Peoplecare Health Insurance Review 2024

Peoplecare is a not-for-profit mutual fund, 100% owned by more than 34,000 members. It's also part of the Members Health Fund Alliance as well as the Members Own Health Funds, an alliance of 15 non-profit and mutual health funds. Peoplecare has five straightforward hospital plans, with simple tiers of Bronze, Silver, Silver Plus and Gold. Four extras policies are also available.

Members of Peoplecare can get discounts at a range of retailers, across dentists, optical retailers and travel insurance. You'll also receive a gift card if you refer a friend or family member to Peoplecare’s health insurance policy. Peoplecare isn't on our panel but we're confident we can get you a great deal on your health cover.

Hospital cover

Nobody chooses to go to hospital.

But when you do, hospital cover will help you get the treatment you need, where and when you want it.

It also helps to pay the bills, as fees for hospital rooms and specialists can add up.

Think about what services you're likely to need, in line with your budget.

If you earn over $90,000 individually or $180,000 as a couple, you could avoid paying the Medicare Levy Surcharge.

Peoplecare currently offers five straightforward hospital plans, ranging from Basic to Gold.  

Basic Plus Hospital

A budget-friendly plan that covers you as a private patient in a public hospital. Is only available with a $500 or $750 excess.

Key inclusions:

• Emergency ambulance cover included at no extra cost

• Covers tonsil adenoids, joint reconstruction and more

• Restricted access to rehabilitation, palliative care and hospital psychiatric services

Bronze Hospital

This level of cover offers you the essentials while still being budget-conscious. This policy comes with a $500 or $700 hospital excess.

Key inclusions:

• Brain and nervous system

• Digestive system

• Gynaecology

Silver Hospital

This level of cover aims to be affordable for young families and couples. This level of cover allows you to choose your doctor. This policy comes with a $500 or $750 hospital excess. 

Key inclusions:

• Ear, nose and throat

• Skin

• Back, neck and spine

Silver Plus Hospital

This level of cover is designed for empty nesters who don’t want pregnancy included in their hospital cover. This policy comes with a $500 or $750 hospital excess.

Key inclusions:

• Hernia and appendix

• Plastic and reconstructive surgery

• Joint replacements

Gold Hospital

This is the most extensive hospital product available with Peoplecare. This policy comes with a $750 hospital excess.

Key inclusions:

• Weight loss surgery

• Pregnancy and birth

• Insulin pumps

Ambulance cover

All Peoplecare hospital, extras or combined hospital and extras cover includes 100% ambulance cover. You can also purchase ambulance cover on its own. Ambulance cover differs from state to state, so if you’re confused, read our guide here.

Extras cover

Peoplecare’s extras reset on July 1 every year.

From dental, to optical, to chiro and more, extras insurance helps cover the bills for routine treatments with rebates of up to 100%.

While we’ve summarised the key points of Peoplecare’s extras cover below, it’s always worth taking a closer look at potential gap fees, how much you can claim back, and whether your preferred healthcare provider is recognised by the health fund.

Take the time to work out what you need and what you're prepared to pay.

If this feels a bit overwhelming, our experts are here to help.

Peoplecare offers four extras policies.

Simple Extras

Simple Extras provides a wide range of benefits including dental, physio, optical and natural therapies. It’s ideal for people who want entry-level extras. Peoplecare offers 50% back as well as 100% on optical.

Key inclusions:

• General dental

• Optical

• Physio 

Mid Extras

Mid Extras cover orthoptics (eye therapy), major dental, podiatry and more. This cover is best suited for young couples or families with young children. Peoplecare offer 60% back as well as 100% back on optical with this level of cover.

Key inclusions:

• Podiatry

• Dietetics

• Remedial massage

High Extras

Smart Extras cover orthodontic treatment, major dental, podiatry and more. Peoplecare offers 70% back as well as 100% back on optical with this level of cover.

Key inclusions:

• Braces and orthodontics

• Laser eye surgery

• Psychology

Premium Extras

Premium Extras is the top level of extras cover and offers 80% back on services. There is also 100% back on optical benefits.

Key inclusions:

• Hearing aids

• Major dental

• Orthodontics

Waiting periods

To stop people signing up, claiming, then cancelling their health insurance, all insurers apply waiting periods.

Generally, the more expensive the treatment or medical services, the longer you'll wait.

But keep an eye out for special deals with waiting periods reduced or waived.

Hospital waiting periods

• 12 months for pre-existing conditions, pregnancy and birth

• 2 months for hospital psychiatric services, rehabilitation and palliative care as well as health programs and all other services

• 1 day for ambulance

Extra waiting periods

• 24 months for laser eye surgery and hearing aids

• 12 months for major dental, pre and post natal services

• 6 months for optical and health management programs

• 2 months for general dental, physio, chiro, pharmacy, podiatry and natural therapies as well as all other health services

• 1 day for ambulance cover

• No waiting periods for services covered by your old fund if you switch to a similar level of cover with Peoplecare  other health partners

Member benefits

Peoplecare has plenty of benefits to offer their members. If you combine both your hospital and extras cover, you receive a 10% discount on your cover.

You can also get a range of discounts across a range of dentists, optical retailers and more.

Peoplecare members living in Wollongong, NSW can also get discounts at the city's Peoplecare Eyes and Teeth clinic^^.

How to claim

Claim on the spot through the HICAPS payment system at your provider.

You can also claim online through Peoplecare's Larry app or the Online Member Services hub.

You can also email or post your claim form.

Hospital agreements

Peoplecare has agreements with most private hospitals and day clinics across Australia.

When comparing health insurance policies and other private health insurers, it's worth checking if your local hospitals and clinics are covered.

Our specialists at Compare Club can do this for you.

Customer service

Peoplecare Health received 0.5% of complaints in 2021, and has a market share of 0.5%^.

Frequently Asked Questions

 Is Peoplecare a not-for-profit fund?

Peoplecare is a not-for-profit fund.

Who can apply? Are there restrictions?

Anyone can apply, there are no restrictions.

Is it easy to switch to Peoplecare?

Peoplecare isn’t on our panel so you’ll need to contact them directly to switch. We’re confident the Compare Club team can find you a great deal from the insurers on our panel.

Do I need to re-serve waiting periods?

If you switch to an equivalent or lower level of cover, you won’t have to serve new waiting periods. However, you may need to serve new waiting periods if your new policy includes additional services or higher benefits

Can I change my level of cover?

Yes, you can choose a lower or higher level of cover.

If you move to a higher level of cover, you will usually need to serve waiting periods on the extra services/higher benefits.

Do I get the government rebate?

For every dollar of private health insurance premiums, the Australian Government provides eligible Australians with a rebate of up to 33.4% (depending on your age and income). To learn what you’re entitled to, read our rebate guide.

Do I have to pay the Lifetime Health Cover loading?

If you’re 31 or over, you usually need to pay 2% loading for each year you’ve gone without hospital cover since the 1st July following your 31st birthday. You can find out more here.

Up to what age are children covered?

Children are automatically covered under family cover until the day before they turn 21.

Sources

^Private Health Ombudsman, Peoplecare, accessed 13 January 2022.

^^Peoplecare, Peoplecare Eyes and Teeth, accessed 13th January 2022.