• Singles
  • Single Parent Family
  • Single Parent Plus
  • Couples/Family
  • Family Plus

Basic Plus

0
$750 excess
*applicable from
July 1, 2019
Add

Five Star Gold

0
No excess $150 excess $250 excess $500 excess $750 excess
Add

Dental*

0 Add

Base Extras*

0 Add

Mid Extras*

0 Add

Five Star Extras*

0 Add
Basic Plus hospital cover will give you shared room accommodation in a public hospital with your choice of doctor. It is designed to provide full cover against the cost of shared room accommodation in public hospitals as a private patient with the choice of doctor or specialist. Even though default benefits are paid against the cost of private hospital treatment, this cover is not recommended for people wanting comprehensive private hospital cover.
Effective 1 April 2019

What you're covered for:

Basic Plus gives you shared ward accommodation in public hospitals across Australia with your choice of doctor. Should you be admitted to a private hospital or day facility, restricted benefits only will be payable leaving you with sometimes large out of pocket costs.

Excess

An excess of $750 will apply to this level of cover as from 1 July 2019.

Clinical categories

Hospital services/treatments are classified by Clinical Category in order to make it easier for you to know exactly what you are covered for, and what you are not covered for, should you be admitted to hospital.

Waiting Periods
  • None for accidents
  • 2 months for general illness
  • 12 months for pre-existing conditions
  • 12 months for pregnancy and birth related services
  • 2 months for psychiatric, rehabilitation and palliative care

Detailed information can be found here.

Restrictions

Hospital treatment in a private hospital in day facility are restricted to default public hospital benefits.

Exclusions

None

Co-payments

None

What are my options if I am admitted to a public hospital?

When you are admitted to a public hospital, you can to choose whether to be treated as a public patient or as a private patient. If you choose to be a public patient, you will be treated by a doctor appointed by the hospital and not be charged for your care.

You can choose to be treated as a private patient in a public hospital to have your choice of treating doctor, or to have a private room. However, this may not necessarily guarantee the doctor of your choosing or that a private room will be available, nor does it guarantee a higher level of care.

There is no difference in the level of care you receive at a public hospital if you elect to be a private patient, you may however be charged some out-of-pocket costs.

What else is covered?

Gap Medical Benefits

When you are admitted to hospital you will be charged separately for medical fees by your doctor, medical specialist, surgeon, anaesthetist, radiologist or pathologist.

These fees will be in addition to your accommodation and theatre fees, and are always negotiable between you and your health care provider. You will receive 100% of the Medicare Benefit Schedule (MBS) fee, the Medicare benefit, plus the Fund Benefit for inpatient services. Detailed information can be found here.

No gap medical Benefits at MHPH

Mildura Health Fund has no gap medical agreements with a number of medical specialists, doctors and surgeons who operate at Mildura Health Private Hospital (MHPH). The current list of no gap medical providers can be found here.

Prostheses

A prosthesis is a surgically implanted medical device or artificial body part, such as a hip or knee joints or a cardiac pacemaker.

Other costs you may incur

Depending on the procedure you are having whilst an inpatient in hospital, your doctor may need to use high cost items that are not normally covered.

Our top, comprehensive cover gives you 100% cover Australia wide with or without an excess option, no restrictions or exclusions. We have contracts with more than 435 private hospitals Australia wide, to give you peace of mind knowing that you will be covered.
Effective 1 April 2019

What you're covered for:

If you would prefer to pay a lower premium and still have the most comprehensive cover, our Five Star Gold cover has a choice of five different excess amounts that you can choose to pay.

It is the same top cover with no exclusions but with a known upfront excess amount to pay. The higher the excess, the lower the premium.

Clinical categories

Hospital services/treatments are classified by Clinical Category in order to make it easier for you to know exactly what you are covered for, and what you are not covered for, should you be admitted to hospital.

Youth Discount

The Youth Discount is available to persons aged 18 to 29 inclusive who join a Five Star Gold level of cover.

Waiting Periods
  • None for accidents
  • 2 months for general illness
  • 12 months for pre-existing conditions
  • 12 months for pregnancy and birth related services
  • 2 months for psychiatric, rehabilitation and palliative care

Detailed information can be found here.

