What is hospital and extras cover?
Hospital insurance is used for admissions to hospital as a private patient and extras insurance is cover for non-hospital treatments such as dental, optical, physio and other complementary therapies.
Combined cover is when you take out both hospital and extras insurance together.
How does hospital and extras cover work?
When you take out a hospital and extras policy, you’ll be provided with a cover description which outlines all the services you’re covered for. You can get this on the Peoplecare mobile app or Online Member Services at any time. It’s always best to check what you’re covered for before undergoing treatment if you’re unsure. Call us and we’ll talk you through it.
Learn about a whole range of extras benefits.
1. Swipe your card - claim instantly
EFTPOS-style claiming is easy. Swipe your membership card and your claim is paid. On-the-spot claiming, called HICAPS, is available at most health providers like dentists, optometrists, physios, chiros and more. You just pay the difference between their fee and your fund benefit – all processed instantly.
2. Claim through digital member services
Download the Peoplecare mobile app or use Online Member Services to upload a photo or pdf of your receipts and invoices.
3. Email us
Just scan your completed claim form with your receipts and email us at info@peoplecare.com.au.
4. Post
Send your claim to us along with a claim form by post, addressed to Peoplecare, Locked Bag 33, Wollongong NSW 2500.
Read our going to hospital guide to learn about making a hospital claim. There are two types of bills:
1. Medical
2. Hospital
Annual limits
These are the most we’ll pay in a financial year for a specific extras service. Our annual limits refresh on 1 July each year. Check your extras limits at any time via Online Member Services or in our mobile app.
Waiting periods
Waiting periods apply to hospital and extras services and states how long you have to hold your cover before you can make a claim. Each hospital and extras service has different waiting periods. Refer to your Cover Description or call us for more detail.
We pay benefits for diagnostic health screening services such as blood pressure testing, cholesterol checks, mammograms and hearing tests which can be claimed if Medicare don’t pay a benefit. Health Management Benefits are available on all of our extras covers.
Our hospital cover advantages
- Less waiting for elective surgery. Get into private hospital for surgery as soon as your doctor is ready^
- Choose your own doctor
- Access Australia-wide coverage at more than 540 hospitals with 37,000 medical specialists
- No excess for kids under 21 on a family hospital cover if they go to hospital
- Avoid Lifetime Health Cover loading
- Receive a government rebate to reduce your premiums (also applies to extras cover – see the income tiers for eligibility)
- Avoid paying the Medicare Levy Surcharge. The Medicare Levy Surcharge is an extra tax to pay for people who don’t have hospital cover and earn over certain income thresholds.
^You’ll need to have served your waiting periods and have inclusions on your cover for your surgery.
Expenses hospital cover can pay:
- Hospital accommodation (100% if the treatment is included on your cover)
- Theatre fees (100% if the treatment is included on your cover)
- In-hospital medicine (100% of PBS listed medications if the treatment is included on your cover)
- Doctor’s fees. Peoplecare pays a minimum of 25% on each Medicare Benefit Schedule fee if the treatment is included on your cover (we pay more if your doctor uses our Access Gap scheme) and Medicare pays 75%. Learn more about Access Gap.
Which hospital and extras cover should I choose?
Below we have some popular combinations to suit each life stage.
| Life stage |
|
|---|---|
|
Young, fit & healthy You only want cover for services you need and don’t want to pay for services you don’t expect to use. You need cover suited to your lifestyle and budget. |
Basic Plus Hospital ($750 excess) or Bronze Plus Hospital ($750 excess) & Simple Extras |
|
You & your partner You have a partner, have settled down and are planning for the future. You want to get ahead & take care of your health. You need a well-priced cover that gives you more benefits and still lets you save for your future. |
Bronze Plus Hospital ($500 or $750) or Silver Hospital ($750 excess) & Mid Extras |
|
Planning a family You’re planning on having kids as a private patient. You need to hold cover for 12 months before you can claim pregnancy and birth services. Even if you aren’t going private, you might want to consider upgrading so that your baby is covered for a wider range of private hospital treatments once they’re born. You also want to be set up for the extra needs of a growing family. |
Silver Plus Grow Hospital ($500 or $750 excess) & High Extras |
|
Your family with kids You're not having any more kids and you want to strike the right balance between affordability and cover that suits young families. |
Bronze Plus Hospital ($500 or $750 excess) or Silver Hospital ($750 excess) & Premium or High Extras |
|
On a budget with kids This is for young families who don’t need much hospital cover but want a good level of extras cover to keep everyone healthy and smiling. |
Basic Plus Hospital ($750 excess) or Bronze Plus Hospital ($500 or $750) & High Extras |
|
Your family with older kids (21–30 years, inclusive) If your child is studying full-time, you can keep them on your family cover until they’re 30 (inclusive) for no extra cost if they don’t have a partner and you register them each year for both semesters (or only the first semester if that’s the only one that applies). *Gross premium refers to the base premium amount before any Australian Government Rebate, Lifetime Health Cover loading, discounts or employee subsidies (if relevant) have been factored in. |
Your choice of Family Plus Cover & High or Premium Extras |
|
Middle-aged & young at heart You are a middle-aged single, couple or a family without kids at home. You want a quality cover to protect you at this stage of life and still let you save money to do the things you love (now that you’ve got more free time on your hands). |
Silver Plus Hospital ($750 excess) & High Extras |
|
Seniors You’re older and wiser, and you know that it’s a good idea to make sure you’re well covered. You’ll probably need more healthcare services as time goes on and you want to make sure you have the best cover possible. You want to know that you’ll get the treatment you want as soon as you need it. You no longer need cover for treatments such as pregnancy and birth. |
Silver Plus Hospital ($500 excess) & Premium Extras |
|
Ambulance cover included |
One thing that Peoplecare includes as a bonus is 100% land, air and sea ambulance cover with no annual limits with every Peoplecare cover.* A short trip in an ambulance can be eye-wateringly pricey. To view what you get, read here. *State-recognised ambulance providers only. |
