Platinum Health

The vast majority of our members choose to be covered with our Platinum Health cover, why?- because it is Police Health's total health package and gives you the simplicity and claims convenience of an all-in-one, money-saving cover.

Platinum Health is a unique combination of all the security of Top Hospital and all the convenience of SureCover Extras, but at a contribution lower than if you have both of these covers separately. It gives you the advantage of having one package with one fund and ensures that you don't miss out on some vital aspect of health cover.

The hospital component in Platinum Health provides top level cover for your treatment in any registered hospital or day-surgery of your choice anywhere in Australia. This is without any exclusions, excesses or daily co-payments (private or public).

It gives you complete freedom of choice and greater control as to where you are treated, by which doctor, and when you will be treated. Forget about the lengthy waiting lists with possible cancellations that you hear far too often in the public healthcare system, with Platinum Health you're in control of your treatment for both the expected and unexpected. Police Health's products are designed only to give you the best cover, so you can be assured you are looked after when you need it the most. We don't choose to get sick or have accidents, but in the event that something does happen why pay an excess to use your cover, when the hospital component in Platinum Health is excess free.

The extras component in Platinum Health covers many services that are not covered by Medicare, such as dental, optical, physiotherapy and other therapies, also known as 'extras' or 'ancillary' cover. Few health insurers can match our extras benefits for value or number of services available.

You won't be left wondering how much your health insurer will repay on your extras claims. For the majority of services*, Police Health pays a generous 80% of the net cost of the service up to 15% higher than our calculated average cost for the service.

* Police Health only pays benefits for extras services by providers recognised by Police Health who are in private practice in Australia. If you wish to ensure that your provider is recognised and covered by Police Health, try using our provider search or contact us prior to treatment. Please note not all recognised providers are published on the search engine if you can not find a provider please contact Police Health, 1800 603 603.

Annual Maximums & our exclusive Rollover Benefit

The generous Annual Maximums shown on this page are based on calendar year allowances per person unless stated otherwise. On many of these Annual Maximums, we will give you up to two calendar years in which to use them. We call this our Rollover Benefit which allows members to carry unused Annual Maximums, into the next calendar year.

Effectively the Rollover Benefit increases the maximum benefits you can claim in a calendar year by giving you access to unused Annual Maximums remaining from the previous year. Claims are always paid from the relevant service year's Annual Maximums before accessing your Rollover Benefit. If an Annual Maximum is reached in any calendar year, there will be no Rollover Benefit available for the next calendar year.

This highly valued benefit provides you with increased security; imagine your dentist tells you need two crowns! With Police Health you could have up to total of $2400 in benefits available in one calendar year when the Rollover Benefit is accessed. (Subject to years of membership).

For more information on the Rollover Benefit, please see our Rollover Benefit Page. If you wish to clarify whether you are eligible for a Rollover benefit, please give us a call 1800 603 603.

Limit to extras services

To provide equity for all members, limits may apply to some specific extras services relating to their frequency of use, or to the way they are combined with other services. However, this affects very few members because Police Health's restrictions are often far less onerous than those of many other funds. Contact us if you have any queries.

Benefits limit to extras services

Generally health funds have benefit limits for individual services based on what they see as their average charge. However, Police Health recognises charges up to 15% higher than our calculated average, thus ensuring that members do receive a true 80% rebate for the vast majority of health services in most cases.

If your charges are more than 15% above Police Health's average fee, the benefit you receive will be less than 80% of your cost. Our 80% benefit applies to the net amount payable on any account, inclusive of any discounts the provider might be offering at the time.

Benefit for benefit, premium for premium, Police Health's Platinum Health offers great value. Just take a look at what you are covered for in the table below. Compare this with other insurers' top level products and it will be clear that we are comprehensive and offer excellent value;

Waiting Periods

Waiting periods may apply for further information go to Important Information.


