Health Partners Review
Overview
Health Partners is 80 years old and South Australia’s largest open health fund. Health Partners is not-for-profit and invests its dividends back into the health fund to afford members more quality and competitive health care.
Health Partners is part of Members Own, a group of like-minded health funds that operate to invest its profits back into its membership. Health Partners has its own Dental centers and Optical stores in South Australia with over 75,000 appointments each year.
Health Partners Key Facts
Founded: 1937
For-Profit or Not-For-Profit? Not-For-Profit
Private Hospital Agreements Nationwide: 285
Day Hospital Agreements Nationwide: 274
Health Deal Represented? No
Headquarters: Adelaide, SA
Health Partners Hospital Cover
Health Partners offer 5 hospital policies suitable for all needs and ages, ranging from Basic Hospital Plus to Gold hospital cover. All of these policies provide coverage for your stay as a private patient and as a minimum benefit include restrictive cover for rehabilitation, psychiatric, and palliative services. Here is a list of the current hospital covers available:
- Basic Hospital Plus
- Bronze Hospital Plus
- Silver Hospital
- Silver Hospital Plus
- Gold Hospital
Health Partners Extras Cover
South Australian Residents
- Base Extras
- Best Extras
- Better Extras
- Good Extras
- Freedom Extras
- Freedom Max Extras
Health Partners Waiting Periods
Health Partners recognise the waiting periods you have already served with a previous health fund if you switch, this is called “portability”. For first-timers taking out a hospital cover, members who may have lapsed in hospital coverage and those upgrading their level of cover, the waiting periods below will have to be served before members can claim on services:
Hospital Waiting Periods
- Ambulance services: 2 months
- Accidental Injury: None
- New Conditions: 2 Months
- Pregnancy and birth-related services: 12 months
- Pre-existing conditions: 12 months
- Rehabilitation & Palliative care: 2 months
How Do You Claim Extras with Health Partners?
Claiming extras with Health Partners is rather easy. There are 5 ways to claim, which are:
On the spot: Swipe your membership card at a health provider that uses the HICAPS system to have your claim processed immediately.
Via a mobile app: You can lodge a claim using the My Health app by submitting a photo of your receipt.
Online: You can log into your online account and lodge your claim by providing the details on your receipt.
Email: You can lodge a claim by sending a completed claim form with a photo of your relevant accounts and receipts to ask@healthpartners.com.au
Mail: You can claim by posting a completed claim form with the relevant accounts and receipts to:
Health Partners Claims Assessor
Reply Paid 1493
Adelaide SA 5001
Health Partners Gap Cover
Health Partners gap cover is called Access Gap Cover. If your doctor charges you more than the standard MBS fee, this is known as the ‘gap’ and can leave you with an out-of-pocket expense. Access Gap can help to minimise or eliminate personal expense but it is the choice of the physician to participate in any given gap scheme.
Gap Cover Ratings By State
To determine how beneficial a gap scheme will be, we suggest comparing health funds in the same state or territory to show which of the funds offer a greater proportion of medical services covered with no gap. While it is more likely that a medical service covered under your health fund can be utilized at no personal cost to you, it is entirely the choice of the physician whether or not to participate in the gap cover scheme.
Medical Services with No Gaps — The percentage of claims that were fully refunded.
Medical Services with No or Known Gaps — The percentage of claims that were fully refunded, or where the policy holder knew the cost before the surgery was performed.
The information below outlines the percentages of services covered under no-gap and known-gap.
Health Partners Medical Services with No Gap: 85%
Industry Average: 79.1%
Health Partners Medical Services with No or Known Gap: 93.8%
Industry Average: 90.5%
Health Partners Medical Services with No Gap: 91.2%
Industry Average: 89.5%
Health Partners Medical Services with No or Known Gap: 96.8%
Industry Average: 95.7%
Health Partners Medical Services with No Gap: 89.5%
Industry Average: 86.7%
Health Partners Medical Services with No or Known Gap: 97.7%
Industry Average: 95.1%
Health Partners Medical Services with No Gap: 94.0%
Industry Average: 89.2%
Health Partners Medical Services with No or Known Gap: 97.8%
Industry Average: 94.5%
Health Partners Medical Services with No Gap: 93.1%
Industry Average: 89.5%
Health Partners Medical Services with No or Known Gap: 99.7%
Industry Average: 96.6%
Health Partners Medical Services with No Gap: 83.7%
Industry Average: 84.4%
Health Partners Medical Services with No or Known Gap: 92.2%
Industry Average: 96.2%
Health Partners Medical Services with No Gap: 98.1%
Industry Average: 90.2%
Health Partners Medical Services with No or Known Gap: 98.3%
Industry Average: 96.7%
Health Partners Medical Services with No Gap: 86.5%
Industry Average: 84.2%
Health Partners Medical Services with No or Known Gap: 100%
Industry Average: 93.8%