Interested in taking out health insurance? Compare Peoplecare policies and apply for cover.
Peoplecare is a not-for-profit health fund that offers a range of cover options to its members. Named by the Australian Financial Review's Smart Investor magazine as the number-one open health fund in Australia, Peoplecare prides itself on offering competitive cover solutions to its members.
Peoplecare Health Insurance Cover Options
- #1 open health fund in Australia – The Australian Financial Review's Smart Investor, Australia's ten best private health funds*
Entry to Peoplecare is non-restricted, so any Australian who is eligible to take out private health cover can join the fund. A not-for-profit fund, Peoplecare is run in the interests of its members and aims to pass on profits to its customers in the form of improved products and premium rates.
With an emphasis on customer service, Peoplecare has a 24-hour Online Member Services department ready to field any questions you may have. It can also provide national coverage, as it has agreements in place with 30,000 doctors and 500 private hospitals around the country.
Peoplecare Health Insurance Levels of Cover
Hospital cover options
- This entry-level hospital cover requires you to pay a $500 excess when you are admitted to hospital. It covers accommodation in a public or private hospital for things like intensive care, in-hospital pharmacy and some basic Medicare-eligible procedures.
- Also attracting a $500 excess, this mid-level cover combines a broader range of benefits with affordability. Including cover for sterilisation, plastic and reconstructive surgery, joint replacements, spinal procedures, gastric banding and more, it also includes restricted cover for assisted reproductive services, pregnancy services and major eye surgery.
- This is the highest level of hospital cover available from Peoplecare and it is available with your choice of excess: $0, $250 or $500. The higher the excess you choose, the lower your premiums will be. This policy covers an extensive range of in-hospital procedures including major eye surgery, intensive care, palliative care, psychiatric services, rehabilitation, pregnancy services, assisted reproduction services, cardiothoracic and related services, gastric banding, hip and knee replacements and much more.
These three hospital cover options can be taken out on their own or paired with one of the following extras cover options to create a combined policy.
Extras cover options
- This affordable option is suited to members who are young, healthy and fit. It covers 100% of ambulance costs, 50% of general dental costs, optical, physio, chiro and health management programs.
- For cover that is a little more comprehensive, Peoplecare Mid Extras covers ambulance expenses and 60% of both general and major dental costs. It also provides benefits for pharmacy, optical, physio, orthoptics, occupational therapy, chiro, natural therapies, remedial massage, podiatry and health management programs.
- This provides even more generous benefit limits than the above option and also adds cover for orthodontics, laser eye surgery, psychology, speech therapy, health aids, orthotics and hearing aids.
- Offering the maximum level of extras cover available from Peoplecare, Premium Extras offers higher benefit limits and cover for a comprehensive range of general treatments. This includes 80% cover for the cost of dental, major dental, orthodontics, laser eye surgery, exercise physiology, speech therapy, health management programs, health aids and a whole lot more.
Are there any additional benefits?
- Combine cover. Combine hospital and extras cover to receive a discount on the cost of taking out each cover separately.
- Eyewear discounts. Members can enjoy a range of discounts on eyewear purchased from Peoplecare Eyes. Further eyewear discounts are available through OPSM and Laubman & Pank.
- Members Own Health Fund. Peoplecare has joined forces with 14 other health funds under the Members Own Health Fund brand. Like these other funds, Peoplecare is run solely to benefit its members.
- Peoplecare Eyes and Teeth. Peoplecare also operates an optical and dental centre in Wollongong to offer a range of treatments and services to members.
General exclusions and waiting periods
Peoplecare will not pay your private health insurance claim if:
- It is for services received outside of Australia
- You lodge your claim more than two years after you have received the services
- You have already reached your annual benefit limit for a general treatment
- It is for treatment received within a waiting period
- It is for any treatment which Medicare doesn’t cover, such as cosmetic surgery that is not medically necessary
- It is for treatment that is covered by compensation payments or another form of insurance, such as third party insurance
- It is for services you receive as an outpatient
- It is for certain high-cost drugs
- It is for prostheses that aren’t on the Commonwealth Government’s list of approved prostheses
- It is for ambulance services paid for by the government, some other type of insurance or a subscription
- It is for discharge pharmaceuticals.
Peoplecare Health Insurance Excess
A private health insurance hospital excess is the amount you pay upfront when you are admitted to hospital, and it’s your contribution to the cost of your hospital accommodation. While Basic Hospital and Mid Hospital both require you to pay a $500 excess, Premium Hospital allows you to choose between a $0, $250 or $500 excess. The lower your excess, the higher your premiums will be.
However, you will not need to pay any excess for children under the age of 21 who are included on your policy, and you’ll only have to pay half the relevant excess for public hospital or day surgery visits.
In addition, no matter how many times anyone on your fund membership is admitted to hospital in any year, you’ll only have to pay the maximum annual excess as listed on your policy. For example, if you hold a single policy and your excess is $500, that is the maximum amount you pay every year. If you hold a couples or family policy, the maximum annual excess amount rises to $1,000.
How do I join?
Making a claim with Peoplecare is easy
Peoplecare aims to make the process of lodging a claim as easy as possible. If you incur hospital costs, in most cases the hospital will send the bill straight to your health fund. Peoplecare will then take care of the cost for you.
When it comes to medical claims, doctors should again send any claim straight through to Peoplecare, but if they don’t you will need to claim from Medicare first and Medicare will then forward your claim on to Peoplecare.
Finally, if you need to make an extras claim there are several options at your disposal:
- Electronic claiming. Swiping your Peoplecare membership card on the spot at most general treatment providers will see the benefits you are entitled to deducted from your bill.
- Use the Peoplecare app. Peoplecare’s claims app is available from the Apple App Store and the Google Play store.
- Claim online. Many extras claims can be lodged online through the Peoplecare website.
- Email. Complete a claim form, scan the form and your receipts and then email them back to your health fund.
- Post or fax. You can send your completed claim form and any receipts by mail or fax to Peoplecare.
Download the Peoplecare app