are listed separately under hernia and appendix.
Bariatric surgery is listed separately under weight loss surgery.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: damaged ear drum, sinus surgery, removal of foreign bodies, stapedectomy and throat cancer.
Tonsils, adenoids and grommets are listed separately under tonsils, adenoids and grommets.
The implantation of a hearing device is listed separately under implantation of hearing devices.
Orthopaedic neck conditions are listed separately under back, neck and spine.
Sleep studies are listed separately under sleep studies.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: retinal detachment, tear duct conditions, eye infections and medically managed trauma to the eye.
Cataract procedures are listed separately under cataracts.
Eyelid procedures are listed separately under plastic and reconstructive surgery.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: colonoscopy, gastroscopy, endoscopic retrograde cholangiopancreatography (ERCP).
Non-endoscopic procedures for the digestive system are listed separately under digestive system.
For example: endometriosis, polycystic ovaries, female sterilisation and cervical cancer.
Fertility treatments are listed separately under assisted reproductive services.
Pregnancy and birth-related conditions are listed separately under pregnancy and birth.
Miscarriage or termination of pregnancy is listed separately under miscarriage and termination of pregnancy.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: heart failure and heart attack, monitoring of heart conditions, varicose veins and removal of plaque from arterial walls.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
Digestive conditions are listed separately under digestive system.
Stapedectomy is listed separately under ear, nose and throat.
For example: torn tendons, rotator cuff tears and damaged ligaments.
Joint replacements are listed separately under joint replacements.
Bone fractures are listed separately under bone, joint and muscle.
Procedures to the spinal column are listed separately under back, neck and spine.
Podiatric surgery performed by a registered podiatric surgeon is listed separately under podiatric surgery (provided by a registered podiatric surgeon).
For example: replacement of shoulder, wrist, finger, hip, knee, ankle, or toe joint.
Joint fusions are listed separately under bone, joint and muscle.
Spinal fusions are listed separately under back, neck and spine.
Joint reconstructions are listed separately under joint reconstructions.
Podiatric surgery performed by a registered podiatric surgeon is listed separately under podiatric surgery (provided by a registered podiatric surgeon).
For example: kidney stones, adrenal gland tumour and incontinence.
Dialysis is listed separately under dialysis for chronic kidney failure.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: lung cancer, respiratory disorders such as asthma, pneumonia, and treatment of trauma to the chest.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: male sterilisation, circumcision and prostate cancer.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: treatment of nerve pain and chest pain due to cancer by injection of a nerve block.
Pain management using a device (for example an infusion pump or neurostimulator) is listed separately under Pain management with device.
For example: treatment of nerve pain, back pain, and pain caused by coronary heart disease with a device (for example an infusion pump or neurostimulator).
Treatment of pain that does not require a device is listed separately under pain management.
For example: burns requiring a graft, cleft palate, club foot and angioma.
Plastic surgery that is medically necessary relating to the treatment of a skin-related condition is listed separately under skin.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
- - accommodation; and
- - the cost of a prosthesis as listed in the prostheses list set out in the Private Health Insurance (Prostheses) Rules, as in force from time to time.
Note: Insurers are not required to pay for any other benefits for hospital treatment for this clinical category but may choose to do so.
For example: melanoma, minor wound repair and abscesses.
Removal of excess skin due to weight loss is listed separately under weight loss surgery.
Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
For example: sleep apnoea and snoring.
Exclusions
For example: retrieval of eggs or sperm, In vitro Fertilisation (IVF), and Gamete Intra-fallopian Transfer (GIFT).
Treatment of the female reproductive system is listed separately under gynaecology.
Pregnancy and birth-related services are listed separately under pregnancy and birth.
For example: peritoneal dialysis and haemodialysis.
Treatment for the baby is covered under the clinical category relevant to their condition (provided your baby is included under your cover). For example, respiratory conditions are covered under lung and chest.
Female reproductive conditions are listed separately under gynaecology.
Fertility treatments are listed separately under assisted reproductive services.
Miscarriage and termination of pregnancy is listed separately under miscarriage and termination of pregnancy.
For example: gastric banding, gastric bypass, sleeve gastrectomy.
Key
Top Extras cover
Claim up to $9,150 per person per calendar year
Extras covered
Yearly limits (per person)
/what you get
back
Waiting periods
Covers selected services such as examinations, some x-rays, scale and clean, fluoride treatment and mouthguards.
