Select from a category below to view the related FAQs.
- Ambulance Cover
- Do I have full ambulance cover?
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All Health Partners and Extras covers provide full ambulance cover Australia-wide. This includes both emergency and non-emergency services, by road or air, provided that the service is required on medical grounds.
Health Partners Gold and Silver Hospital covers provide full ambulance cover Australia-wide. This includes both emergency and non-emergency services, by road or air, provided that the service is required on medical grounds.
Ambulance cover is not included in Bronze Hospital Cover.
- Claiming
- Extras Cover
- What is Extras cover?
- Extras cover provides benefits for a large range of services that are not covered by Medicare. The most popular services include Optical, Dental, Physiotherapy, Chiropractic, Naturopathy, Dietetics and Podiatry. The actual services covered and benefits paid will depend on your particular level of cover.
- Where is my nearest Health Partners Dentist?
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There are five Health Partners Dental centres in Adelaide:
Adelaide - Level 1, 50 Hutt St
Adelaide - Level 7, 55 Gawler Pl
Woodcroft - 185-191 Bains Rd
Modbury - 12 Smart Rd
Modbury - 33 Smart Rd
- Where is my nearest Health Partners Optometrist?
- Where is my nearest Health Partners Participating Pharmacy?
- There are over 40 Health Partners Participating Pharmacies in South Australia. For a list of locations click here.
- Where is my nearest Health Partners Participating Physiotherapist?
- There are over 30 Health Partners Participating Physiotherapists in South Australia. For a list of locations click here.
- Can I use my own Dentist/Optomitrist/Physiotherapist?
- Yes. You are free to use the provider of your choice. The benefits you receive will depend on your level of cover. Higher benefits are available at Health Partners professionals.
- What does Natural Plus cover provide?
- Natural Plus cover provides a wide range of natural therapies by recognised providers. Services include therapeutic and remedial massage, Bowen therapy, reflexology, Chinese herbalism, myotherapy and much more. Natural Plus is available in addition to any level of Extras cover.
- Will having Extras cover exempt me from paying Lifetime Health Cover?
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No. Lifetime Health Cover is a Federal Government initiative to encourage you to join private Hospital cover earlier in life.
For more information on Lifetime Health Cover visit the Department of Health and Ageing.
- Where can I find information on levels of cover?
- Government Related
- What is Lifetime Health Cover (LHC)?
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Lifetime Health Cover is a Federal Government initiative to encourage you to join private hospital cover earlier in life. For every year you are aged over 30 and do not have hospital cover, you will pay an additional 2% loading on top of your ‘base’ hospital contribution. The maximum loading for any person is 70%.
For a single policy, the loading is applied directly to the base hospital contribution rate. For a couple/family policy, the loading is calculated by taking the average of yours and your spouse/partner’s loading, and then applying this new percentage to the base hospital contribution.
You will not have to pay a loading if you:
Have maintained hospital cover since 30 June 2000
Joined hospital cover before 30 June following your 31st birthday
Were born before 1 July 1934
Have recently migrated to Austrlia and you join hospital cover within 12 months of entitlement to full Medicare benefits.
After 10 years of continuous hospital cover, any loading that you currently pay will be removed.
For more information on Lifetime Health Cover visit the Department of Health and Ageing.
- What is a Standard Information Statement (SIS)?
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A Standard Information Statement is a legislative requirement of all Australian private health funds which provides basic cover information, for the purpose of comparison only.
For more information on Standard Information Statements visit PrivateHealth.gov.au.
- What is the Federal Government 30% Rebate?
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The Federal Government 30% Rebate on private health insurance is available on all health cover contributions to every Australian Citizen and permenant resident entitled to Medicare. This includes both Hospital and Extras cover. Members under the age of 65 receive a 30% rebate, members aged 65 to 69 receive a 35% rebate, and members aged 70 and over receive a 40% rebate. The rebate is available as a reduced contribution, as part of your tax return, or as a cash payment at any Medicare office.
For more information on the Federal Government 30% Rebate on private health insurance visit the Australian Taxation Office.
- What is the Medicare Levy Surcharge (MLS)?
