Peoplecare health insurance hospital cover review

Is Wollongong’s Peoplecare health fund right for you?

Peoplecare started in Wollongong, but offers hospital insurance to everyone around Australia. With a focus on simplicity and affordable policies, it might be worth considering.

Find out whether Peoplecare hospital cover is right for you.

finder.com.au does not currently have access to this health insurance brand. You may wish to compare options available on the health insurance homepage.

The hospital cover options

There are three levels of cover available.

  • Basic hospital
  • Mid hospital
  • Premium hospital

The following key will help you understand the different types of cover shown in the table below:

  • Covered in a private hospital
  • Covered as a private patient in a public hospital
  • Not covered. You may have to go with Medicare as a public patient in a public hospital.
Basic hospitalMid hospitalPremium hospital
Excess
  • $500
  • $500
  • Choice of $0, $250 or $500
Ambulance
  • Yes
  • Yes
  • Yes
Theatre fees
  • Yes
  • Yes
  • Yes
Cosmetic surgery
  • No
  • No
  • No
Pregnancy and birth related
  • No
  • Restricted
  • Yes
Assisted reproductive
  • No
  • Restricted
  • Yes
Palliative care
  • Restricted
  • Restricted
  • Yes
Rehabilitation
  • Restricted
  • Restricted
  • Yes
Psychiatry
  • Restricted
  • Restricted
  • Yes
Cardiac related services
  • No
  • Restricted
  • Yes
Major eye surgery
  • No
  • Restricted
  • Yes
Dialysis for chronic renal failure
  • No
  • Restricted
  • Yes
Sterilisation
  • No
  • Yes
  • Yes
Plastic and reconstructive surgery
  • No
  • Yes
  • Yes
Hip and knee replacements and related services
  • No
  • Restricted
  • Yes
Other joint replacements and related services
  • No
  • Yes
  • Yes
Spinal procedures and related services
  • No
  • Yes
  • Yes
Gastric banding and obesity-related services
  • No
  • Yes
  • Yes
Other Medicare eligible services
  • Yes
  • Yes
  • Yes
Cover for any non-Medicare services?
  • No
  • No
  • No

What are the benefits and features of the cover?

Peoplecare includes 100% unlimited ambulance cover for necessary transport in all its hospital policies. It also operates a medical gap scheme with participating doctors around Australia, to help keep costs down.

You can choose from a number of cover options, so consider what they have to offer and how they compare with other health funds.

Picking a policy

The four hospital options range from public hospital only cover, to comprehensive premium hospital cover. Each has some notable features:

  • Basic hospital: This gives you private hospital cover for all Medicare procedures not otherwise specified. The most notable of these is probably cancer treatment. Other than this, your cover is still relatively limited, and you will often need to go through Medicare as a public patient to avoid significant extra expenses.
  • Mid hospital: On the whole, this policy is very similar to basic hospital cover, but has a handful of additional specialised procedures. The main difference is that you can get certain joint replacements in private hospital, although you will still need to go through the public hospital waiting list for hip and knee replacements. Unlike other health funds, Peoplecare includes private hospital cover for gastric banding and reconstructive surgery under this mid-level cover.
  • Premium hospital: Full private hospital cover for all Medicare services, without any excluded treatments, and your choice of excess. This type of cover is typical for top hospital cover with almost all health funds, and may be a useful option if Peoplecare is more affordable than equivalent products by other health funds.

Limitations and waiting periods

Waiting periods apply as follows:

  • 12 months: Obstetrics and pre-existing conditions except palliative care, rehabilitation and psychiatric
  • 2 months: Everything else, including pre-existing palliative care, rehabilitation and psychiatric
  • None: Ambulance and accident cover

How to make claims

You will generally need to pay any relevant gap expenses and excess to the hospital, while Peoplecare will typically be in contact with the hospital or doctors to pay the other amounts directly.

If the doctor does not send the bill straight to Peoplecare, you may need to submit a two-way Medicare claim form to Peoplecare yourself.

How to pay premiums

You can pay premiums by automatic direct debit, as specified when you sign up, or you can log in to the online members area to pay premiums with a credit card.

Compare your health insurance options today

Picture: Shutterstock

Andrew Munro

Andrew writes for finder.com, comparing products, writing guides and looking for new ways to help people make smart decisions. He's a fan of insurance, business news and cryptocurrency.

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