Premiums for Platinum Health (Queensland)

Payment Method Fortnightly (Direct Debit) Fortnightly (Payroll) Quarterly Half-Yearly Yearly
Age of oldest person under policy Under 65 years 65 - 69 years Over 70 years

Family
(& Couples)
Single Parent
Family
Single
Base Tier
(Full Rebate)
- - -
Tier 1 - - -
Tier 2 - - -
Tier 3
(No Rebate)
- - -
Prices as of:
For descriptions on income tiers, see the Government Rebate page.

Important note: The premiums shown in this table are base rates applying to those having an existing hospital cover with a certified age of entry of 30 or, who join hospital insurance by June 30 following their 31st birthday. If neither of these apply, you need to contact Police Health for the Lifetime Health Cover premiums that will apply to you.

Benefits for Platinum Health (Queensland)

select

QLD

Service Type Example of Benefits Annual Maximum per person * Rollover Maximum per person
General Dental
(2 months waiting period) Includes checkups, X-rays, simple extractions, fillings and root canal
Oral Exam (2 every calendar year) 80% up to $50.60 Unlimited N/A
Scale and clean ( 2 every calendar year) 80% up to $103.00
Filling- adhesive posterior 3 surface 80% up to $202.40
Mouth Guard (1 every calendar year) 80% up to $141.30
Major Dental 
(12 months waiting period) Includes crowns and dentures
Full crown-veneered 80% up to $1,403.00  $1,300

 $2,600


Complete upper & lower dentures (1 every 3 yrs) 80% up to $1,794.00
12 month waiting periods may be waived where it has been served with previous fund. Rollover Maximum available after 2 years membership.
 
N/A
Orthodontic
(12 months waiting period) Benefits apply to specialist orthodontists only 
1st yr $0 
2nd yr $800 
3rd yr $800 
4th yr $1,500
Lifetime limit- $3000 80% up to annual maximum
We recognise your time served with other health insurers and in many cases new members can go direct to our $1,500 Annual Maximum
 
Optical
(2 months waiting period)
Standard single vision lenses 80% up to $109.45 $330 $660
Standard progressive lenses 80% up to $258.20
Contact lenses, disposable-spherical 80% up to $134.40
Contact lenses, rigid 80% up to $249.60
Frames $110.00
At OPSM and Laubman & Pank. Standard single vision lenses 100%
Standard progressive lenses 100%
Contact lenses, disposable-spherical 100%
Contact lenses, rigid 100%
Frames $110.00
Physiotherapy 
(2 months waiting period)
Initial consult 80% up to $78.20 $850 Combined
Sub-limit for 
Exercise Physiology 
$400 per person, or $800 per family
$1,700
Subsequent consult 80% up to $73.60
Exercise Physiology
(2 months waiting period)
Initial consult 80% up to $74.70  N/A
Subsequent consult 80% up to $59.80
Chiropractic
(2 months waiting period)
Initial consult 80% up to $74.45 $700 Combined