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The Medicare Levy Surcharge is a tax to encourage high income earners to join private hospital cover. In addition to the 1.5% Medicare levy, you will have to pay the Medicare Levy Surcharge if:
- You are single and have a taxable income of more than $50,000 per year
- You are a sole parent and have a taxable income of more than $100,00 per year (add $1,500 per child after the first child)
- You and your partner have a combined taxable income of more than $100,000 per year (add $1,500 per child after the first child).
The surcharge is calculated at 1% of your taxable income. If you suspend your cover to travel, or do not register a dependant or newborn, you may be subject to the Medicare Levy Surcharge for the period for which you were not covered.
For more information on the Medicare Levy Surcharge visit the Australian Taxation Office.
- What is the Pharmaceutical Benefits Scheme (PBS)?
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Many medications cost much more than what you actually pay. The Australian Government provides a subsidy for many essential and commonly used medicines, so that you pay less. The PBS Schedule lists all medicines that are available at the Government-subsidised price.
For more information on the Pharmaceutical Benefits Scheme visit the Department of Health and Ageing.
- What is the Private Health Insurance Code of Conduct?
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The code is a voluntary industry code designed to enhance standards of practice in the private health industry. In supporting the code, we are committed to the following:
- Continuously improving the standards of practice and service within Health Partners
- Providing you with information in plain English – making it easier for you to understand
- Training staff to ensure their competency in dealing with all enquiries
- Ensuring all information between our members and Health Partners is protected in accordance with our Privacy Policy
- Providing a reliable system to address any complaints you may have.
For more information on the Code of Conduct visit the Australian Health Insurance Association.
- Hospital Cover
- What is Hospital cover?
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With Health Partners Gold and Silver Hospital cover, you are covered for all medically necessary admissions for which a Medicare Rebate applies, including pregnancy, knee reconstructions and heart surgery.
With Health Partners Bronze Hospital cover, you are covered for all medically necessary admission for which a Medicare Rebate applies, except for pregnancy, assisted reproductive services, dialysis associated with chronic renal failure and joint replacement.
Restrictions may apply for procedures where a Medicare Rebate does not apply (eg. cosmetic surgery, laser eye surgery and sterilisation reversal).
If you need to go to hospital, we recommend you contact Health Partners on 1300 113 113 prior to your admission to verify your level of cover, as well as any excess, co-payment or gap payments you may have to make.
- What is an excess?
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An excess is the amount you have to pay towards your hospital accommodation. This is also known as a front-end deductible.
By selecting an ‘excess’ Hospital cover option, you can reduce the cost of your Hospital cover contributions. Instead, you pay an excess if or when you are admitted to hospital as an inpatient.
By selecting an ‘excess’ Hospital cover option, you can reduce the cost of your Hospital cover contributions. Instead, you pay an excess if or when you are admitted to hospital as an inpatient. Excesses only apply to three of our Hospital cover – Silver 250, Silver 500 and Bronze 500.
The excess amount you pay is capped, depending on the level of cover you have chosen. For example, if you have Single Silver 250, you will pay an excess of $250 (plus a $50 a day co-payment), when admitted to hospital.
- What is a co-payment?
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A co-payment is the amount you pay in addition to your excess (if applicable), towards hospital accommodation.
A co-payment is a daily amount you pay, in addition to your excess (if applicable), towards hospital accommodation.
The co-payment amount depends on your level of cover, and is $50 per day and is capped at $500 per person, per year. For a single membership the co-payment is capped at $500 per year, and for a famliy membership this is capped at $1000 per year. For example, with Single Silver Hospital 250, you will pay an excess of $250 plus $50 per day for every day you are in hospital. The excess is limited to only once per year.
- How can I reduce the gap when I go to hospital?
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With Health Partners Access Gap cover you can eliminate or reduce the gap you pay when you are admitted to hospital. Access Gap is included in your Health Partners Hospital cover. To find out more, download the ‘Your gap checklist’.
It is your doctor's choice to participate in Access Gap cover. It is important to ask your doctor if they, or any other assisting doctor or anaesthetist, will participate in Health Partners Access Gap cover.
- Am I covered if I go to the emergency department?
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Treatment received as an outpatient at a public hospital emergency department is free for all Australian Citizens and permenant residents eligible for Medicare. However, if you choose to attend a private hospital emergency department, you will have some out-of-pocket costs. These costs may include gap charges for services such as x-rays and other tests, as well as service facility fees (this fee my vary for each private hospital).
