Peoplecare extras cover can help with the cost of certain health programs, equipment and screening services.
What does that mean? It means that if your doctor or other registered healthcare professional diagnoses you with a condition that needs things like gym equipment to treat it, you might be able to claim back some of the costs with us.
Important: to claim fitness equipment and exercise program benefits, you’ll need to fill out a Declaration of condition form to let us know what condition is being treated.
Swimming Lessons
From 1 July 2025 the following changes have been made.
Swimming lessons criteria has been expanded to include any diagnosed condition in line with general treatment definition. You may be able to claim for swimming lessons run by swim schools that are AUSTSWIM or Swim Australia accredited swim centres. A Declaration of Condition Form is required to be completed by the member (in conjunction with their treating practitioner) to let the Fund know what condition is being treated. Please note that squad training isn’t covered.
You can search AUSTSWIM or Swim Australia to confirm all qualified Swimming Schools, Instructors or Centres.
Benefits are available for conditions or risk factors like:
- Coronary artery disease
- Joint health (arthritis & osteoporosis)
- Diabetes
- Mental health (stress & anxiety)
- Lung conditions (asthma, COPD)
- Weight management (obesity or malnutrition)
- Chronic pain (back pain)
- High blood pressure
- High blood cholesterol
- High blood glucose
- Poor diet
- Overweight
- Stress
- Smoking
These are just some examples, there are plenty of other conditions that you can claim health management benefits for. If you’d like more information give us a call.
What falls under Health Management?
- Fitness equipment
- Fitness programs
- Improvement programs
- Weight management programs
- Parent and baby program
- Health screening
| Fitness equipment & programs | |
|---|---|
|
We can only pay benefits for fitness programs and equipment if it's part of a health management plan/program from your GP or other healthcare professional. To claim these benefits, you'll need to fill in a Declaration of condition form. Things that might be covered:
To find out if a program you’re doing is eligible for benefits, call us on 1800 808 690. |
What you need:
|
Please note: pregnancy isn’t considered a medical condition. For more information, download our Having a baby fact sheet.
| Improvement & weight management programs | |
|---|---|
|
Improvement programs:
Approved weight loss program providers:*
To find out if a program you’re doing is eligible for benefits, call us on 1800 808 690. *These providers are correct as of September 2023 and are subject to change without notice. Please give us a call if you would like to know more. |
What you need:
|
| Parenting and baby programs | |
|---|---|
|
Parenting and baby programs:
|
What you need:
|
| Health screening | |
|---|---|
Any of the above tests must be requested by a medical professional and not claimable through Medicare. For more information on services that are eligible for benefits, call us on 1800 808 690. |
What you need:
|
You need to have extras cover and have served your 6-month waits to use these benefits. We pay benefits for approved programs to manage or treat a specific health condition. Under the Private Health Insurance Act, we can’t pay benefits for goods and services that are for the purposes of sport, recreation or entertainment (such as gym sports shoes).
The benefits
| Product | Benefit | Limit (reset every financial year) |
|---|---|---|
| Premium Extras | 80% of the cost | $250 (per person) max $500 (per family) |
| High Extras | 70% of the cost |
$200 (per person) |
| Flex Up Extras | 60% of the cost | $150 sub-limit |
| Mid Extras | 60% of the cost | $150 (per person) max $300 (per family) |
| Flex Essentials Extras | NA | NA |
| Simple Extras | 50% of the cost | $100 (per person) max $200 (per family) |
| Comprehensive Extras^ | 100% of the cost | $150 (single cover) $300 (all other covers) |
| Value Extras^ | 100% of the cost | $125 (single cover) $250 (all other covers) |
| Standard Extras^ | 100% of the cost | $100 (single cover) $200 (all other covers) |
The Nourish Baby program attracts a benefit of 100% of the $90 cost up to the per person limit on all of the above Peoplecare extras covers when in combination with a hospital cover.
^ Please note that Comprehensive, Value and Standard Extras are closed to new members.