$1,400 


(excludes complementary therapies)
Subsequent consult 80% up to $48.10
Naturopathy
(2 months waiting period)
Initial consult 80% up to $103.50
Subsequent consult 80% up to $68.65
Acupuncture 
(2 months waiting period)
Initial consult 80% up to $74.50
Subsequent consult 80% up to $64.85
Osteopathy
(2 months waiting period)
Initial consult 80% up to $87.40
Subsequent consult (16 - 30 mins) 80% up to $77.65
Complementary Therapies 
(2 months waiting period)
Therapies consult $25.00
Note: While many therapies are covered, some are not. Please refer to our Brochure for more information.
Speech Therapy 
(2 months waiting period)
Initial consult (46 - 90 mins) 80% up to $128.80 $850 $1,700
Subsequent consult (46 - 90 mins) 80% up to $115.00
Occupational Therapy
(2 months waiting period)
Initial consult (76 - 90 mins) 80% up to $147.20 $600 $1,200
Subsequent consult (46-60 mins) 80% up to $101.20
Corrective Laser Eye Surgery
(3 years continuous membership with Platinum Health or Platinum Plus, or both)
 Lifetime Limit- $1600 $800 per eye service   $1600  N/A
Eye Therapy 
(2 months waiting period)
Initial consult 80% up to $50.60 $600 $1,200
Subsequent consult (< 30 mins) 80% up to $41.40
Dietary 
(2 months waiting period)
Initial consult 80% up to $105.80 $600 $1,200
Subsequent consult 80% up to $64.40
Podiatry 
(2 months waiting period)
Initial consult (46-75 mins) 80% up to $70.65 $700 $1,400
Subsequent consult (< 20 mins) 80% up to $61.35
Psychology
(2 months waiting period)
Consultations (46-60 mins) 80% up to $150.80 $850 $1,700
Pharmaceutical 
(2 months waiting period) Available at any pharmacy
(excludes government subsidised PBS prescriptions) $600 $1,200
Per script Up to $50 after you pay the first $20
Note: While many medicines are covered, some are not. $20 may increase for dispensing greater than the minimum standard packaged quantity. For more information.
Health Appliances
(12 months waiting period)
Hearing aids 80% $1200 per 5 yrs N/A
Nebulisers 80% up to $200 1 unit per 3 yrs
Blood glucose monitors 80% up to $250 1 unit per 3 yrs
Blood coagulation monitor (INR) 80% up to $400   1 unit per 3 yrs
(Doctor's referral required on all appliances)  
School Accident
(2 months waiting period)
Additional benefits apply to clinically required services resulting from an accident whilst travelling to or from school (some restrictions apply).  100% $500   N/A

* Rollover Maximum available after 12 months membership with extras cover, except Major Dental which requires 2 years membership.

Note: All the benefits shown here are payable only on services and at health providers recognised by Police Health.

What is not covered in hospital cover (non exhaustive list*)
 

  • Services incurred before waiting periods have been served.

  • Treatment for which Medicare does not pay a benefit, including cosmetic surgery. (Some benefits may be payable for hospital treatment following this surgery. Contact Police Health for more details.)

  • Services that are provided outside the Commonwealth of Australia.

  • Services where an entitlement exists or may exist under any compensation, sports club or third party insurance.

  • A claim for a service that is submitted more than two years after the date of service.

  • Outpatient services unless there is an agreement between Police Health and the hospital.

  • Pharmaceuticals not related to the reason for hospitalisation or not covered under the agreement with the hospital or provided on discharge.

  • Exceptional high cost drugs that may be excluded or limited.

  • Prostheses items that are not included on the Federal Government approved list.

  • Charges greater than the benefit defined in the Federal Governments Prosthesis List.

  • Personal and take-home items, e.g. newspapers, toiletries, television, hairdressing, manicure, etc.

  • Treatment provided to a person in a hospital emergency department.

  • Aged care and accommodation in an aged care facility.

  • If you are in hospital for more than 35 consecutive days and not classified as an acute care patient, your benefits will significantly reduce.

* This provides a general description of what is not covered. Should you require information about a particular treatment or benefit please contact Police Health.

What is not covered in general treatment (non exhaustive list**)

  • Claims for a service that has exceeded the Annual Maximum & Rollover Maximum.

  • The second and subsequent consult with the same profession on the same day.

  • Where the service charge exceeds the fee recognised by Police Health, the benefit you receive may be less than 80% of your cost.

  • Where the service provider is partner, dependent, or parent of the person being treated. Business partners within the practice are also excluded.

  • Services incurred before a waiting period has been served.

  • Services where a Medicare benefit is payable.

  • Services that are provided outside the Commonwealth of Australia.

  • Services where an entitlement exists or may exist under any compensation, sport club or third party insurance.

  • A claim for a service that is submitted more than two years after the date of service.

  • Services provided by practitioners not registered or recognised by the fund.

** This provides a general description of what is not covered. Should you require information about a particular treatment or benefit please contact Police Health. Benefits are correct as of .