If you need recovery aids (such as crutches, wheelchair or compression garments) you can claim for the hire or purchase of these aids. The benefit is 75%, up to $250 per person per year.
If you are admitted as a private patient, your private Hospital cover will apply, provided relevant waiting periods have been served.
- Will I be exempt from Lifetime Health Cover (LHC) if I have Hospital cover?
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Lifetime Health Cover is a Federal Government initiative to encourage you to join private hospital cover earlier in life. For every year you are aged over 30 and do not have hospital cover, you will pay an additional 2% loading on top of your ‘base’ hospital contribution. The maximum loading for any person is 70%.
For a single policy, the loading is applied directly to the base hospital contribution rate. For a couple/family policy, the loading is calculated by taking the average of yours and your spouse/partner’s loading, and then applying this new percentage to the base hospital contribution.
You will not have to pay a loading if you:
Have maintained hospital cover since 30 June 2000
Joined hospital cover before 30 June following your 31st birthday
Were born before 1 July 1934
Have recently migrated to Australia and you join hospital cover withing 12 months of entitlement to full Medicare benefits.
After 10 years of continuous hospital cover, any loading that you currently pay will be removed.
For more information on Lifetime Health Cover visit the Department of Health and Ageing website.
- What does my Hospital cover not cover me for?
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Your Hospital cover does not pay benefits towards medical fees charged in excess of the Medicare scheduled fee unless you doctor is participating in Access Gap Cover, or for any outpatient services (eg. ultrasounds, x-rays in doctor’s rooms, MRI services, emergency department facilities, and unregistered day facilities).
For cosmetic surgery, laser eye surgery, sterilisation reversal and any other admissions where a Medicare rebate does not apply to the treatment procedures, restricted benefits apply which may result in significant out-of-pocket expenses.
Health Partners Bronze Hospital cover also excludes pregnancy, assisted reproductive services, joint replacement and dialysis associated with chronic renal failure.
- Where can I find more information on my level of cover?
- Membership
- How do I join Health Partners?
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Joining Health Partners is easy. You have three options to choose from:
Join now online
Download a ‘Membership Application’ form and send it to Health Partners Reply Paid 1493, Adelaide SA 5001, or fax to (08) 8227 2055
Complete the application form enclosed in the Health Partners brochure. Brochures are available at all Health Partners locations or request one by calling 1300 113 113.
- How do I transfer to Health Partners from another fund?
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If you currently have private health insurance and would like to transfer your membership to Health Partners, simply complete the ‘Transfer of membership from another fund’ section on your application form, or when joining online.
It is important to note that if you transfer to a higher level of cover you may have to serve waiting periods for any additional benefits. Health Partners Member Services consultants are happy to discuss this with you.
- How can I add a dependant to my membership?
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You can add a spouse/partner or dependant child to your membership by downloading a ‘Membership Application’ form and sending it to Health Partners Reply Paid 1493, Adelaide SA 5001 or faxing to (08) 8227 2055.
Alternatively, you can contact Health Partners on 1300 113 113 to request an application form.
Dependants cannot be added to a membership online.
- How can I remove a dependant from my membership?
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You can remove a spouse/partner or dependant child from your membership by downloading a ‘Membership Application’ form and sending it to Health Partners Reply Paid , Adelaide SA 5001, or faxing to (08) 8227 2055.
Alternatively, you can contact Health Partners on 1300 113 113 to request an application form.
Dependants cannot be removed from a membership online.
- How do I update my address details if I have moved?
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Download an ‘Update of personal member details’ form and send the signed form to Health Partners Reply Paid 1493, Adelaide SA 5001, or fax to (08) 8223 1108.
Alternatively, you can contact Health Partners on 1300 113 113 to request an ‘Update of personal member details’ form. This form is also available at Health Partners Member Services, Optical and Dental centres.
Only the main member or authorised person can update these details.
- How do I update my details with Health Partners if I have changed my name?
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Once you have updated your details with Medicare and have been issued with a new Medicare number, you will need to complete a‘Membership Application’ form with these new details. Health Partners also requires a copy of your change-of-name certificate or marriage certificate.
You can request a ‘Membership Application’ form by calling 1300 113 113. This form is also available at Health Partners Member Services, Optical and Dental centres.
- How can I change my type of cover if I am already with Health Partners?