What else is covered?

Gap Medical Benefits

When you are admitted to hospital you will be charged separately for medical fees by your doctor, medical specialist, surgeon, anaesthetist, radiologist or pathologist.

These fees will be in addition to your accommodation and theatre fees, and are always negotiable between you and your health care provider. You will receive 100% of the Medicare Benefit Schedule (MBS) fee, the Medicare benefit, plus the Fund Benefit for inpatient services. Detailed information can be found here.

No gap medical Benefits at MHPH

Mildura Health Fund has no gap medical agreements with a number of medical specialists, doctors and surgeons who operate at Mildura Health Private Hospital (MHPH). The current list of no gap medical providers can be found here.

Prostheses

A prosthesis is a surgically implanted medical device or artificial body part, such as a hip or knee joints or a cardiac pacemaker.

Other costs you may incur

Depending on the procedure you are having whilst an inpatient in hospital, your doctor may need to use high cost items that are not normally covered.

Base Extras offers lower benefits and limits at a lower cost whilst still covering a great range of services our members use. Can be taken as a standalone cover or combined with Dental cover and / or Hospital cover.

Effective 1 April 2019

EXTRAS BENEFIT TABLE BASE EXTRAS
SERVICE BENEFIT SUB-LIMIT* CALENDAR YEAR LIMIT
Physiotherapy &
Other Therapies
Physiotherapy Initial - $27
Standard - $24
Group* - $8
$80* $390 person
$780 family
Exercise Physiology
Occupational Therapy
Podiatry Podiatry Initial - $27
Standard - $24
$390 person
$780 family
Foot Orthotics Set benefit per item
Dietician Dietician Initial - $27
Standard - $24
$390 person
$780 family
Therapies Remedial Massage No benefit No benefit
Acupuncture
Myotherapy
Chiropractic &
Osteopathic
Chiropractic Initial - $22
Standard - $21
$390 person
$780 family
Osteopathic Initial - $27
Standard - $24
Clinical Psychology Clinical Psychology No benefit No benefit
Optical Prescription Glasses
& Contact Lenses
$165
Per Person
$165
Per Person
Ambulance
Subscription
Ambulance subscription refund Family - $70
Single - $35
Equal to benefit
Eye Therapy &
Audiology
Eye Therapy Initial - $27
Standard - $24
$390 person
$780 family
Hearing Test
Speech Pathology Speech Pathology Initial - $27
Standard - $24
$390 person
$780 family
Home Nursing District Visiting Nurse
(Excludes midwifery services)
$12 $350 person
$700 family
Pharmacy Non PBS prescriptions No benefit No benefit
Health Aids
& Appliances ^
Blood Glucose Monitor $150
(every 3 years)
$600 person
$1200 family
Blood Pressure Monitor $125
(every 3 years)
TENS Machine $125
(every 3 years)
Nebuliser $125
(every 3 years)
CPAP (Machine only) $230
(every 3 years)
Hearing Aid $450
(every 5 years)
Braces & Splints 65% up to $300
(every 3 years)
CAM Boot 65% up to $300
(every 3 years)
Artificial limbs & prosthesis 65% up to $300
(every 2 years)
Crutches, walking frame
& walking stick
65% up to $25
(every 2 years)
Wigs + 65% up to $150
(every 2 years)
Compression Garments + 65% up to $150
(every 2 years)
Five Star Health
Management Benefits
Approved Programs No benefit No benefit

* Sub-limits apply to these services

^ Health Aids and Appliances must be medically necessary and for the treatment of specific conditions.

+ Conditions apply, sport and pregnancy related garments are excluded. Contact the Fund for further information.

All benefits subject to waiting periods and benefit limitation periods.

Our mid-range extras cover offering benefits for Remedial Massage, Physiotherapy, Chiropractic and Health Aids & Appliances. This a stand-alone extras cover that does not include dental cover. Can be taken on its own or combined with dental and/or hospital cover for greater flexibility.

