StarterPak

StarterPak
Basic +

Your Cover

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* Based on an Australian Government Rebate of %, % LHC loading, $ excess for a in . Please note the amount quoted may vary after 1 April due to base price changes and rounding adjustment.

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StarterPak Basic +

Get off to a good start

StarterPak (Basic Plus) combines a big range of Hospital and Extras services – without a big price tag.

 

Hospital Cover

Legend

Covered
Not Covered
Restricted

Scope of cover

Additional Information
Services for which a Medicare benefit is not payable e.g. cosmetic surgery & laser eye surgery
Current

StarterPak Extras

Legend

More Information

Click on the service to learn more
Services
Benefit
Yearly Limits
Periodic oral examination (012) - limit of 2 services, per person/year
$40
Benefits
Yearly Limit
Yearly Limit

$500 per person, $1,000 per family.

Intraoral radiograph - per exposure (022)
$30
Benefits
Yearly Limit
Yearly Limit

$500 per person, $1,000 per family.

Removal of calculus (114) - limit of 2 services, per person/year
$70
Benefits
Yearly Limit
Yearly Limit

$500 per person, $1,000 per family.

Topical application of remineralising agent (121) - limit of 2 services per year
$25
Benefits
Yearly Limit
Yearly Limit

$500 per person, $1,000 per family.

Removal of tooth (311)
$90
Benefits
Yearly Limit
Yearly Limit

$500 per person, $1,000 per family.

Filling: 1 surface metallic (511)
$63
Benefits
Yearly Limit
Yearly Limit

$500 per person, $1,000 per family.

Filling: 3 surface metallic (513)
$109
Benefits
Yearly Limit
Yearly Limit

$500 per person, $1,000 per family.

Filling: 1 surface adhesive restoration (531)
$80
Benefits
Yearly Limit
Yearly Limit

$500 per person, $1,000 per family.

Filling: 3 surface adhesive restoration (533)
$115
Benefits
Yearly Limit
Yearly Limit

$500 per person, $1,000 per family.

Services
Benefit
Yearly Limits
Surgical removal of a tooth requiring bone removal (324)
$150
Benefits
Services
Benefit
Yearly Limits
Frames
$100
Benefits
Yearly Limit
Yearly Limit

$165 per person, $330 per family.

Single vision lens - pair
$95
Benefits
Yearly Limit
Yearly Limit

$165 per person, $330 per family.

Bifocal lens - pair
$95
Benefits
Yearly Limit
Yearly Limit

$165 per person, $330 per family.

Multifocal lens - pair
$95
Benefits
Yearly Limit
Yearly Limit

$165 per person, $330 per family.

Contact lenses - rigid or soft
$165
Benefits
Yearly Limit
Yearly Limit

$165 per person, $330 per family.

Contact lenses - disposable
$165
Benefits
Yearly Limit
Yearly Limit

$165 per person, $330 per family.

Services
Benefit
Yearly Limits
Chiropractic & Osteopathy - Visits 1-6
$40
Benefits
Yearly Limit
Yearly Limit

$400 per person / $800 per family. Sub-limits apply.

Chiropractic & Osteopathy - Visits 7+
$32
Benefits
Yearly Limit
Yearly Limit

$400 per person / $800 per family. Sub-limits apply.

Chiropractic & Osteopathy - group therapy
$20
Benefits
Yearly Limit
Yearly Limit

$400 per person / $800 per family. Sub-limits apply.

Physiotherapy - Visits 1-6
$40
Benefits
Yearly Limit
Yearly Limit

Combined limit - see Chiropractic.

Physiotherapy - Visits 7+
$32
Benefits
Yearly Limit
Yearly Limit

Combined limit - see Chiropractic.

$20
Benefits
Yearly Limit
Yearly Limit

Combined limit - see Chiropractic.

Exercise physiology – Visits 1-6
$40
Benefits
Yearly Limits
Yearly Limits

Combined limit - see Chiropractic.

Exercise physiology – Visits 7+
$32
Benefits
Yearly Limits
Yearly Limits

Combined limit - see Chiropractic.

Exercise physiology – group therapy
$20
Benefits
Yearly Limits
Yearly Limits

Combined limit - see Chiropractic.

Natural therapies (Remedial Massage, Acupuncture, Chinese herbal medicine consultations, Myotherapy)
$34
Benefits
Yearly Limit
Yearly Limit

$200 per person, $400 per family.

