Peoplecare Health Insurance ☑️ (2025)

Peoplecare Health Insurance Review

Peoplecare Health Insurance offers 5 Health Insurance plans, including the Bronze Plus Hospital Cover, Basic Plus Hospital Cover, and Silver Hospital Cover. These plans start from approximately $18.97 to $54.54 per week, depending on the coverage level and options.

Peoplecare Health Insurance offers unique features such as Access Gap cover, ambulance services, and several discounts through HelloFresh, smile.com.au, Q Optical Network, etc.

🔎 Date Established	1952
📌 Headquartered	Wollongong, NSW, Australia
📍 Registration Number	ABN 95 087 648 753
👤 Average Number of Members	Over 75,000 members
👥 Number of Employees	Approximately 150
🛡️ APRA-Regulated	Yes
📉 Most Recent Market Cap Reported	N/A (Peoplecare is a not-for-profit health insurer)
📈 Average Customer Rating	4.8 stars (based on app ratings)
📊 Average Number of Reviews	100+
💹 Market Share	Approximately 0.5% of the private health insurance market
💱 Number of Plans Offered	Multiple plans, including a range of Hospital and Extras cover options
🎁 Sponsorships	Sponsors community events like the Illawarra Business Chamber and sporting teams like UC Canberra Capitals
📲 Is a Mobile App Offered	Available on iOS and Android
🖱️ Medical Claims Portal	Available through the Online Member Services portal
⏲️ Customer Support Operating Hours	Monday to Friday, 8:30 am – 5:00 pm AEST
🖱️ Information Hub and Blog	Yes, offers various health guides and updates
🩺 Chronic Illness Benefits	Provides specialized support programs for conditions like Heart Health and Cancer Support
💊 Screening and Prevention Offered	Covers various preventive programs under extras cover
🍼 Maternity Benefit	Included in Hospital cover plans
💶 Health Insurance Premium Range (AUD)	$18.97 to $54.54 per week
⏰ Average Waiting Period	Standard waiting periods, including 12 months for pre-existing conditions and pregnancy services
🌎 Is International Medical Cover Offered	No specific international medical coverage is offered; focus is on domestic coverage
✈️ International Travel Benefit	Limited to domestic programs like Hospital at Home and partner services

Peoplecare Health Insurance Plan Overview

🔎 Plan	💶 Premium Range AUD	📌 Exclusions	🩷 Ideal For	↪️ Gap Cover	📍 Rebate Percentage	⏰ Average Waiting Period	🌟 Key Features
🥇 Basic Plus Hospital	From $18.98 per week ($750 excess)	Limited coverage on private hospital services for restricted treatments like psychiatric services and certain elective surgeries	Singles, couples, families, single parents on a budget	✅Yes	24.608%	2 months (most services), 12 months (pregnancy)	Ambulance cover, moderate excess options, coverage for essential treatments, and restricted services at default benefit rates
🥈 Bronze Plus Hospital	From $21.33 per week	Excludes pregnancy and cosmetic surgeries, restrictions on non-essential elective treatments	Singles, couples, families, single parents	✅Yes	24.608%	2 months (most services), 12 months (pregnancy)	Comprehensive ambulance cover, $500 or $750 excess options, covers essential medical categories like ENT and bone services
🥉 Silver Hospital	From $29.10 per week	Excludes pregnancy and restricted elective treatments	Singles, couples, families, single parents	✅Yes	24.608%	2 months (most services), 12 months (pregnancy)	Extensive ambulance coverage, access gap cover, and coverage of services like heart and vascular care, joint replacements, and gynecology
🏅 Silver Plus Hospital	From $39.64 per week	Excludes pregnancy and certain elective surgeries	Middle-aged couples, families with growing needs	✅Yes	24.608%	2 months (most services), 12 months (pregnancy)	Covers critical services, extensive ambulance services, hospital substitution programs like “Hospital at Home” and “Rehab at Home”
🎖️ Silver Plus Grow Hospital	From $54.54 per week	Excludes specific elective surgeries, limited cosmetic procedures	Families planning for children, singles with diverse needs	✅Yes	24.608%	2 months (most services), 12 months (pregnancy)	Offers comprehensive maternity and pediatric care, includes “Rehab at Home” and “Chemo at Home” programs, covers assisted reproductive services

Peoplecare Health Insurance Plans – Features and Benefits

Peoplecare Health Insurance offers tailored hospital-only plans to cover different medical needs and provide flexible financial contributions for individuals, couples, families, and single parents.

