Health Partners offers four different levels of hospital cover, and no excess for kids on family policies.
Health Partners is a members' health fund for South Australia, but it offers cover Australia-wide. They are a not-for-profit fund that offers four levels of health cover with various benefits, flexible excesses and scaling loyalty benefits for insulin pump and hearing device replacements after 3 years of continuous membership.
What hospital cover is available?
Health partners offer four different levels of cover, with different benefits and exclusions:
- Bronze hospital
- Silver hospital
- Silver plus hospital
- Gold hospital
|Feature||Bronze Hospital||Silver Hospital||Silver Plus Hospital||Gold Hospital|
|No excess for kids|
|Ambulance||Emergency only||Emergency only||Emergency and non-emergency||Emergency and non-emergency|
|Chemotherapy and radiotherapy|
|Tonsils, adenoids and grommets|
|Brain and nervous system|
|Hernia and appendix|
|Ear, nose and throat|
|Male reproductive system|
|Heart and vascular system|
|Back, neck and spine|
|PBS approved prescriptions|
|Pregnancy and birth|
|Assisted reproductive services|
Other benefits of Health Partners Hospital Cover
In addition to the benefits detailed above, Health Partners offer a number of services on their different policies for you to take advantage of:
- Rehab in the home. On all policies, Health Partners will provide a personalised rehabilitation program delivered by allied health professionals in your own home.
- Health coaching. On Silver and higher policies, Health Partners provides a telephone system to help support self-management of chronic diseases, mental health and complex health issues.
- Newborn Support Program. On Gold cover, Health Partners will give extra support and benefits concerning many aspects of managing a newborn from your child's birth to 8 weeks of age.
- No gap or known-gap doctors. If you go to a partnered doctor, you may have your gap payments reduced or eliminated.
- No waiting period for accident cover. If you suffer an accident more than a day after taking out cover, you will receive benefits for the treatment even if a waiting period normally applies.
How do the costs work?
Whenever you make a claim on your policy, you'll be required to pay the applicable excess. For Health Partners, this could be anywhere between $0 - 750 depending on what excess you nominate for your level of cover. Remember, a higher excess will lead to lower premiums, which you are able to pay weekly, fortnightly, monthly, quarterly or yearly.
Certain services may be restricted on certain policies, such as psychiatric or rehabilitation on Bronze cover. This means you won't be able to claim full benefits for them and will still have to pay out-of-pocket costs. If Medicare is applicable for any treatments, you will still be covered as a private patient in hospital.
Waiting periods and limitations
When taking out a new private health insurance policy, certain waiting periods apply before you can claim on particular treatments. The following waiting periods apply with Health Partners hospital cover:
- 2 months: For all other hospital services, including ambulance and rehabilitation services.
- 12 months: For initial insulin pump and hearing device implantation on Silver Plus and Gold, and on pregnancy and birth and assisted reproductive services on Gold.
- 36 months: For replacement hearing device implantation on Silver and higher, and for replacement insulin pump implantation on Silver Plus and Gold.
Other limitations you should be aware of include:
- Podiatric surgery. Benefits on Gold cover are limited to 85% of the podiatric surgeon's fees, up to a maximum of $350 for hospital procedures.
- Non-listed prostheses. You are covered for prostheses that aren't listed on the Commonwealth Prostheses List on Silver Plus and Gold tiers, but only up to a maximum of $1500 per person.
How to make a claim
Making a claim can be done in the following ways:
- If the provider uses HICAPS and Health Point, you can claim on-site using your membership card.
- You can use the free Health Partners app or login online at www.healthpartners.com.au. Upload a photo of the itemised account and your receipt to submit a claim.
- You can also claim by post or email, by sending in a completed claim form from the Health Partners website.