Benefits claimed as No Gap Dental do not count towards your yearly limit.
100% of the cost for selected services at our No Gap Dental Network
0 months
$800 per person
Up to 100% of the cost per item
A lifetime maximum of $3,200 per person applies
12 months
Covers selected services such as scale and clean, fluoride treatment and mouthguards.
Covers most fillings and simple extractions
$1000 per person, $2000 per family
Set amounts per item
0 months
0 months for selected diagnostic services
2 months
A full denture replacement is limited to once every three years.
$1000 per person, $2000 per family
Set amounts per item
12 months
12 months
A full denture replacement is limited to once every three years.
For prescription glasses, contact lenses or repairs provided by a recognised optometrist in private practice. Excludes non-prescription sunglasses and contact lenses, and optical consultations.
$300 per person, $600 per family
Up to 100% of the cost per item
6 months
Including sports physiotherapy and hydrotherapy.
Includes hydrotherapy
Combined maximum of $600 per person
$70 per consultation
2 months
2 months
Combined maximum of $400 per person
$50 per consultation
2 months
2 months
2 months
Excludes podiatric surgery
When recommended by a podiatrist/orthotist or medical practitioner and supplied by an approved provider in a private practice.
Combined maximum of $400 per person
$50 per podiatric consultation
Up to 80% of the cost per item
2 months
12 months
Combined maximum of $400 per person
$50 per consultation
$50 for a chiropractic x-ray
Limit of one chiropractic x-ray per person
2 months
TENS Machines must be recommended by a physiotherapist or medical practitioner and supplied by an approved provider in private practice.
For hire or purchase of wheelchairs or crutches used in prevention or support post injury.
Combined maximum of $500 per person
Up to 80% of the cost per item
12 months
Benefit for each item is payable every 2 calendar years
12 months
Benefit for each item is payable every 2 calendar years
12 months
Benefit for each item is payable every 2 calendar years
2 months
12 months
Benefit for each item is payable every 2 calendar years (does not apply to wigs)
Includes hearing aid appliance, replacement and repairs.
Benefit for each item is payable every 3 years (does not apply to repairs)
$1,000 per person
Up to 80% of the cost per item
12 months for items
2 months for repairs
Benefit for each item is payable every 3 years (does not apply to repairs)
$500 per person
$50 per consultation
2 months
Combined maximum of $400 per person
$80 per consultation
2 months
$600 per person
$100 per consultation
2 months
For non-prescription PBS pharmaceuticals only, after you pay a sum equal to the current Pharmaceutical Benefits Scheme (PBS) contribution. Excludes vitamins, minerals and Supplements
$500 per person
Up to $50 per script
2 months
For approved travel vaccines, supplied and administered in Australia prior to departure and for the purpose of overseas travel
$250 per person
Up to $50 per script
0 months
A top-up benefit to help pay for out-of-pocket costs for services on your Extras cover if your child has an accident at school.
Benefit applies where you are otherwise eligible to claim for the service, to cover additional out-of-pockets.
Claim must be accompanied by a communication from the school’ from ‘A top-up benefit to help pay for out-of-pocket costs for services on your Extras cover if your child has an accident at school.
$200 per child dependant
Up to $200 of the out-of-pocket costs
0 months
For medically necessary treatment requiring a minimum return trip of 200km or more.
Combined maximum of $300 per membership
80% of the cost
2 months
Top Extras cover cover
Claim up to $9,150 per person per calendar year
Extras covered
Covers selected services such as examinations, some x-rays, scale and clean, fluoride treatment and mouthguards.
Yearly limits (per person)
Benefits claimed as No Gap Dental do not count towards your yearly limit.
100% of the cost for selected services at our No Gap Dental Network
Waiting Periods
0 months
Covers selected services such as scale and clean, fluoride treatment and mouthguards.
Yearly limits (per person)
$1000 per person, $2000 per family
Set amounts per item
Waiting Periods
0 months
Covers most fillings and simple extractions
Yearly limits (per person)
$1000 per person, $2000 per family
Set amounts per item
Waiting Periods
0 months for selected diagnostic services
2 months
Yearly limits (per person)
$1000 per person, $2000 per family
Set amounts per item
Waiting Periods
12 months
A full denture replacement is limited to once every three years.
Yearly limits (per person)
$1000 per person, $2000 per family
Set amounts per item
Waiting Periods
12 months
A full denture replacement is limited to once every three years.
