Need health insurance? Compare your options from Health Partners and get covered.
Private health insurance is all about peace of mind. Not only does private health cover give you the peace of mind that comes with knowing you will be able to access medical treatment whenever you need it, but it also gives you the freedom to choose your treating doctor and hospital.
Health Partners is a Members Own Health Fund that offers value-for-money cover backed by friendly customer service. It offers a wide range of hospital cover, extras cover and package cover options to suit many different health insurance needs.
Health Partners options and levels of cover
- Bronze Hospital. This entry-level hospital cover option provides cover for a number of essential treatments and services. But it does exclude high-cost procedures and services, for example pregnancy and joint replacements. It is designed for people who are young and healthy and only need minimal cover. Bronze Hospital cover includes cardiac procedures, treatment for accidents, joint reconstructions, pharmaceuticals, tonsil and appendix removal and wisdom teeth removal.
- Silver Hospital. Designed to offer mid-level hospital cover, this standalone policy option provides an extensive range of services and benefits. It covers accident treatment, cardiac procedures, psychiatric services, rehabilitation, pregnancy and birth-related procedures, assisted reproductive services, home nursing, and emergency and non-emergency ambulance transport. Silver Hospital also provides a choice of excess payment amounts to help you reduce your premiums.
- Gold Hospital. This is Health Partners’ top-level hospital cover option and is designed to provide complete peace of mind. It covers everything from pregnancy and psychiatric services to dialysis, health management programs and even home sleep studies. This policy does not exclude any procedures or services for which a Medicare benefit applies.
|What's covered||Gold Hospital||Silver Hospital||Bronze Hospital|
|Psychiatric services||Yes||Yes||Restricted benefit|
|Rehabilitation services||Yes||Yes||Restricted benefit|
|Accident-related treatment after joining||Yes||Yes||Yes|
|Pharmaceuticals related to admission (PBS approved)||Yes||Yes||Yes|
|No exclusions on Medicare-recognised procedures||Yes||Yes||No|
|Pregnancy and birth-related procedures||Yes||Yes||No|
|Assisted reproductive services (e.g. IVF)||Yes||Yes||No|
|Dialysis for chronic kidney failure||Yes||Yes||No|
|Surgical weight loss procedures||Yes||Yes||No|
|Removal of tonsils, adenoids||Yes||Yes||Yes|
|Removal of appendix||Yes||Yes||Yes|
|Removal of wisdom teeth||Yes||Yes||Yes|
|Non-surgical prostheses and recovery aids||Yes||Yes||Yes|
|Health management programs||Yes||Yes||Yes|
|Home health partner||Yes||Yes||Yes|
|Newborn support program||Yes||Yes||No|
|Home sleep studies||Yes||No||No|
|Chronic condition management||Yes||Yes||No|
- Bronze Extras. Bronze Extras is Health Partner’s entry-level option for general treatment cover. It provides cover for the cost of general dental, optical, physio and pharmacy, as well as full cover for emergency and non-emergency ambulance services.
- Silver Extras. This mid-level extras cover option provides generous benefit limits on the most commonly claimed extras services. In addition to cover for general and major dental, orthodontic, optical, pharmacy and physio, it also covers acupuncture, naturopathy, chiro/osteo, exercise physiology, podiatry, full ambulance and health management programs.
- Gold Extras. This is the ultimate level of extras cover available from Health Partners. It covers a broad range of general treatments and services. As well as generous benefit limits for dental, orthodontic, optical, physio, chiro/osteo and pharmacy, it also covers pilates, acupuncture, exercise physiology, orthotics, dietetics, psychology, remedial massage, occupational therapy and a whole lot more.
|What's covered||Gold Extras||Silver Extras||Bronze Extras||Waiting period|
|General dental||Yes||Yes||Yes||2 months|
|Major dental||Yes||Yes||Yes||12 months|
|Emergency ambulance||Yes||Yes||Yes||2 months|
|Non-emergency ambulance||Yes||Yes||Yes||2 months|
|Health management (e.g. gym and fitness)||Yes||Yes||No||2 months|
|Exercise physiology||Yes||Yes||No||2 months|
|Speech therapy||Yes||No||No||2 months|
|Eye therapy||Yes||No||No||2 months|
|Occupational therapy||Yes||No||No||2 months|
|Apparatus (e.g. hearing aids, sleep apnoea machine)||Yes||No||No||12 months|
|15 natural therapies (including massage)||Yes||Yes||Yes||2 months|
- Single Starter. Designed for members who are young and healthy and don’t require a high level of cover, Couples Choice combines a basic level of hospital and extras cover. It covers hospital accommodation, theatre and intensive care fees, PBS prescriptions and surgically implanted prostheses to help with the cost of a wide range of treatments and procedures. But services such as pregnancy and dialysis are excluded from cover. An essential level of extras cover is also provided to help keep optical, dental and physio costs down.
