Bronze Plan Cover

Bronze Plan Cover

The "Bronze Plan" is an affordable level of cover that is tailored specifrically to the needs of the majority of young single people.

The cover combines a combination of benefits for the common hospital, medical, ancillary and Health Management services that young single people typically need from time to time.

The cover is designed to offer young single people an affordable and tailored level of cover.  However, to enable us to do this it is important to note this product does not offer cover (or provides minimal benefits) for a number of hosopital, medical and ancillary services that the majority of young single people typically do not need (e.g. heart surgery, joint replacements, obstetrics, crown and bridgework, dental treatment etc).

IMPORTANT: It is very important that you read the following information closely as it contains important information about about what is and is not covered under the Bronze Plan.  If you have any questions please do not hesitate to contact the fund on FREECALL:  1800 808 690 during business hours or send us an email (info@peoplecare.com.au).

Prices

The following premiums are applicable from 1 April 2008. The premiums displayed are after the Federal Government’s 30% Rebate on private health insurance has been deducted and assumes that you do not have a Lifetime Health Cover loading.

Please note:

• Fortnightly, Quarterly, Half-Yearly and Yearly rates are also available. No discounts apply for different payment frequencies.
• Membership Contribution Payments can only be made by Direct Debit  from a nominated Bank, Building Society or Credit Union Account.
• Claim Benefit Payments must also be made to a nominated Bank, Building Society or Credit Union Account.

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Bronze Hospital Cover

Bronze Hospital Cover provides Private and Public hospital and medical coverage for the majority of services required by young single people.

IMPORTANT: However MINIMAL Private Hospital coverage is provided for services described below as "Restricted Services". If you select this level of cover and you are admitted to a Private Hospital requiring one of these "Restricted Services" you will have a large out of pocket expense.

All other services that are eligible for Medicare Benefits are defined as "Non-Restricted Services" and accordingly are eligible for Public and Private Hospital cover as defined below.

Hospital Cover - Non-Restricted Services

Our Bronze Hospital cover for Non-Restricted Services provides:

• 100% cover for Non-Restricted private and public hospital services nationwide (after the up front excess has been paid) with access to an extensive range of quality services and approved programs in contracted private hospitals. The fund has agreements with the vast majority of private hospitals in all States and Territories of Australia. Our hospital agreements total more than 500 Australia wide and you can search our agreement hospitals schedule here.
• The services listed in the table above are applicable in all private hospitals that have entered into an agreement with Peoplecare. There are a small number of private hospitals that do not have agreements with the fund. In these cases a limited personal payment may apply.
• Apart from the services clearly outlined above as "Restricted Services" we do not have any treatment exclusions on services eligible for Medicare benefits.

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.

Excess

If you are admitted to a private or public hospital you will pay an up front excess of hospital costs until you have reached your excess maximum of $500 within a financial year (1st July through to 30th June).

The excess is applied as follows:

1. The full $500 excess is payable on the first overnight admission to a Private Hospital, and
2. A $250 up front excess is payable on overnight admissions to a Public Hospital and any Day Surgery Admissions (Private or Public Hospital).
   

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Bronze Extras Cover

The Bronze Plan provides Extras cover for the common services that young single people typically need from time to time:

Please note:

1. Financial Year is 1 July to 30 June and waiting periods may apply.
2. No benefits are payable by the fund when:

• A member is given treatment without charge.
• The services received are not recognised by the fund and are not provided by providers registered with the fund.
• The services are provided outside the Commonwealth of Australia (excludes members overseas for more than 12 months).
• An entitlement exists or may exist under any compensation, third party or sports club insurance.
• A claim for a service is submitted more than 24 months after the date of service.
• A claim is submitted for optical appliances not requiring sight correction.
• The claim benefit is less than $5, although this can be accumulated with other claims.
• Services are provided by family members or relatives.
• The claim is for goods and services that are deemed to be primarily for the purposes of sport, recreation or entertainment.