Effective 1 April 2019

EXTRAS BENEFIT TABLE MID EXTRAS
SERVICE BENEFIT SUB-LIMIT* CALENDAR YEAR LIMIT
Physiotherapy &
Other Therapies
Physiotherapy Initial - $36
Standard - $32
Group* - $9
$90* $540 person
$1080 family
Exercise Physiology
Occupational Therapy
Podiatry Podiatry Initial - $36
Standard - $32
$540 person
$1080 family
Foot Orthotics Set benefit per item
Dietician Dietician Initial - $36
Standard - $32
$540 person
$1080 family
Therapies Remedial Massage Initial - $29
Standard - $27
$540 person
$1080 family
Acupuncture
Myotherapy
Chiropractic &
Osteopathic
Chiropractic Initial - $29
Standard - $27
$540 person
$1080 family
Osteopathic Initial - $36
Standard - $32
Clinical Psychology Clinical Psychology Initial - $46
Standard - $42
Group - $10
$540 person
$1080 family
Optical Prescription Glasses
& Contact Lenses
$220
Per Person
$220
Per Person
Ambulance
Subscription
Ambulance subscription refund Family - $85
Single - $42.50
Equal to benefit
Eye Therapy &
Audiology
Eye Therapy Initial - $36
Standard - $32
$540 person
$1080 family
Hearing Test
Speech Pathology Speech Pathology Initial - $36
Standard - $32
$540 person
$1080 family
Home Nursing District Visiting Nurse
(Excludes midwifery services)
$12 $500 person
$1000 family
Pharmacy Non PBS prescriptions No benefit No benefit
Health Aids
& Appliances ^
Blood Glucose Monitor $200
(every 3 years)
$1000 person
$2000 family
Blood Pressure Monitor $150
(every 3 years)
TENS Machine $150
(every 3 years)
Nebuliser $150
(every 3 years)
CPAP (Machine only) $400
(every 3 years)
Hearing Aid $700
(every 5 years)
Braces & Splints 75% up to $500
(every 3 years)
CAM Boot 75% up to $500
(every 3 years)
Artificial limbs & prosthesis 75% up to $500
(every 2 years)
Crutches, walking frame
& walking stick
75% up to $35
(every 2 years)
Wigs + 75% up to $250
(every 2 years)
Compression Garments + 75% up to $250
(every 2 years)
Five Star Health
Management Benefits
Approved Programs No benefit No benefit

* Sub-limits apply to these services

^ Health Aids and Appliances must be medically necessary and for the treatment of specific conditions.

+ Conditions apply, sport and pregnancy related garments are excluded. Contact the Fund for further information.

All benefits subject to waiting periods and benefit limitation periods.

Five Star Extras is our most comprehensive level of extras cover includes Dental benefits and offers the highest benefits and yearly limits of our extras and dental covers.

The Five Star Health Management benefit is exclusive to the Five Star Extras cover, and includes benefits for Fitness and Prevention programs including Swimming Lessons, Personal Training, Group Training and Aqua Aerobics. Health screening tests not covered by Medicare such as Mole Mapping and Lung function testing and Weight Management and Quit Smoking programs. A detailed fact sheet can be found here.