Each plan has distinctive clinical categories, exclusions, and additional services for different health requirements. In this section, we’ll explore each plan’s unique elements in depth, focusing on key features, premium ranges, and ideal beneficiaries.

Basic Plus Hospital Cover

Basic Plus Hospital Cover is a mid-tier option with moderate coverage for essential treatments and services. With flexible excess options ($500 or $750), it caters to individuals and families who want more extensive coverage while managing costs effectively.

Basic Plus Hospital Cover Details

🔎 Feature	📌 Details
📉 Premium Range	From $18.98 per week (based on Single Cover, NSW)
📈 Excess Options	$500 or $750
📊 Clinical Categories	Bone, joint, ENT, psychiatric services
💹 Exclusions	Cosmetic surgery, outpatient services, non-Medicare items
💱 Ambulance Coverage	Comprehensive emergency ambulance coverage
⏰ Waiting Periods	2 months for most services, 12 months for pregnancy services
↪️ Gap Cover Available	✅Yes

Key Features and Benefits

Choose between $500 or $750 per person annually.
Comprehensive coverage includes emergency transport.
Includes Hospital at Home and Rehab at Home.
Ideal for families with young children, individuals managing psychiatric health, and couples planning joint medical needs.

Bronze Plus Hospital Cover

The Bronze Plus Hospital Cover has moderate but extensive coverage for major medical treatments. It provides financial flexibility through excess options and covers clinical categories for individuals, couples, and families.

Bronze Plus Hospital Cover Details

🔎 Feature	📌 Details
📉 Premium Range	From $21.33 per week (based on Single Cover, NSW)
📈 Excess Options	$500 or $750
📊 Clinical Categories	ENT, joint, digestive, male reproductive
💹 Exclusions	Non-essential surgeries like cosmetic procedures
💱 Ambulance Coverage	Emergency transport and treatment
📌 Waiting Periods	2 months for most, 12 months for pregnancy services
↪️ Gap Cover Available	✅Yes

Key Features and Benefits

Includes ENT, joint, and male reproductive system services.
Emergency transport is included without additional costs.
Excess levels can be adjusted to manage premium costs.
Suitable for active couples and families who need extensive medical coverage.

Silver Hospital Cover

The Silver Hospital Cover has coverage focused on essential treatments and extensive clinical categories. It is ideal for members who require additional support and services for major health concerns.

Silver Hospital Cover Details

🔎 Feature	📌 Details
📉 Premium Range	From $29.10 per week (based on Single Cover, NSW)
📈 Excess Options	$500 or $750
📊 Clinical Categories	Heart, vascular, maternity, eye, and reconstructive
💹 Exclusions	Cosmetic surgery, outpatient treatments
💱 Ambulance Coverage	Comprehensive emergency transport
⏰ Waiting Periods	2 months for most, 12 months for pregnancy services
↪️ Gap Cover Available	✅Yes

Key Features and Benefits

Includes heart and vascular treatments, reconstructive surgeries, and maternity services.
Access to programs like Chemo at Home and Rehab at Home.
Extensive coverage for emergency transport and treatment.
Ideal for families and individuals managing chronic or severe medical conditions.

Silver Plus Hospital Cover

Silver Plus Hospital Cover offers more coverage across specialized clinical categories. This plan is ideal for additional protection for high-cost services like joint replacements and major surgeries.

Silver Plus Hospital Cover Details

🔎 Feature	📌 Details
📉 Premium Range	From $35.45 per week (based on Single Cover, NSW)
📈 Excess Options	$500 or $750
📊 Clinical Categories	Heart, eye, maternity, dialysis, joint replacements
💹 Exclusions	Non-essential surgeries like cosmetic procedures
💱 Ambulance Coverage	Emergency transport covered
⏰ Waiting Periods	2 months for most, 12 months for pregnancy services
↪️ Gap Cover Available	✅Yes

Key Features and Benefits

Covers heart surgeries, dialysis, and joint replacements.
Emergency transport nationwide without additional charges.
Access to specialized services like Chemo at Home and Hospital at Home.
Ideal for families, couples, and individuals with high-cost medical needs.

