Review Peoplecare Health Insurance and Cover Options

Published: November 2, 2018

If you’re thinking of signing up or moving to Peoplecare health insurance and would like a review of their products and how they compare to other leading health insurers, then our breakdown of the health fund’s pricing and benefits might be useful to you.

The Peoplecare health fund is a not-for-profit health insurer that offers 3 Hospital cover options and a choice of 4 Extras policies. They have arrangements with over 36,000 doctors and 550 hospitals all over Australia, which includes Medical Gap cover with participating doctors, which aims to reduce the gap between the Medicare fee and what doctors actually charge.

ComparingExpert does not currently have access to this provider. Visit peoplecare.com.au to request a quote and compare their price and benefits to the Australian private health insurance companies we have access to.

About the health fund

The private health insurer was established in 1952 and used to restrict membership to employees of BlueScope Steel, One Steel, BHP Billiton and more than 40 affiliated companies. In 2006, they opened their doors to the public and now covers over 78,000 Australian singles, couples, families and seniors. Their head office is in Wollongong, just South of Sydney.

Today, Peoplecare is a not for profit private health insurance company and forms part of the Members Own health funds; which is a collection of not-for-profit and mutual funds in Australia, meaning they do not have shareholders and are 100% owned by members.

Health cover options from Peoplecare

The health fund offers 3 levels of Hospital cover and 4 levels of Extras cover, which you can combine into one policy if you wanted to.

Hospital cover

The not-for-profit health fund has arrangements with over 500 hospitals Australia-wide, meaning the hospital will charge your in-patient accommodation, theatre and special unit accommodation directly to Peoplecare Australia, on your behalf.

3 Peoplecare Hospital cover options

Public Hospital Basic Hospital Premium Hospital
$103.79 per month $117.35 per month Between $201.55 and $239.47 depending on your excess.
No Excess and no co-payment $500 excess A choice between $0, $250 and $500
Only covers accommodation as a private patient in a public hospital. Accommodation in a private or public hospital as a private patient. Includes obstetrics and pregnancy-related services, hip and knee replacement, gastric banding and heart and chest procedures.
Benefits are limited to Commonwealth Government set benefits only. Palliatives care, psychiatric services and rehabilitation are only covered in a public hospital as a private patient. Does not include cosmetic surgery or services not covered by Medicare.
Comprehensive ambulance cover with no waiting period. Comprehensive ambulance cover with no waiting period. Comprehensive ambulance cover with no waiting period.

Source: privatehealth.gov.au
The above pricing is based on a single adult, living in Victoria, with no dependents as at November 2018.

When purchasing a Premium Hospital policy, you’ll get access to Peoplecare’s free health programs created to help you stay healthy and manage chronic and complicated medical conditions, so you can leave the hospital faster and recover at home.

You'll generally need to serve a 2-month waiting period to be eligible for health programs like:

  • The coach program: Helping keep your heart healthy with telephonic and written communication.
  • Mindstep: Mental health program to help you manage stress, anxiety and depression.
  • Healthy weight for life: Helps you manage weight and chronic diseases, like diabetes.
  • Strive for health: Provides support and useful information to help you manage chronic illnesses.
  • Hospital at home: Receive short-term therapy services, like IV antibiotics and would care in the comfort of your home.
  • Rehab at home: Receive rehab services at home for short-term therapy services like physio and occupational therapy.

Hospital waiting periods

  • Ambulance cover: None
  • Hospital accommodation: 2 months
  • Joint replacements, including hip and knee: 2 months
  • Obesity-related services: 2 months
  • Cardiothoracic services: 2 months
  • Eye procedures like cataract surgery: 2 months
  • Palliative care: 2 months
  • Psychiatric services: 2 months
  • Obstetrics, including midwifery: 12 months
  • Assisted reproductive services: 12 months

Please contact the insurer for a complete list of hospital services, their corresponding waiting periods and a full list of exclusions.

Peoplecare Hospital exclusions

  • Ambulance services that aren’t medically necessary.
  • Services for which Medicare does not provide a benefit.
  • Treatments received outside of Australia.
  • Procedures that were done more than 2 years ago.
  • Out-patient treatment.
  • Experimental treatments.
  • Most pharmacy items that were given to take at home.
  • Prostheses not on the Government’s Prostheses List.