Effective 1 April 2019

EXTRAS BENEFIT TABLE FIVE STAR EXTRAS
SERVICE BENEFIT SUB-LIMIT* CALENDAR YEAR LIMIT
Physiotherapy &
Other Therapies
Physiotherapy Initial - $50
Standard - $45
Group* - $10
$100* $650 person
$1300 family
Exercise Physiology
Occupational Therapy
Podiatry Podiatry Initial - $42
Standard - $38
$650 person
$1300 family
Foot Orthotics Set benefit per item
Dietician Dietician Initial - $42
Standard - $38
$650 person
$1300 family
Therapies Remedial Massage Initial - $36
Standard - $34
$600 person
$1200 family
Acupuncture
Myotherapy
Chiropractic &
Osteopathic
Chiropractic Initial - $36
Standard - $34
$600 person
$1200 family
Osteopathic Initial - $50
Standard - $45
Clinical Psychology Clinical Psychology Initial - $65
Standard - $55
Group - $12
$650 person
$1300 family
Optical Prescription Glasses
& Contact Lenses
$250
Per Person
$250
Per Person
Ambulance
Subscription
Ambulance subscription refund Family - $95
Single - $47.50
Equal to benefit
Eye Therapy &
Audiology
Eye Therapy Initial - $42
Standard - $38
$650 person
$1300 family
Hearing Test
Speech Pathology Speech Pathology Initial - $50
Standard - $45
$650 person
$1300 family
Home Nursing District Visiting Nurse
(Excludes midwifery services)
$12 $600 person
$1200 family
Pharmacy Non PBS prescriptions $35 $300 person
$600 family
Health Aids
& Appliances ^
Blood Glucose Monitor $260
(every 3 years)
$1200 person
$2400 family
Blood Pressure Monitor $200
(every 3 years)
TENS Machine $200
(every 3 years)
Nebuliser $200
(every 3 years)
CPAP (Machine only) $520
(every 3 years)
Hearing Aid $1000
(every 5 years)
Braces & Splints 85% up to $600
(every 3 years)
CAM Boot 85% up to $600
(every 3 years)
Artificial limbs & prosthesis 85% up to $600
(every 2 years)
Crutches, walking frame
& walking stick
85% up to $50
(every 2 years)
Wigs + 85% up to $300
(every 2 years)
Compression Garments + 85% up to $300
(every 2 years)
Five Star Health
Management Benefits
Approved Programs 70% $150 person
$300 family

* Sub-limits apply to these services

^ Health Aids and Appliances must be medically necessary and for the treatment of specific conditions.

+ Conditions apply, sport and pregnancy related garments are excluded. Contact the Fund for further information.

All benefits subject to waiting periods and benefit limitation periods.

Dental Benefits
DENTAL BENEFITS TABLE FIVE STAR EXTRAS
SERVICE BENEFIT SUB-LIMIT* FIRST YEAR MEMBERSHIP LIFETIME LIMIT CALENDAR YEAR LIMIT
General & Major Dental Preventative Dental 100% * $390 Maximum benefit payable per person $1,400 Maximum benefit payable per person once first year is completed
General & Major Dental 85% **
Inlay/Onlay, Crown & Bridge As per dental schedule 1st calendar year of membership $390
2nd calendar year of membership $510
3rd calendar year of membership $570
4th calendar year of membership $630
5th calendar year of membership $690
6th calendar year of membership $750
Orthodontics 50% up to $800 $800 Per person per calendar year $2,400 Per person

* Dental 100% benefit available at super dental providers.For more information see Gap Free Preventative Dental.

** Percentage based on MHF dental schedule

All benefits subject to waiting periods and benefit limitation periods.

DENTAL BENEFIT TABLE FIVE STAR EXTRAS
SERVICE BENEFIT
Preventative Treatment Periodical oral examination $48.65
Emergency consultation $30.60
X-Ray $41.20
Scale & Clean $99.70
Fluoride Treatment $38.55
General & Major Dental Surgical Extraction $201.00
Filling - Adhesive one surface $108.95
Filling of one root canal $196.90
Full crown veneer $750
Full denture $1,400

All benefits subject to waiting periods and benefit limitation periods.

Or drop in

Your quote

Smart Starter $ 0.00
Total Extras $ 0.00
Total $ 0.00

*These quotes are effective from 1 April 2019 to 31 March 2020.

Note: Quote is indicative only and may vary by up to .10 cents to the actual amount. E&OE.

Contact Us for Youth Discount Quotes.

Determine your rebate

Your Age:

Under 65 65 - 69 70+

Rebate Tier:

Full rebate
Singles: <$90,000
Families: <$180,000
If you are unsure of your tier please contact the ATO or your financial advisor.
Tier 1
Singles: $90,000-$105,000
Families: $180,000-$210,000
If you are unsure of your tier please contact the ATO or your financial advisor.
Tier 2
Singles: $105,001-$140,000
Families: $210,001-$280,000
If you are unsure of your tier please contact the ATO or your financial advisor.
No rebate
Singles: >$140,001
Families: >$280,001
If you are unsure of your tier please contact the ATO or your financial advisor.
Your calculated rebate: 0%

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