- Couples Choice. This package provides a basic level of hospital and extras cover and is designed to meet the insurance needs of couples. It covers a wide range of Medicare-recognised procedures when you are admitted to hospital. Pregnancy, dialysis and a number of other services are excluded or restricted. Extras benefits are available for treatments such as general and major dental, optical, pharmacy, physio, chiro and emergency ambulance.
- Family Essentials. This package is designed to help you provide an adequate level of hospital and extras insurance for the whole family. It covers a broad range of Medicare-recognised hospital procedures but excludes some, such as eye surgery. It also has restricted pregnancy and joint replacements benefits. Extras cover includes the essentials like dental, optical, physio and pharmacy, while services such as dental check-ups, prescription glasses and physio consultations are provided gap-free.
- Prime Living. This package provides comprehensive hospital and extras cover for singles and couples who want the highest level of insurance, but who aren’t looking to start a family. It covers an extensive range of Medicare-recognised hospital procedures, full ambulance services, and provides benefits for services like laser eye surgery. It also provides benefits of up to 100 per cent for dental, optical and physio services.
General exclusions, waiting periods and excesses
Restrictions of cover
Your Health Partners hospital cover claim will not be paid if:
- It is for a non-Medicare recognised procedure
- It is for outpatient services
- It is for services at an unregistered day facility
- It is for emergency department facility fees
- It is for a service specifically excluded from your chosen cover, for example pregnancy
There are also certain circumstances when an extras benefit is not payable, such as if:
- The treatment is not covered by your chosen extras cover
- The service is received from a provider not recognised by Health Partners
- You’ve reached your benefit limits
- You have not served a waiting period
- Your premium payments are not up to date
The following waiting periods apply to Health Partners hospital cover benefits:
- 12 months. Pre-existing conditions, pregnancy and birth-related services, home nursing, home sleep studies
- 2 months. All other services
Separate waiting periods also apply to extras cover:
- 12 months. Major dental, orthodontics, apparatus
- 3 years. Laser eye surgery
- 2 months. All other services
- Bronze Hospital features a $500 excess when you are hospitalised. It also requires you to make a daily co-payment of $50 for a maximum of five days per year.
- Silver Hospital Cover is available in two forms. Silver Hospital 250 features an excess of $250 and a daily co-payment of $50, while Silver Hospital 500 features a $500 excess and a $50 co-payment.
- Neither Gold Hospital or Gold Hospital 50 requires you to pay an excess when hospitalised, but the latter requires a daily co-payment of $50 for a maximum of five days per year.
In terms of package covers, the following excesses and co-payments apply when you are hospitalised:
- Single Starter. A $500 excess
- Couples Choice. A $300 excess
- Family Essentials. A $300 excess, but no excess is payable for children
- Prime Living. No excess or co-payment required
Are there any additional benefits?
- Dental and optical centres. Health Partners operates its own network of dental and optical centres, providing exclusive benefits and discounts to health fund members.
- Pharmacy network. Health Partners has a statewide network of 50 South Australian pharmacies, where health fund members can access unique benefits and discounts for no extra cost.
- Itsmygoal.com.au. This free online health management tool helps members set, track and achieve their health and fitness goals.
- Health Risk Assessment. Available to members who hold package cover or Gold or Silver Extras, this online tool allows you to evaluate your current health status and work out how you can improve your health.
- Home Health Partner. Available to all Health Partners members with package cover or standalone hospital cover, this program makes it easier to transfer from hospital to home.
- Newborn Support Program. This program gives members access to their very own midwife to provide advice on the health of you and your baby.
- Travel insurance. Health Partners also offers travel insurance policies to members through Allianz Global Assistance.
- Special member offers. Health Partners members can also take advantage of discounts at a range of partner businesses, including savings on everything from pharmacy products and sunglasses to sporting goods and camping supplies.