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Peoplecare Extras

When purchasing an extras policy from the health insurer, you can access any smile.com.au dentist and get 15% off your usual fee. You can also claim for certain health screening services, like mammograms, hearing tests, stress management and blood pressure testing, if Medicare doesn’t pay a benefit.

Take note; the below prices were gathered from privatehealth.gov.au on 1 November 2018.

Basic Extras

At $30.78 per month this is the most affordable extras policy, and generally best suited toward individuals who are young and healthy, without any dependents. The Basic Extras policy includes:

  • General dental
  • Optical cover, like glasses and contact lenses
  • Non-PBS pharmaceuticals
  • Physiotherapy, occupational therapy and eye therapy
  • Chiropractic and osteo
  • Exercise physiology
  • Ambulance services

Mid Extras

For about $64.36 you’ll generally get higher benefit limits for all the services listed in the Basic cover, plus gain access to:

  • Major dental and endodontic
  • Natural therapy, remedial massage and acupuncture, and dietics
  • Podiatry

High Extras

If you suffer the occasional health problem or are a bit more senior, then this policy at $112.46 per month, might be for you. It includes everything listed in the Basic and Mid Extras packages with higher benefit limits, as well as:

  • Orthodontics
  • Laser eye surgery
  • Psychology
  • Hearing aids, and
  • Blood glucose monitors.

Premium Peoplecare Extras

If your planning to start your family, already have children or have some serious health concerns, this top extra cover might be right for you. For $164.57 a month it includes everything in the High Extras package with higher benefit limits.

OSHC Extras

This extras package is specifically designed for overseas students needing private health cover. At the cost of $24.88 per month, you'll receive coverage for general dental, optical, physiotherapy and chiropractic.

Please note; ambulance cover is not included in OSCH Extras.

Extras waiting periods

  • Ambulance cover: None
  • General dental: 2 months
  • Major dental: 12 months
  • Optical: 6 months
  • Physiotherapy: 2 months
  • Natural therapy: 2 months
  • Psychology: 2 months
  • Laser eye surgery: 24 months
  • Hearing aids: 24 months

What Peoplecare health insurance extras doesn’t cover

  • Services provided outside of Australia or received more than 2 years ago.
  • Treatments that were done by providers that aren’t registered or recognised by the insurer or was performed by a family member, relative, business partner or yourself.
  • Naturopathic and herbal medicines.
  • Sports and recreation activities.
  • When using a gift voucher to pay for services.
  • Services you weren’t charged for.

Contact the health fund directly for the complete list of extras they provide, their relevant waiting periods and a full list of exclusions.

Combined policies

Peoplecare generally offers a 10% discount on their extras cover if you combine your extras policy with hospital cover.

Generally, you can combine any hospital option with any extras policy and create a combined Peoplecare product. For example, Basic Hospital $500 excess and Mid Extras or Premium Hospital no excess with Premium Extras.

Children that are between 21 and 25 and are studying full time (not married or living with a partner), can remain on your family cover at no extra premium. If they’re not studying, but still rely on you financially, Peoplecare's Family Plus cover lets you keep them on your policy for an extra premium of 30%.

Have you met Larry the app?

Members have access to the Peoplecare app named Larry. When using Larry, you can

  • Get an update on your benefits and limits,
  • Make and track your claims.
  • Receive tailored health info.
  • Check your payment details,
  • Update your contact information, and
  • Send through pictures of your health receipts for quick claiming.

Frequently asked questions and answers

What’s covered by Peoplecare’s ambulance cover?

  • The full cost of medically necessary ambulance treatment and transport Australia-wide,
  • Unlimited ambulance cover on all policy options,
  • Free with any hospital, extras or combination policy,
  • Land, air and sea ambulance travel,
  • No annual limits,
  • No waiting periods,

Should I join Peoplecare health insurance?

Whether or not you should join or switch to Peoplecare Australia is completely up to you and should be determined by your specific requirements and your budget. You might want to request a quote from them and compare their offering to other leading health insurance companies in Australia.

How do you apply for a policy?

You can apply online through their website, call them directly or download an application form from their website and email or post it to them.

How do you make a claim?

The hospital you've been treated at or the doctor you visited will generally send your claim directly to the insurer to take care of. If you’re claiming extras, you can:

  • Swipe your card and claim on the spot at most health providers.
  • Use your phone to download Larry, the app, from the Apple store or Google Play.
  • Claim online using their Online Membership Service.
  • Scan your claim forms and receipts and email, post or fax it to them.

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Need help? Call us on 1300 786 328

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