Silver Plus Grow Hospital Cover

Silver Plus Grow Hospital Cover offers an all-encompassing package combining comprehensive hospital cover with additional extras to support inpatient and outpatient needs.

Silver Plus Grow Hospital Cover Details

🔎 Feature	Details
📌 Premium Range	From $54.54 per week (based on Single Cover, NSW)
📉 Excess Options	$500 or $750
📈 Clinical Categories	Heart, maternity, joint replacements, weight loss surgery
📊 Exclusions	Cosmetic surgery, outpatient services
💹 Ambulance Coverage	Comprehensive, including emergency transport
⏰ Waiting Periods	2 months for most, 12 months for pregnancy services
↪️ Gap Cover Available	✅Yes

Key Features and Benefits

Includes heart, maternity, joint replacements, and weight loss surgeries.
Emergency and non-emergency services are included.
Provides Hospital at Home, Rehab at Home, and Chemo at Home.
Ideal for families seeking all-around coverage, individuals planning elective surgeries, and couples with expanding families.

Peoplecare Extras and Overseas Options

Here’s a compressed view of the Extras and Overseas options from Peoplecare Health Insurance:

🔎 Plan	🔑 Key Features	💶 Cost	💵 Annual Limits
📉 Simple Extras	Essential coverage includes dental, optical, physio, and unlimited ambulance.	From $6.51/week	Dental: $500, Optical: $150
📈 Mid Extras	Covers essential dental, optical, physio, and more, with moderate benefits.	From $12.80/week	Dental: $750, Optical: $200
📊 High Extras	Higher limits on dental, optical, therapies, and ambulance coverage without limits.	From $19.09/week	Dental: $1,000, Optical: $250
💹 Premium Extras	Comprehensive cover with higher benefits on dental, optical, laser eye surgery, and therapies.	From $29.75/week	Dental: $1,500, Optical: $300
💱 OSHC	Covers hospital, emergency, and medical services for international students as required by the Australian government.	Varies	Coverage based on policy
📌 OSHC Extras	Additional extras cover for international students, including dental, optical, physio, and chiropractic services.	Varies	Dental: $500, Optical: $150
📍 OVHC	Covers hospital, emergency, and medical costs for international visitors with options like pharmacy and specialist care.	Varies	Coverage based on policy

Recent User Reviews

🥇 Efficient Claims Processing and Easy-to-Use App

There was a marked change in the claims processing procedure when I transferred to Peoplecare. Not only is it quick, but it’s also easy. Their lack of red tape in reimbursing me for treatments is appreciated. An added advantage is how easy their app is to use, and I love how quickly they respond to my claim updates. – James

🥈 Excellent Maternity Coverage and Support for Growing Families

Peoplecare provides excellent maternity coverage at a reasonable price, so I transferred our family to them after the birth of my second child. So far, I’ve had nothing but good experiences with excellent coverage for both regular exams and unexpected medical needs. When I contacted customer support for assistance in understanding our new family plan, they were patient and kind. They are great for expanding families, in my opinion. – Luna

Peoplecare Health Insurance vs Union Health vs Australian Unity Health Insurance – A Comparison

🔎 Providers	🥇 Peoplecare Health Insurance	🥈 Union Health	🥉 Australian Unity Health Insurance
📌 Years in Operation	Over 70 years	6 years	184 years
📍 Average Number of Members	Over 75,000	Not published	Approximately 280,000
🛡️ APRA Regulation	✅Yes	✅Yes	✅Yes
🫶 Number of Employees	150+	1,000 – 5,000	Over 7,000
📉 Market Share	Approximately 0.5%	Less than 0.5%	Estimated at around 3%
📈 Market Coverage	Australia	Australia	Australia
⭐ Customer Rating	4.8/5	4.5/5	4.2 stars
💛 Number of reviews	100+	100+	1,000+ reviews
📊 Mobile App	✅Yes	✅Yes	✅Yes
💶 Premium Range (AUD)	$18.97 to $54.54 per week	From $36.30 per fortnight to $3,253.55/year	From $38.60 per fortnight to $3,172.79 per year
🌎 International Travel Benefit	✅Yes	✅Yes	✅Yes
❤️ Unique Features	Comprehensive ambulance cover with all plans, digital member services, and access gap benefits, not-for-profit and member-owned, giving back over 80% of premiums in benefits	Focus on Pediatric and Neonatal Service, Chronic Illness Benefit, Tailored Plans for Union Members	Hospital Substitution Programs, Health Support Programs, Chronic Illness Benefits, Screening and Prevention Programs, comprehensive hospital and extra coverage options

