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SERVICES EXPLAINED
Benefit included
Benefit excluded
Low-cost extras cover for General Dental, Optical and 5 other common services.
EXTRAS HEALTH SERVICES BY CATEGORY
Covered for preventative dental treatments, such as consultations and scale & cleans, and general restorative dental treatments such as simple fillings and extractions.
Covered for major dental treatment, which refers to more complex procedures such as a surgical root canal, dentures, crowns, bridges and dental implants.
Covered for orthodontic treatment including braces and retainers.
Cover for prescription glasses and contact lenses to correct vision impairments.
Covered for Physiotherapy consultations, which involves the treatment of physical issues caused by injury, illness and ageing.
Covered for chiropractic consultations, which involves treatment of the musculoskeletal structure, including the spine.
Covered for Osteopathy consultations, involving treatment muscles and joint issues by massage and manipulation to improve mobility and reduce pain.
Fully covered for unlimited urgent ambulance transport by road only (excludes air transport). Ambulance services are not free or not covered by Medicare in most Australian states (Queensland and Tasmania exempt).
Covered for access to a range of HBF approved health services, such as flu vaccinations, weight management and quit smoking programs. These programs are designed to prevent illness, help you make healthy lifestyle changes and manage your overall health and wellbeing.
Covered for pharmaceutical items not included on the Government Pharmaceutical Benefits Scheme (PBS), allowing access to a broader range of medications.
Covered for foot orthoses, also known as orthotics, which are shoe inserts to correct biomechanical imbalances to realign the foot and ankle.
Covered for remedial massage and myotherapy, which involves the massage and manipulation of soft tissue, allowing the body to return to normal health.
Covered for medically necessary appliances that help manage, monitor or treat a health condition. For example, splints, prosthesis, supports and braces.
Covered for a hearing aid so a person with hearing loss can listen, communicate, and participate more fully in daily activities.
Covered for consultations with an Orthoptist for eye therapy. Orthoptists help treat problems like lazy eye, eye alignment, coordination and poor focus.
Covered for Occupational Therapy consultations, which help people with illnesses, injuries and emotional issues engage in everyday activities.
Covered for Speech Therapy which can involve the diagnosis and treatment of communication disorders such as speaking, stuttering, listening, reading, writing and social skills.
Covered for consultations with a Clinical Psychologist, who can diagnose and treat mental, emotional and behavioural disorders.
Cover for consultations with a Psychologist, who helps people experiencing difficulties in their life such as anxiety and depression, relationship breakdowns, eating disorders and chronic illness.
Covered for consultations with a Dietitian, who can give nutrition and dietary advice to promote health and help with prevention and treatment of illness.
Covered for consultations with a Nutritionist, who can provide advice on healthy eating and nutrition for health management.
Covered for Traditional Chinese Medicine, Acupuncture and Hypnotherapy.
Covered for consultations with an Exercise Physiologist, who specialises in the prevention and management of chronic disease and injury through exercise.
Annual limit
Waiting period
Basic Extras
EXTRAS HEALTH SERVICES
Saver Flexi Extras
Standard Extras
Flexi Extras
Top Extras
Choose from 5 Hospital products, which cover you for inpatient surgery and other medical treatments in a hospital.
Extras insurance, also known as general treatment cover or ancillary cover, helps cover the cost of everyday healthcare services.
These can be minor services like dental check-ups, new glasses, and physio appointments, to more major services like wisdom teeth removal and dental implants.
Medicare generally doesn’t cover extras services, so extras insurance can be a way to help cover those costs.
The specific extras services you’re covered for depends on your health fund, level of cover and the specific policy you choose. Here are some examples of common services extras insurance can cover:
There are some situations where your health fund cannot pay a benefit (because they legally can’t), but Medicare will.
For example, a visit to a doctor outside of hospital, like a General Practitioner (GP), will never be covered by health insurance, no matter what fund you’re with – that’s covered by Medicare.
Consultation fees for a doctor or a specialist appointment outside of hospital, tests and examinations like x-rays or blood tests and eye tests by an optometrist are common situations where your health fund won't pay a benefit but Medicare will.
The amount you can claim back on extras services depends on your benefits (the amount you get back when you claim) and your annual limits (the maximum amount you can claim in a year).
Nearly all extras insurance policies only cover services to a limited extent, which means you’ll usually pay for some of the service out of your own pocket.
But extras insurance is still worth it because Medicare generally doesn’t cover extras services, so without it you’d have to cover the full cost of treatment.
When you buy extras insurance for the first time, if you’ve not had it for a long time, or if you’ve just upgraded to a higher level of cover, there will generally be a waiting period you need to serve before you can claim.
Waiting periods for extras vary between health funds, but with HBF most services have a 2-month waiting period, while more high-cost services (like orthodontics) have a waiting period of 12 months or more.
A lifetime limit is the total amount you can claim for a service over the course of your lifetime. Each person on your policy has their own lifetime limits. A lifetime limit applies to orthodontic cover with HBF. That means, once you’ve claimed for orthodontics, you won’t ever be able to claim again even if you upgrade your level of cover with HBF.
An annual limit is the maximum amount of money you can claim for a service within a calendar year. Each person on your policy has their own annual limits.
A benefit is the amount you can claim back for a service/the amount HBF will pay towards a service.
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