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You can change your cover online by completing the 'Change Member Details' form. If you prefer, download a ‘Membership Application’ form and send it to Health Partners Reply Paid 1493, Adelaide SA 5001, or fax to (08) 8227 2055.
Alternatively, you can contact Health Partners on 1300 113 113 to request an application form.
Information on Health Partners Extras and Hospital cover is available online. If you have any questions regarding suitable cover for you (or your family), please don’t hesitate to contact Health Partners directly.
- Miscellaneous
- Where is Health Partners Member Services located?
- Where is Health Partners Optical located?
- For a list of Health Partners Optical locations click here.
- Where is Health Partners Dental located?
- For a list of Health Partners Dental locations click here.
- Can I suspend my health cover to travel overseas?
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Yes. You can suspend your full membership if you are travelling overseas for a minimum of 21 days and a maximum of two years.
In all circumstances, you must complete a ‘Suspension of cover for overseas travellers’ form prior to your departure. Please note that suspension applies to the whole membership and is not available if any person on the membership remains in Australia. In some cases, the 1% Medicare Levy Surcharge will apply for the period that hospital cover is suspended.
To request a 'Suspension of cover for overseas travellers' form call Health Partners on 1300 113 113.
- I am going overseas; am I still covered?
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Your private health cover does not cover you outside Australia. For medical cover overseas, you should take out appropriate travel insurance. All Health Partners members save 20% on QBE travel insurance purchased through Health Partners.
For more information or to purchase travel insurance, click here, or call 1300 113 113 to request a QBE travel insurance brochure.
- What is a Pre-Existing Condition(PEC)?
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A pre-existing condition is an illness, condition or ailment where, in the opinion of a medical practitioner appointed by the health fund, signs or symptoms of your ailment, illness or condition existed at any time during the six months preceding the day on which you purchased your hospital cover benefits.
A 12-month waiting period applies for pre-existing conditions. For more information, click here, or call Health Partners on 1300 113 113.
- My membership card isn't working properly. What can I do?
- If you have trouble using your membership card in HICAPS machines, please call or email Health Partners and we will issue you with a replacement card.
- I am not happy with the way my problem was handled. What can I do?
- Health Partners is committed to discussing any concerns you may have and addressing these concerns promptly. For more information on Health Partners resolution process, please click here.
- How will my personal information be treated?
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Health Partners is committed to providing quality and affordable health care services appropriate to your needs. We appreciate and highly value our relationship with you and we are committed to protecting your privacy. We comply with the National Privacy Principles (NPPs) in the Privacy Act 1988 (Cth) in relation to our handling of your personal information.
For a copy of Health Partners privacy policy click here.
- What is HICAPS?
- HICAPS (Health Industry Claims and Payment Service) is an electronic claiming system. When you receive treatment you can swipe your card and just pay the gap, which means no claim forms to fill in. This is only available where the provider is set up on the HICAPS system.
- What is Health Partners' Fund ID?
- Health Partners Fund ID (used for your Tax Return) is SPS.
- Payments
- Pharmacy
- Waiting Periods
- Will I have to serve any waiting periods?
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When you join Health Partners without current health cover, you will have to wait a certain period of time before being eligible for health fund benefits. This is called a waiting period.
If you have health cover already, but are transferring to a higher level of cover, waiting periods may apply for all additional benefits.
For full details on waiting periods click here or call Health Partners on 1300 113 113.
- I previously had health insurance with another fund and would now like to join Health Partners. Will I have to re-serve waiting periods?
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If you join Health Partners within 30 days of cancelling your health cover with another fund, (where you had met waiting period requirements), you do not need to re-serve waiting periods.
In some cases, some waiting periods will apply. For example, if you are transferring to a higher level of cover. For full details on waiting periods click here, or call Health Partners on 1300 113 113.
- What is a Pre-Existing Condition (PEC)?
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A pre-existing condition is an illness, condition or ailment where, in the opinion of a medical practitioner appointed by the health fund, signs or symptoms of your ailment, illness or condition existed at any time during the six months preceding the day on which you purchased your hospital cover benefits.
A 12-month waiting period applies for pre-existing conditions. For more information, click here, or call Health Partners on 1300 113 113
- Website
If you have any questions that have not been answered by the FAQs or this website, please come in and see us at 76 Pirie St, or call us on 1300 113 113.
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