Advantages of Using Peoplecare Health Insurance – Unique Selling Points

Peoplecare Health Insurance operates on a not-for-profit model, focusing on prioritizing member benefits rather than shareholder profits. Any surplus is reinvested into improving member services, offering better coverage options, and maintaining stable premiums.

Peoplecare provides access to a range of health programs like ‘Hospital at Home’ and ‘Rehab at Home.’ With its ‘Family Plus’ cover, Peoplecare extends coverage to dependents up to the age of 30. All plans include comprehensive ambulance cover, and Peoplecare’s decisions are shaped by the needs of its members. Members can access over 540 hospitals and 37,000 doctors.

Additionally, Peoplecare waives the excess for hospital claims involving children under 21 and offers an Access Gap Cover scheme to bridge the gap between Medicare benefits and provider fees. The digital services include a user-friendly app to manage claims, check benefits, and update membership details. Peoplecare members also receive discounts on dental, optical, and other services, making it a comprehensive and member-focused health insurance provider.

Peoplecare Health Insurance Gap Cover

Peoplecare Health Insurance offers the Access Gap scheme to address members’ financial concerns when accessing inpatient services. Members can use this scheme to reduce expenses when their specialist participates, ensuring support for essential medical care.

How the Access Gap Scheme Works

Members can consult with their specialist to verify their participation in the Access Gap scheme.

Peoplecare covers amounts above the Medicare Benefits Schedule fee if the specialist participates.
When a general practitioner provides a referral, members can consult other specialists in the same field.

The Access Gap scheme applies a maximum gap of $500 per doctor per hospital episode. This limit extends to $800 per doctor for services related to pregnancy and birth.

Peoplecare Health Insurance App Features

Peoplecare offers an iOS and Android app as a self-service portal where members can easily manage their cover from anywhere. Peoplecare’s mobile app provides the following key functionalities:

Members can submit claims by:

Getting a receipt from their medical provider.
Take a photo of the receipt.
Uploading it through the app.
Monitoring the claim process.

Users can update personal and payment information, and members have real-time access to their extra benefits limits and covered clinical categories under hospital cover. Furthermore, all communications from Peoplecare are securely stored within the app’s inbox. Members can securely upload documents like government rebate applications or student declarations.

🔎 Feature	📌 Description	✅ Pros	❌ Cons
📉 Claim Submission	Submit claims by taking a photo of receipts	Quick processing, no paperwork	Requires a clear photo for processing
📈 Membership Management	Update contact and payment details	Convenience in maintaining records	Limited editing options for some fields
📊 Benefit and Coverage Checker	View remaining limits and covered categories	Instant access to coverage info	May require internet access
💹 Secure Document Upload	Upload key documents securely	Safe and secure digital storage	Dependent on file size and upload speed
📒 Secure Inbox	Store and access all communications with the fund	Privacy and ease of access	None identified

How to Apply for Health Insurance

To apply for health insurance with Peoplecare Health Insurance, follow these steps:

Gather necessary information, including your membership ID (if transferring), full name, date of birth, and any dependent details. If you don’t have a membership ID, Peoplecare can help you register.
Complete the application form with your membership and personal details. The form is available online or can be completed over the phone with Peoplecare’s assistance.
Submit the premium payment for the minimum period required based on your chosen coverage. Payments can be made via direct debit or other methods provided by Peoplecare.

Once your application is processed, Peoplecare will issue a PHIS (Private Health Insurance Statement) outlining your selected policy features. This statement is provided annually or upon request.