Yearly limits (per person)
$800 per person
Up to 100% of the cost per item
A lifetime maximum of $3,200 per person applies
Waiting Periods
12 months
For prescription glasses, contact lenses or repairs provided by a recognised optometrist in private practice. Excludes non-prescription sunglasses and contact lenses, and optical consultations.
Yearly limits (per person)
$300 per person, $600 per family
Up to 100% of the cost per item
Waiting Periods
6 months
Including sports physiotherapy and hydrotherapy.
Yearly limits (per person)
Combined maximum of $600 per person
$70 per consultation
Waiting Periods
2 months
Includes hydrotherapy
Yearly limits (per person)
Combined maximum of $600 per person
$70 per consultation
Waiting Periods
2 months
Yearly limits (per person)
Combined maximum of $400 per person
$50 per consultation
$50 for a chiropractic x-ray
Limit of one chiropractic x-ray per person
Waiting Periods
2 months
Yearly limits (per person)
Combined maximum of $400 per person
$50 per consultation
Waiting Periods
2 months
Yearly limits (per person)
Combined maximum of $400 per person
$50 per consultation
Waiting Periods
2 months
Yearly limits (per person)
Combined maximum of $400 per person
$50 per consultation
Waiting Periods
2 months
Excludes podiatric surgery
Yearly limits (per person)
Combined maximum of $400 per person
$50 per podiatric consultation
Up to 80% of the cost per item
Waiting Periods
2 months
When recommended by a podiatrist/orthotist or medical practitioner and supplied by an approved provider in a private practice.
Yearly limits (per person)
Combined maximum of $400 per person
$50 per podiatric consultation
Up to 80% of the cost per item
Waiting Periods
12 months
TENS Machines must be recommended by a physiotherapist or medical practitioner and supplied by an approved provider in private practice.
Yearly limits (per person)
Combined maximum of $500 per person
Up to 80% of the cost per item
Waiting Periods
12 months
Benefit for each item is payable every 2 calendar years
For hire or purchase of wheelchairs or crutches used in prevention or support post injury.
Yearly limits (per person)
Combined maximum of $500 per person
Up to 80% of the cost per item
Waiting Periods
2 months
Includes hearing aid appliance, replacement and repairs.
Benefit for each item is payable every 3 years (does not apply to repairs)
Yearly limits (per person)
$1,000 per person
Up to 80% of the cost per item
Waiting Periods
12 months for items
2 months for repairs
Benefit for each item is payable every 3 years (does not apply to repairs)
Yearly limits (per person)
$500 per person
$50 per consultation
Waiting Periods
2 months
Yearly limits (per person)
Combined maximum of $400 per person
$80 per consultation
Waiting Periods
2 months
Yearly limits (per person)
$600 per person
$100 per consultation
Waiting Periods
2 months
For non-prescription PBS pharmaceuticals only, after you pay a sum equal to the current Pharmaceutical Benefits Scheme (PBS) contribution. Excludes vitamins, minerals and Supplements
Yearly limits (per person)
$500 per person
Up to $50 per script
Waiting Periods
2 months
For approved travel vaccines, supplied and administered in Australia prior to departure and for the purpose of overseas travel
Yearly limits (per person)
$250 per person
Up to $50 per script
Waiting Periods
0 months
A top-up benefit to help pay for out-of-pocket costs for services on your Extras cover if your child has an accident at school.
Benefit applies where you are otherwise eligible to claim for the service, to cover additional out-of-pockets.
Claim must be accompanied by a communication from the school’ from ‘A top-up benefit to help pay for out-of-pocket costs for services on your Extras cover if your child has an accident at school.
Yearly limits (per person)
$200 per child dependant
Up to $200 of the out-of-pocket costs
Waiting Periods
0 months
For medically necessary treatment requiring a minimum return trip of 200km or more.
Yearly limits (per person)
Combined maximum of $300 per membership
80% of the cost
Waiting Periods
2 months
Value Hospital (Silver Plus) with $100 daily co-payment And Top Extras
From
$110.14*
$ after April 1
$110.14*
Minimum direct debit period
/ Fortnightly
30 day cooling off period
Join now with peace of mind
* Assumes a 4% discount for direct debit and 0% aged based discount. Any rebate and Lifetime Health Cover loading listed above has been factored into the price. Price includes cover for non-student dependants aged 23 and over.Price excludes cover for non-student dependants aged 23 and over.