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Health Management Program

Benefit conditions of the Health Management Program:

• Benefits may be paid at 80% of eligible cost to a maximum benefit of $100 per single member and $200 per family membership each financial year (for services received in that year).  The financial year is 1 July to 30 June.
• We are not permitted under the National Health Act to pay benefits for goods or services that are deemed to be primarily for the purposes of sport, recreation or entertainment.
• We are however permitted to provide benefits for approved health management programs where members are in receipt of services that are intended to prevent or improve a specific health condition.  This may include situations such as rehabilitation following surgery for example joint replacement, cardiac procedures or illnesses such as asthma and diabetes.
• Where these circumstances apply and the specific program is endorsed by a health professional we will continue to provide benefits under the Health Management Program to assist in the recovery or health maintenance for the member.  To enable us to pay benefits in these circumstances we will have to receive a report from the relevant health professional that recommends the health management program.

What We Will Pay For:

• Approved health management programs where members are in receipt of services that are intended to prevent or improve a specific health condition.
• Health Management improvement programs such as stress management, quit smoking, weight control, first aid courses and kits.
• Health screening services such as blood pressure testing, cholesterol checks, mammograms, hearing test.

What We Will Not Pay For:

• Sports club membership such as gym, tennis, golf, swimming lessons and sporting equipment for recreational or general fitness purposes.
• Footwear, clothing or any other goods and services that are primarily for the purposes of sport, recreation or entertainment.
• Services where a Medicare benefit is payable.
• Health screening services such as medical examinations for employment, insurance, or for other similar purposes.

Please note:

• The list of benefit items may be modified from time to time, depending on community standards.
• The claim for benefits is to be submitted with a tax invoice and/or a receipt that includes the Australian Business Number (ABN) of the provider of the service.
• 6 month waiting period applies.

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.

Waiting Periods

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, but,

• Members transferring from another fund that have used all or part of their annual limits with this other fund will only receive the difference between Peoplecare’s limit and the amount already claimed from the other fund in the first year of membership, and
• Members transferring from another fund that have lower limits than Peoplecare must serve the waiting periods listed above before they can claim more than the former fund’s limit.
• Members transferring from another fund will not be entitled to continuity for any Health Management benefits ie the normal 6 months waiting period must be served before any Peoplecare benefits are payable.

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Dependants

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

• 21 years, whether or not they are working full time. However they must not be married or living in a de-facto relationship,
  or
• 25 years if they are full time students and documentation confirming this is provided to Peoplecare annually. However they must not be married or living in a de-facto relationship.
• Once dependants 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.
  

    Benefits of membership with Peoplecare

        More details available at our website www.peoplecare.com.au or by calling us on 1800 808 690

• Online member services at our website www.peoplecare.com.au

• Electronic "eftpos style" claiming at more than 20,000 dentists, physiotherapists, optical dispensers, chiropractors, osteopaths and podiatrists Australia wide.
• Discounted Travel Insurance.

     Privacy Statement

Peoplecare respects your privacy and is committed to keeping your personal information safe through compliance with the Privacy Act and the National Privacy Principles.

Peoplecare only collects information that is necessary to assist the fund in providing its services. We do not collect personal information unless we first ask the member or individual for it.

Peoplecare exercises great care to protect the personal information that is held.

If you wish to obtain additional information regarding our Privacy Policy please contact the fund Privacy Officer on 1800 808 690 or refer to our website www.peoplecare.com.au

     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.

     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.

     How do I join?

To take the Bronze Plan level of cover you can either:

1. Click here to join Peoplecare online at our website www.peoplecare.com.au

or

2.  Join via Fax or Mail:

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Bronze Plan Authorisation Form

I have read the information on the Bronze Plan "Restricted Services" and I understand that MINIMAL Private Hospital coverage is provided for the services listed under this category.

I understand if I am admitted to a Private Hospital requiring one of these "Restricted Services" I will have a very large out of pocket expense and have ticked each restricted service category listed below to confirm I agree with these conditions.

Signature:
Date:

Click here to download an application form ,
or
Click here to join Peoplecare

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If you have any questions please call us on FREECALL: 1800 808 690 during business hours or send us an e-mail ( info@peoplecare.com.au )