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How to apply for Gap Cover with Peoplecare Health Insurance

Members must consider eligibility and the process outlined in Peoplecare’s official guidelines when applying for Access Gap Cover. Members must confirm whether their healthcare provider is an Access Gap scheme participant. Here’s how to apply for gap coverage with Peoplecare Health Insurance:

Check Specialist Participation

Use the provider search tool to confirm if your specialist participates in Access Gap.

Discuss Financial Consent

Speak with your specialist about their costs and secure Informed Financial Consent before treatment.

Submit Your Application

Complete the form and ensure that the information provided is updated and accurate.

Peoplecare will review the application and communicate the status thereof.

How to Submit a Claim with Peoplecare Health Insurance

Peoplecare Health Insurance’s claims process accommodates multiple scenarios and ensures that members can choose the most convenient claim method based on their requirements. Here’s how to submit a claim with Peoplecare:

Instant Claiming via Card Swipe

Most health service providers, including dentists, optometrists, chiropractors, and physiotherapists, support on-the-spot claiming through Peoplecare’s membership card using the HICAPS system. To use this service, members simply swipe their membership card at the provider, and the claim is processed instantly.

The only cost to the member is the difference between the provider’s fee and the benefit paid by Peoplecare. However, not all service providers are connected to HICAPS, and this method may not be available for more complex claims, such as orthodontics or specialized health services that require additional documentation.

Claim Submission via Mobile App

Before submitting through the app, members need to collect a receipt with essential information, including:

Patient’s name
Provider’s name and registration number
Date and details of the service
Amount paid

Here are the steps involved:

Download and open the Peoplecare mobile app on an iOS or Android device.
Take a clear photo of the receipt, ensuring all required details are visible.
Upload the receipt through the app, attach any additional supporting documents if applicable (e.g., an Orthodontic Treatment Plan), and submit the claim.

Claiming through Online Member Services

Log in to the Online Member Services on Peoplecare’s website.
Navigate to the claims section and upload a photo or scanned copy of the receipt.
Submit the claim after reviewing all information.

Submitting Claims via Email

Members need a completed claim form along with a scanned receipt.

Scan or digitally complete the Peoplecare claim form and the receipt.
Email these documents to [email protected] with the member’s details.

Claiming by Post

Members must complete a claim form and have a hard copy of the receipt.

Fill out a Peoplecare claim form manually.
Attach the original receipt and mail it to Peoplecare at Locked Bag 33, Wollongong, NSW 2500.

How to Downgrade My Plan with Peoplecare Health Insurance

Plan downgrades at Peoplecare Health Insurance involve specific steps and policies that can help members change their cover level. Members must review their current plan options and then follow these steps:

Before downgrading, members must evaluate their current level of coverage using the ‘Help Me Choose’ tool on the Peoplecare website or consult a health coverage expert by phone.
Call Peoplecare’s customer support at 1800 808 690 to initiate a downgrade. Members can discuss their plan changes and receive guidance on selecting a suitable new cover option.
When downgrading, members must remember that the premium costs will be adjusted based on the new level of coverage.
Members should understand the waiting periods that apply when switching to a lower coverage level, especially for previously covered services.

After the changes are confirmed, Peoplecare will provide updated documentation reflecting the new cover level and any adjustments made to the policy.

How do I add a Beneficiary to Peoplecare Health Insurance?

Adding a beneficiary like an adult or child dependent is easy with Peoplecare, especially since the health insurance accommodates student and non-student dependents. Here’s how:

Call Peoplecare directly at 1800 808 690 during business hours (8:30 am to 5:00 pm AEST, Monday to Friday) to start the process. Alternatively, you can reach out through their online portal if you cannot call during these hours.
Provide details about the dependent like their full name, relationship to you, age, and student status if applicable. Peoplecare representatives will guide you on any additional documentation needed.
Waiting periods could apply depending on the type of coverage and the new dependent’s previous health insurance. If the dependent transfers from another health fund within 30 days.

Confirm any changes to your premiums based on your current coverage and the type of dependent added. For example, adding a child under a single-parent policy will affect your premiums differently than adding a partner under a single-parent policy.

