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Understand your extras cover

How your Extras cover can help you stay healthy - and what you’ll get back.

What is Extras cover?

Extras insurance covers you for the everyday services you might need to stay healthy, like dental, physio, optical and natural therapies. These services are generally not covered by Medicare so without private health insurance you could incur large out-of-pocket expenses for them.

How much money do I get back?

The amount you can claim back (known as a ‘benefit’) depends on the level of cover you’ve selected.

Benefits for Extras services are either a percentage or a set amount. HBF's Flex 50 Extras, for example, gives you 50% or more back when you claim. HBF's Flex 60 Extras gives you 60% or more back. This makes it easy to know what you're paying for when you choose your level of cover. If you see a physiotherapist and they charge you $90, HBF will pay a benefit of $45 on Flex 50, and $54 on Flex 60.

Generally, benefits for Extras services have a maximum amount (known as an ‘annual limit’) that you can claim per year.

Find out how much you’ll get back for an upcoming treatment by checking your product sheet in myHBF.

Your annual limits

An annual limit is the maximum amount of money you can claim for a particular service within a year. Annual limits only apply to Extras services (there are no annual limits for any procedures or services you receive in hospital) and they generally reset on 1 January. That means if you bought and claimed a pair of glasses in December, you will be able to buy and claim a new pair in January.

Combined annual limits

A combined annual limit is a limit that can be used for a variety of services. For example, HBF's Flex 50 Extras has a combined annual limit of $800. You can choose to use it for Chiro, Physio, Major Dental, Natural Therapies or a selection of other services. Combined limits make your benefits more flexible so you can use your cover where you need it.

Annual limits when you switch funds

If you’re switching from another health fund and you’ve already claimed some of your benefits in the same calendar year, we’ll adjust the balance of your annual limits to reflect this. If you’re unsure how much of your annual limit is left, contact us before you use your cover.

Annual limits when you change your HBF cover

If you’re an HBF member and you change your Extras cover, we’ll adjust the balance of your annual limit if you've already claimed some of your benefits in the same calendar year. If you're unsure how much of your annual limit is left, contact us before you use your cover.

Sub-limits

A sub-limit is the maximum amount of money you can claim for a specific service, deducted from your annual limit or combined annual limit. For example, Top 70 Extras has an annual limit of $400 for Podiatry, with a $250 sub-limit for Foot Orthoses - this means you can claim up to a maximum of $250 for Foot Orthoses in a calendar year.

Lifetime Limits

A lifetime limit is the total amount you can claim for a service over the course of your lifetime. Orthodontics is the only service with a Lifetime limit. Benefits that you received at any other health fund plus the benefits you’ve received at HBF count towards your Lifetime Limit.


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