Does Health Partners offer a loyalty benefit?
Health Partners members can take advantage of the following discounts at participating partner businesses:
- 20%pharmacy discount. Available at participating pharmacies for most non-prescription items.
- 20% oral health discount. This discount is available at all Health Partners Dental Centres.
- Sunglasses discount. All members receive a minimum 30% discount at all Health Partners Optical Centres.
- $12 movie tickets. Discounted movie tickets are available at any Wallis cinema.
Members who take out the Couples Choice package option can also take advantage of the Pregnancy Loyalty Reward. While this package excludes pregnancy and birth-related services from cover, after two years of having cover in place, members can transfer to a policy that does cover pregnancy and avoid the usual 12-month waiting period.
What amount of cover do Health Partners pay?
As a policy holder, the dollar amount you can expect from Health Partners change depending on what condition or treatment you claim for. The Australian Medical Association publishes an annual report card, which is displayed below, where you can view a wide range of commonly claimed medical services and see what Health Partners and Medicare (MBS) pay.
Due to Health Partners being a member of the Australian Health Services Alliance (AHSA) they are listed under their name. More information about the AHSA can be found at the bottom of the table:
|Basal Cell Carcinoma or Squamous Cell Carcinoma removal from nose, eyelid, lip, ear, digit or genitalia||$221.35||$366.10|
|Breast, benign lesion surgical biopsy of excision||$260.05||$356.40|
|Carpal Tunnel Release||$276.80||$440.20|
|Complicated Delivery (of baby)||$1,629.35||$1,855.90|
|Coronary Artery Bypass||$2,200.00||$3,783.30|
|Femoral on Inguinal Hernia||$464.50||$909.70|
|Overnight investigation for sleep apnoea||$588.00||$682.20|
|Tonsils or Tonsils and Adenoid||$295.70||$513.90|
|Uncomplicated Delivery (of baby)||$693.95||$1,484.50|
I recognise most of these funds except for the AHSA, what is that?
The funds represented by the ASHA are:
- ACA Health Benefits Fund
- Australian Unity Health Limited
- CBHS Health Fund Limited
- CUA Health Limited
- Defence Health
- GMF Health
- Budget Direct Health Insurance
- Frank Health Insurance
- GU Health
- HBF Health Ltd
- Health Care Insurance Limited
- Health Insurance Fund of Australia Limited
- Health Partners
- Navy Health
- Peoplecare Health Insurance
- Phoenix Health Fund
- Police Health Limited
- Queensland Country Health Fund Limited
- Reserve Bank Health Society Ltd
- rt health fund
- Teachers Health Fund > UniHealth Insurance
- Teachers Union Health
- The Doctors' Health Fund Pty Ltd
- Transport Health
How do you make a claim?
There are several options available when you need to make a Health Partners health cover claim. These include:
- The Health Partners App. You can download the free app to your smartphone, register your details and submit a photo of your itemised account. Most benefits are paid within two days.
- Claim form. Claim forms are available to download from the Health Partners website and from Health Partners centres. Completed forms and itemised accounts can then be mailed to the health fund.
- On the spot. You can claim when you visit a HICAPS provider or Health Partners professional by presenting your Health Partners membership card.
Claims are payable by cheque or direct credit.
Still have questions about Health Partners?
Can I claim for visits to my GP?
- No. Visits to your GP are covered by Medicare, not by private health insurance.
How long do I have to claim a benefit?
- You must claim a benefit within two years of receiving a service.
Does Health Partners cover natural therapies?
- Yes. Natural Plus Cover, which is available with all levels of extras cover, provides benefits for 15 natural therapies.
I have Gold Hospital cover – will I need to pay an excess when hospitalised?
- No. There is no excess payable on this policy, but Gold Hospital 50 does require you to make a $50 co-payment when hospitalised, up to a maximum of 5 days per year.
How can I join Health Partners?
- Choose one of the following options:
- Apply online at the Health Partners website
- Download an application form and mail or fax it to the health fund
- Complete the application form in the Health Partners brochure
- Join over the phone
How do I add a dependant to my membership?
- You can add a spouse/partner or child dependant to your membership by downloading a membership application form, or phoning the health fund and requesting a form. The completed form can then be mailed or faxed to Health Partners.