Additional Considerations

Newborns can be added without additional waiting periods if the parent has already served theirs and the addition is made within 12 months of birth.
Dependents added to the policy benefit from a 30-day cooling-off period. If they cancel within this time and haven’t made any claims, the main member will receive a full refund of any premiums paid.

How to Submit a Compliment or Complaint with Peoplecare Health Insurance

Members can easily submit feedback to Peoplecare Health Insurance, whether it’s a compliment or a complaint, using the following information:

You can provide feedback by calling Peoplecare at 1800 808 690 during office hours (Monday to Friday, 8:30 am to 5:00 pm AEST) or emailing [email protected]. Both options allow direct interaction with the Peoplecare team to resolve issues promptly.
When submitting feedback, you must provide member details and a description of your concern or compliment. This helps Peoplecare’s team address the issue and provide accurate assistance.
If your issue isn’t resolved during initial contact, you can ask to speak to a manager or request a formal internal review. Peoplecare encourages members to escalate complaints as necessary to ensure client satisfaction.

If internal avenues don’t lead to a satisfactory resolution, Peoplecare advises contacting the Private Health Insurance Ombudsman (PHIO), an independent body that can help resolve disputes.

How to Switch my Health Insurance to Peoplecare Health Insurance

Switching to Peoplecare Health Insurance seems like an effortless process that involves these steps:

Start the transfer process by signing up with Peoplecare either through their website or via a phone call. You’ll be asked for details about your existing health insurance.
During the sign-up, supply information about your current insurer (basic details like your policy number and membership information).
Once you provide the necessary details, Peoplecare manages the switch for you, making sure that all formalities are completed and any required documents are collected.
To keep your benefits intact, the transfer must be completed within 30 days of your last premium payment to your previous insurer.
Peoplecare requires a transfer certificate from your previous insurer. This document helps Peoplecare verify your previous coverage and evaluate the waiting periods you might be subject to.

Should you ever terminate your membership with Peoplecare, they will issue a transfer certificate within fourteen days to ensure the handover of coverage to a new insure is seamless and you are not left without cover.

Peoplecare Health Insurance Travel Insurance

According to our research, Peoplecare offers a few travel insurance plan options through a partnership with Allianz Global Assistance.

This coverage caters to different travel needs, both domestic and international. Members who sign up for this can benefit from emergency assistance and specialized cover options catering to different travel experiences.

🔎 Plan Name	🔑 Key Features	📌 Additional Options
🥇 Domestic	Covers personal liability, luggage loss, and trip cancellations. Option to add Snow, Cruise, or Adventure Packs	Optional increased item limits and pre-existing medical condition cover
🥈 Essentials	Budget-friendly overseas coverage for medical, hospital, and dental expenses	Covers personal liability and unexpected trip cancellations
🥉 Comprehensive	Offers extensive coverage for overseas medical and emergency expenses, luggage loss, and cancellations	Options to add specialized packs like Snow or Cruise for enhanced protection
🏅 Multi-Trip	Annual cover for multiple trips with benefits similar to the Comprehensive Plan for overseas and Domestic Plan for domestic travel	Additional packs available for snow, cruise, or adventure activities

Unique Features and Exclusions

Snow, Cruise, and Adventure Packs provide additional coverage for skiing, cruising, and adventure sports. Each pack covers activity-specific risks like snow sports emergencies, onboard medical expenses, or adventure-related incidents.
Epidemic and Pandemic Policies: Coverage is limited if travel advisories from Smartraveller or other government bodies are ignored.
Increased Item Limits: The option to increase the insurance coverage limit is available for anyone with high-value items, but this involves an additional premium.

Peoplecare Health Insurance Corporate Responsibility

Peoplecare has a “Community” section on the website listing all Corporate Responsibility initiatives and projects. Here’s an overview of what they’re involved in in terms of charitable initiatives:

Community Involvement

Peoplecare contributes to the Illawarra community via sponsorship and supporting local projects and organizations, including, but not limited to:

Try the Gong and Bulli Burn events promoting health and fitness.
Partnerships with Football South Coast and Illawarra Triathlon Club to support local sports.

Cultural contributions include backing the Merrigong Theatre Company and the Kiama Rotary Car Show.

