Please read all the details on this website carefully. This website does not contain all the rules of the Fund. A copy of Health Partners' rules is available on request. Contact us before commencing treatment to clarify eligibility for benefits. Health Partners benefits are available to Australian residents who are eligible for full Medicare benefits.

The information on this website is subject to change from time to time. Members will be notified of significant changes, which will be binding on each member from the date specified in the notification.

Benefits and limits

• Except where otherwise stated, benefits and limits are per person per calendar year.
• Benefits are only payable on services and goods provided by recognised providers within Australia. Health Partners benefits are not available overseas.
• Benefits are only payable for services or treatments performed in person, except where otherwise permitted by Health Partners.
• Benefits are only payable on goods purchased over the internet or telephone if the provider is recognised by Health Partners.
• Benefits may only be claimed once per treatment, service or purchase of goods, for which a benefit is payable and cannot be greater than the amount charged.
• Once waiting periods have been served, members and registered dependents are eligible for all benefits on their chosen cover while contributions are up to date.
• Benefits must be claimed within 2 years from the date of service and count towards limits for the year in which the service was provided.
• Benefits for vaccination prescriptions are available when purchased at Health Partners participating pharmacies. A limited range of vaccinations are also available at your GP, TMVC, Travel Bug or local council vaccination centre.
• Members with both Hospital and Extras cover have an overall limit of $20,000 for ambulance cover.
• Benefits will be reduced if you have already claimed through another source. In some cases, such as Work Cover, no benefit will be paid. 
• Loyalty benefits are available in some areas of Health Partners covers. These benefits are based on the number of years of continuous membership with Health Partners.  
• The member co-payment ($20 or $34) for eligible pharmacy prescriptions is payable for each pharmacy item dispensed. Benefits for multiple pack dispensing can vary and multiple member co-payments may apply.
• The 20% discount at Health Partners Participating Pharmacies excludes agency lines and Schedule 3 recordable items.

Dependants

• You can add a newborn to your membership with immediate cover and no waiting periods, provided it is within 60 days from their date of birth.
• Adopted or fostered children may be added to your membership and avoid the 2 month waiting period, provided it is within 60 days of obtaining legal guardianship/documentation. Waiting periods apply for pre-existing conditions.
• If you have a Single or Couple membership and wish to add a child dependant you will need to transfer to Family or Sole Parent Family membership, with contributions paid from the date of birth (or from the date of obtaining legal guardianship).
• Benefits are payable on a Family membership for registered dependants up to the age of 21 years and full-time students from their 21st to their 25th birthday.
• If a child ceases to be a student dependant he/she can join their own Health Partners membership, or be covered on a Family Focus membership up to their 25th birthday, provided they are without a partner.

Overseas Travel

You are able to suspend your private health cover while you are overseas for a minimum of 3 weeks and a maximum of 2 years. The 1% Medicare Levy Surcharge may apply for the period that your Hospital Cover is suspended. For more details please phone us, or to suspend your cover download an ‘Application to Suspend Membership’ form.

Review Period

If you are not satisfied with your new cover or change of cover we will refund your contributions in full, provided it is within 30 days of joining or changing your cover and no claims have been made.

Your Choice

Health Partners respects and encourages individual members' choices when it comes to selecting the type of treatment/practitioner for their health needs. Provider registration is not to be taken as Health Partners’ endorsement or recommendation of any particular service, treatment or practitioner.

Privacy

Your privacy is always a priority at Health Partners. If you would like a copy of our privacy policy please contact us on 1300 113 113 or click here.

Glossary

For a glossary on some of the commonly used terms in health insurance, click here.

Private Health Insurance Ombudsman

The Private Health Insurance Ombudsman has produced a State of the Health Funds Report which is available by contacting the PHIO on 1800 640 695 or you can view and download a copy here.

The Office of the Private Health Insurance Ombudsman has produced the following website privatehealth.gov.au to enable consumers to search for, and compare, selected features for all private health insurance products offered in Australia. You can find basic information about all Health Partners products in this website for purposes of comparison only.

In Case of a Complaint

At Health Partners we recognise that despite our best intentions, members may have concerns or complaints regarding their membership with us. To ensure that all feedback and concerns are heard and addressed fairly and satisfactorily, we have a formalised Resolutions Process.

Step One

If you have a concern, or are not satisfied with our products, services, decisions on claims or services received at a Health Partners preferred provider, please contact us by:

Step Two

If, once you have contacted us and despite our best efforts, you are not satisfied with the outcome, the matter can be referred to Health Partners Resolution Officer, who can be contacted by:

If, after this, you are still not satisfied with the outcome, we will refer the matter to the Fund’s Chief Executive Officer.

Step Three

If you feel that your issue is unresolved or that the complaint was not dealt with fairly, the Private Health Insurance Ombudsman (PHIO) can provide free and independent advice. PHIO can be contacted by:

Useful Websites

Further information about private health insurance and government initiatives such as Lifetime Health Cover, Medicare Levy Surcharge and the Federal Government 30% rebate on private health insurance can also be found at:

www.privatehealth.gov.au
www.medicare.gov.au
www.phio.org.au