Public Hospital Cover

effective as at 1 April 2010

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Please Note: This document should be read carefully and retained for future reference.

Prices	Public Hospital Cover
Waiting Periods	Dependents
Change your Level of Cover

Public Hospital Cover

Public Hospital covers your choice of doctor and admission to a public hospital as a private patient only.

Prices

The following premiums are applicable from 1 April 2010. The premiums displayed are after deducting the Federal Government’s 30% Rebate on private health insurance.

Pay Frequency	Single	Single Parent Family	Couple / Family
Weekly	$11.75	$17.68	$23.55
Monthly	$51.07	$76.65	$102.18

Please note:

Fortnightly, Quarterly, Half-Yearly and Yearly rates are available upon request. No discounts apply for different payment frequencies.
Payment can be made by Direct Debit or Payroll Deduction (if we have a payroll deduction arrangement established with your employer).

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Public Hospital Cover

Public Hospital provides public hospital coverage, Australia wide:

Public Hospital Cover
Service	Public Hospital	Private Hospital
Public Hospital Bed	Yes	N/A
Private Hospital Bed - Shared or Private Room	N/A	Restricted Benefit
Choice of Doctor	Yes	Yes
Same Day Patient	Yes	Restricted Benefit
Co-Payments	No	No
Theatre Fees	Yes	No
Intensive Care	Yes	No
Surgical Prosthesis	Yes	Yes
Treatments that have Restricted Benefits	Services not Covered by Medicare	All Services
In-hospital psychiatric treatment	Yes	Restricted Benefit
In-hospital rehabilitation treatment	Yes
Cardio-thoracic surgery (Heart surgery)	Yes
Major Eye Surgery	Yes
Hip and knee joint replacement	Yes
Obstetrics Related Services	Yes
Assisted reproductive services	Yes
Plastic and reconstructive surgery (excludes cosmetic)	Yes
Access Gap Cover	Yes	Yes
Dependents covered to 21 years (or 25 years if full time student)	Yes	Yes
Ambulance	Yes	Yes
Waiting Periods
Standard Waiting Periods	Yes
Instant Coverage if Transferring from another fund with identical cover (see explanation below)	Yes
Exemption from 1% Medicare Levy Surcharge	Yes

Access Gap Cover

Peoplecare has "Access Gap" arrangements with over 20,000 Doctor's Australia wide.
These arrangements maximise the financial benefits for our member's in-hospital medical bills. The ultimate aim is to minimise or eliminate member's out of pocket expenses when our members' are treated as hospital in-patients.
We understand that being admitted to hospital can be a very stressful and uncomfortable experience and we are working very hard to minimise or eliminate the financial impact of this experience.
What is great about these "Access Gap" arrangements is that YOU will have either no out-of-pocket expenses to pay or will know exactly how much you will have to pay before treatment begins, AND be unlikely to have to lodge a claim for benefits as your doctor can bill Peoplecare direct, making it even easier for you.
Search here for a specialist that has a No / Known Gap arrangement with Peoplecare .
Peoplecare is unable to provide details of all Doctor's that we have "Access Gap" arrangements with via this search facility as some doctors have requested not to be publicly listed. If the doctor you are looking for is not listed, please give us a call on 1800 808 690 during business hours or send us an email .

Ambulance Cover

What We Will Cover:

100% reimbursement of the cost of service, irrespective of distance travelled within the Commonwealth of Australia.
There is no annual $ claim limit on these ambulance services and there is no waiting period.

What We Will Not Pay for:

Ambulance subscription or state based ambulance levies.
Ambulance costs that are covered under government legislation or other compensable sources.

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Waiting Periods

Months	Claim Category
NIL	Ambulance
NIL	Accidents
NIL	Transfers from other funds or parent’s membership for equivalent level of cover and if currently financial with the other fund.
2	Rehabilitation and Psychiatric Services
2	On joining the fund or upgrading tables.
12	For services relating to an obstetrics condition
12	In respect of an ailment , condition or illness, the signs or symptoms of which, existed at anytime during the six months preceding the day of joining or upgrading tables. For more details please download our Pre-Existing Ailment information brochure (91 KB)

Please note: If a person is transferring over to Peoplecare from another fund with an equivalent or higher level of cover, is financial and waiting periods from the previous fund have been served, waiting periods will be waived.

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Dependents

Children / dependents are covered as dependents on a family membership to age :

21 years, whether they are working full time or not. However they must not be married or living in a de-facto relationship,
or
25 years if they are full time students and documentation is provide annually confirming this. However they must not be married or living in a de-facto relationship.
Once dependents cease to be covered under the family membership they are then entitled and strongly encouraged to take their own membership with us and continue to enjoy the exceptional benefits, competitive rates and first class service that we offer.

Complaints

If you have a complaint about Peoplecare please contact the fund on 1800 808 690 and ask to speak to the Complaints Officer. If your complaint is not resolved you are entitled to seek the services of the Private Health Insurance Ombudsman (PHIO). PHIO provides free independent services to private health insurance fund members. PHIO (www.phio.org.au) can be contacted on 1800 640 695 and they are located at Level 7, 362 Kent Street, SYDNEY, NSW 2000.

Cooling off Period

We are committed to ensuring that you choose the health cover that is right for you. If for any reason you decide that your choice was not suitable then we will provide a refund of your premiums (provided no claims have been made). You will need to contact us within the first 30 days of joining the fund or changing your level of cover for this 'cooling off period' to be available.