Charitable Engagement

Besides community events, Peoplecare collaborates with charities like SAHSSI for crisis accommodation and the Cancer Council Relay for Life.

Employees are also encouraged to volunteer with programs like the Country Fire Authority and the L2P Learner Driver Mentor Program in the Mornington Peninsula region.

Peoplecare employees also have access to community leave, allowing them to support vital services like the SES or fire brigade.

Peoplecare Health Insurance Regulation

The Australian Prudential Regulation Authority (APRA) and the Australian Competition and Consumer Commission (ACCC) regulate private health insurance in Australia.

Peoplecare Health Insurance is a member of APRA under the Registered Name Peoplecare Health Limited (ABN 95 087 648 753).

The primary regulatory framework comes under the Private Health Insurance Act 2007, alongside the oversight functions of APRA and ACCC. Specific Responsibilities and Regulatory Focus Areas of APRA and ACCC:

Maintaining Financial Stability: The APRA actively monitors private health insurers through regular risk assessments and financial stress testing to ensure their solvency.
Ensuring Fair Pricing and Transparency: The ACCC oversees premium adjustments, reviewing increases to confirm they meet regulatory standards and safeguard consumer fairness.

APRA and ACCC are dedicated to enforcing market integrity and shielding members from misconduct and potential financial threats.

Peoplecare Health Insurance Awards and Recognition

Peoplecare Health Insurance has consistently earned recognition for its commitment to customer satisfaction, workplace excellence, and community involvement. Below is an overview of their key achievements:

🔎 Awards/Recognition	🅰️ Details	🅱️ Significance
📉 2024 IPSOS Member Satisfaction	Achieved 97% member satisfaction, ranking in the top 2 for claims processing and quality of service	Consistent service excellence and trust
📈 2023 Australian Service Excellence Awards	Won’ Customer Service Advocate of the Year’ and received ‘Highly Commended’ for Customer Service Organization (Medium Business)	Dedication to outstanding member service
📊 White Ribbon Australia Accreditation	Recognized as a White Ribbon accredited workplace for efforts to prevent domestic violence	Commitment to a safe and inclusive culture
💹 Aon Best Employer/Kincentric	Recognized since 2017 as a Best Employer, focusing on employee engagement and leadership	Strong internal culture and leadership
📉 HR Awards Finalist	Nominated for ‘Best Change Management Strategy’ and ‘Employer of Choice (NFP)’ categories	Adaptability and focus on employee well-being

Customer Support and Contact Details

🔎 Contact Method	📌 Details
☎️ Phone	New Cover Enquiries: 1800 931 814 Members: 1800 808 690 (Mon-Fri, 8:30 am - 5:00 pm AEST) Providers: 1800 808 690
💌 Email	[email protected] (for non-urgent matters or documentation)
📬 Postal Address	Locked Bag 33, Wollongong NSW 2500 (for documents or formal correspondence)
🥰 In-Person Visits	Peoplecare Eyes & Teeth, 63 Market St, Wollongong (for in-person support or services)
❤️ Digital Self-Service	Member portal and mobile app for managing policies, submitting claims, and updating information

Peoplecare Health Insurance Rebates and Discounts

Peoplecare offers more than just comprehensive hospital and extra plans that cover different health needs of various family dynamics. There are also several bonuses, discounts, and rebate options that members can qualify for, including the following:

Rebates and Discounts Overview

🔎 Discount/Offer	📌 Details	📍 Eligibility
🥳 Refer a Friend Bonus	Receive a $150 EFTPOS gift card when referring a friend or family member who joins with combined Hospital & Extras cover	Referral must be on a new Hospital and Extras policy
🎉 HelloFresh Promotion	New and reactivating customers can receive up to $200 off over six boxes, starting with $75 off the first box	Promo code: “HFPEOPLE200”
🎊 Smile.com.au Dental Discounts	Save 15% to 40% on dental treatments at partnered dentists across Australia	Available to members with Extras cover
🍾 Community First Bank Benefits	Access low-rate financial products, such as the McGrath Pink Visa credit card, with a 50% fee donation to the McGrath Foundation	Members can explore savings on loans and credit cards
🎁 OPSM and Laubman and Pank Discounts	20% off lenses and lens extras and 10% to 15% off contact lenses and non-prescription sunglasses	Applicable to members with Extras cover at retail locations
🎀 Q Optical Network	Provides no-gap glasses options and discounts on additional pairs and contact lenses	Requires specific Extras cover with annual limits available

Government Rebates and Special Discounts

Australian Government Rebate offers up to 32.812% on standard private health cover costs, based on age and income tiers.