Benefits are for face-to-face consultation only. No benefits for remedies, medicines or food preparation.

Psychology assessment
$100
Benefits
Yearly Limits
Yearly Limits

$300 per person, $600 per family.
Sub-limits apply.

Psychology - initial consultation
$72
Benefits
Yearly Limits
Yearly Limits

$300 per person, $600 per family.
Sub-limits apply.

Psychology - subsequent consultation
$72
Benefits
Yearly Limits
Yearly Limits

$300 per person, $600 per family.
Sub-limits apply.

Services
Benefit
Yearly Limits
100%
Benefits
Yearly Limit
Yearly Limit

$150 per person, $300 per family. See more info on programs and claiming.

(Sub-limit of $30 for flu vaccine. See more info on how to claim.)

 

100%
Benefits
Yearly Limit
Yearly Limit

$150 per person, $300 per family. See more info on programs and claiming.

(Sub-limit of $30 for flu vaccine. See more info on how to claim.)

 

100%
Benefits
Yearly Limit
Yearly Limit

$150 per person, $300 per family. See more info on programs and claiming.

(Sub-limit of $30 for flu vaccine. See more info on how to claim.)

 

100%
Benefits
Yearly Limit
Yearly Limit

$150 per person, $300 per family. See more info on programs and claiming.

(Sub-limit of $30 for flu vaccine. See more info on how to claim.)

 

National Healthy Eating Activity and Lifestyle (HEAL) program
100%
Benefits
Yearly Limit
Yearly Limit

$150 per person, $300 per family. See more info on programs and claiming.

(Sub-limit of $30 for flu vaccine. See more info on how to claim.)

 

Flu vaccine (until 31 December 2023)
100%
Benefits
Yearly Limit
Yearly Limit

$150 per person, $300 per family. See more info on programs and claiming.

(Sub-limit of $30 for flu vaccine. See more info on how to claim.)

 

Services
Benefit
Yearly Limits
$60
Benefits
Yearly Limit
Yearly Limit

$400 per person, $800 per family.

Important info

Excess

You won’t need to pay an excess with StarterPak.

 

Restricted services

Here’s an overview of what we’ll pay for and what you’ll have to pay for if going to hospital for treatment for a service that’s restricted. Note that scheduling of treatment will be up to the treating specialist and/or hospital.

In a public hospital:

  • We pay – accommodation in a shared room (as long as the hospital doesn’t charge above the default rate set out by the Federal Government), and medical costs.
  • You pay – any excess (if applicable), and any gap if your hospital charges above the default rate.

In a private hospital:

  • We pay – accommodation in a shared room (at the default rate set out by the Federal Government), and medical costs.
  • You pay – any excess (if applicable) and the balance of accommodation costs, plus any theatre costs. This could be costly, so ensure the hospital provides you with the potential costs upfront.

You should make sure you have a breakdown of all out-of-pocket costs you’ll need to pay before agreeing to treatment. This is called informed financial consent.

Learn more about restricted services

 

Waiting periods

Like all health funds, waiting periods may apply when you take out your cover.

You may have to wait if:

  • You’re new to private health insurance
  • You increase your benefit limits or upgrade your cover to include things that weren’t covered before
  • You switch health funds and increase your cover to include things that weren’t covered before.
If you’ve cancelled your membership with another health fund, you’ll need to join us within 60 days to keep up your continuity of cover and not re-serve any applicable waiting periods.


Hospital waiting periods

Pre-existing conditions* 12 months
Psychiatric, rehabilitation and palliative care 2 months
All other hospital services 2 months
Emergency ambulance transport 1 day
Non-emergency ambulance transport 1 day

Services not recognised by Medicare

You won’t be covered for services that aren’t eligible for a Medicare benefit. This includes non-medically required treatments or services provided by and not limited to, dentists, podiatrists and, cosmetic or podiatric surgeons.

 

Extras waiting periods

Major Dental 12 months
Optical, healthy lifestyle 6 months
All other services 2 months

 

DIY dentistry

Please be aware you can claim for face-to-face dental consultations only. You can’t claim for home (DIY) dentistry – this includes teeth whitening kits, orthodontic aligners and occlusal splints. If unsure, contact us to find out whether a benefit is payable – we’re here to help.

Make sure you claim with a recognised provider

We can only pay benefits if you’ve taken up the service through a provider who’s recognised by Nurses & Midwives Health at the time. To find out if your provider’s one of them, just call us on 1300 344 000.