Age-Based Discount

Members under 30 can receive a 2% to 10% discount on selected hospital covers.

Lifetime Health Cover (LHC) Loading

Avoids a 2% annual increase in premiums for those who maintain continuous coverage from before the age of 31.

Medicare Benefits

Covers 75% of eligible in-hospital medical services under the Medicare Benefits Schedule (MBS). Peoplecare covers the remaining 25% through Access Gap arrangements to reduce or eliminate out-of-pocket costs.

Medicare Levy Surcharge

An additional levy for high-income earners without private hospital cover, ranging from 1% to 1.5% based on income brackets.

Peoplecare Health Insurance Additional Health Services and Products

There are a few additional health services and products available from Peoplecare Health Insurance, including:

Psychology and Mental Health Support offers guidance on using psychology benefits available through Peoplecare’s extras coverage and Medicare support.
Dental Insurance covers general, major, and orthodontic dental treatments.
Physiotherapy and Related Therapies cover physiotherapy, occupational therapy, exercise physiology, and hydrotherapy.
Complementary Therapies have cover for acupuncture, dietetics, and massage therapy.
Optical Insurance has benefits for glasses, contact lenses, and laser eye surgery, with exclusive member deals on eyewear.

Hospital-at-Home programs include Rehab at Home and Chemo at Home, substituting hospital stays with home-based care at no extra cost for eligible members.

Pros and Cons

✅ Pros	❌ Cons
Provides tailored support programs for chronic conditions like heart disease and cancer	No international medical coverage, only domestic coverage
Waives hospital excess fees for dependent children under 21	Comprehensive plans like Silver Plus Grow Hospital can be costly for families
Provides specialized travel insurance packs	Plans focus on broad medical needs, leaving gaps in rare or specialized services
Offers maternity benefits and pediatric services under higher-tier plans	Exclusions apply for outpatient and non-Medicare services in most plans
Offers coverage for dependents up to 30 years under the “Family Plus” cover option	The Access Gap Scheme has set financial limits per doctor per hospital episode
Active engagement with the community through sponsorship of local sports and cultural events	Some plans exclude or limit coverage for maternity and pregnancy-related services
Offers various screening and preventive services under extras cover	Excludes non-essential surgeries

In Conclusion

While reviewing Peoplecare, we found that the insurer emphasizes comprehensive hospital-only, extras, and combined plans. There’s also a focus on providing intuitive digital tools that make policy management much easier (app plus online portal).

The plans are competitively priced, from $18.97 on the Basic Plus Hospital to $54.54 on the Silver Plus Grow Hospital. Each of Peoplecare’s plans addresses the healthcare needs of individuals and families at different life stages.

Peoplecare’s claims processes are streamlined and make it easy for members. There are many additional services offered to extend coverage, like dental, optical, pregnancy extras, complementary therapies, and more.

Despite this, some plans have gaps in coverage, especially in major surgeries and maternity services. The pricing on higher-tier plans can be challenging for some members, especially compared to similar plans offered by competitors.

Peoplecare stands out as a health insurance company that considers unique healthcare needs, but potential members must use the comparison tool on the website to determine whether it’s the right option for them based on their unique needs.

Frequently Asked Questions

What coverage does Peoplecare provide?

Peoplecare has hospital-only, extra, and combination coverage options for individuals, couples, and families.

How can I change my level of coverage?

You can change or boost your coverage anytime using Peoplecare’s app, online member portal, or by contacting customer support directly.

What is the waiting period for pre-existing conditions?

All hospital insurance policies include a 12-month waiting period for pre-existing conditions.

How can I submit a claim?

Claims can be submitted to providers using the HICAPS system or online using the Peoplecare app and online member portal.

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