For procedures identified as Minimum Benefits, we will pay the rate set out by the Commonwealth as the minimum shared room benefit and benefits for Government approved Prostheses List items, if applicable.
Waiting Period: 1 day
This is a service where Minimum Benefits apply, which means that we will pay the rate set out by the Commonwealth as the minimum shared room benefit, and benefits for Government approved Prostheses if applicable.
Waiting Period: 2 months
This is a service where Minimum Benefits apply, which means that we will pay the rate set out by the Commonwealth as the minimum shared room benefit, and benefits for Government approved Prostheses if applicable.
Members who have held hospital cover for at least 2 months and upgrade to HCF Hospital Gold to receive hospital psychiatric services as covered services may not be required to serve the waiting period for hospital psychiatric services. This exemption can only be accessed once in a member's lifetime.
Waiting Period: 2 months
This is a service where Minimum Benefits apply, which means that we will pay the rate set out by the Commonwealth as the minimum shared room benefit, and benefits for Government approved Prostheses if applicable.
Waiting Period: 2 months
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Minimum benefits covered
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
If you have hospital cover, you can claim benefits for things like accommodation and operating theatre fees when admitted to hospital as an inpatient for dental surgery. You may have out-of-pocket costs depending on the hospital and dental surgeon you choose.
If you have eligible extras, you can claim benefits for dental surgery received out of hospital. You may have out-of-pocket costs depending on your annual limits and the services and treatments included in your extras cover.
Waiting Period: 2 months
(12 months pre-existing)
Limited benefits apply. Minimum Benefit level payable by HCF for Hospital accommodation as determined under the Private Health Insurance Act and the cost of prosthesis (as listed on the Prosthesis List). No benefit is payable for podiatric surgeon fees. Ensure you have Informed Financial Consent prior to your treatment, for any out-of-pocket expenses.
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 12 months
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
The waiting period for pre-existing ailments is 12 months. The waiting period for hospital psychiatric services, rehabilitation services and palliative care is 2 months. A pre-existing ailment, illness or condition is one where the signs or symptoms existed in the six months before joining HCF or upgrading your cover.
Waiting Period: 12 months
In Australia, hospital cover is categorised as either Gold, Silver, Bronze or Basic. Hospital cover gives you more control if you need to go to hospital – like getting treated sooner by a doctor of your choice. We offer cover for singles, couples and families. If your situation changes down the track we can help you find cover that suits your new needs.
Hospital waiting periods vary according to the type of treatment or service. If you’re new to private health insurance, rejoining after a break in cover, upgrading to a higher level of cover, or changing your excess, you’ll have to wait before claiming on certain treatment and services.
When you take out hospital cover you’ll be asked to choose your excess. This is the amount you agree to pay if you’re admitted to hospital for planned treatment.
If you choose a higher excess, you’ll lower the cost of your cover. Choosing a lower, or zero excess, means you’ll pay less if you go to hospital, but the cost of your cover will be more.
$350 limit per person max $700 per policy
Max 1 check up, 1 scale and clean, and 1 fluoride treatment per person, per year
| Service | Benefits |
|---|---|
| Examinations | $29 - $60 |
| Single film x-rays | $24 |
| Removal of plaque / calculus | $36 - $55 |
| Application of fluoride | $25 |
| Direct fillings (1-2 surfaces) | $66 - $86 |
| Simple extractions | $78 - $88 |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$150 limit per person max $300 per policy
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent | $40 / $35 |
Combined with physiotherapy limit
| Service | Benefits |
|---|---|
| Chiropractic - initial / subsequent | $33 / $25 |
| Osteopathy - initial / subsequent | $40 / $30 |
| Remedial massage and myotherapy - initial / subsequent | $30 / $25 |
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | $30 / $25 |
| Therapies (excluding foot orthotics) | 2 months |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
$400 limit per person max $800 per policy
Max 1 check up, 1 scale and clean, and 1 fluoride treatment per person, per year
| Service | Benefits |
|---|---|
| Examinations | $29 - $60 |
| Single film x-rays | $24 |
| Removal of plaque / calculus | $36 - $55 |
| Application of fluoride | $25 |
| Direct fillings (1-2 surfaces) | $66 - $86 |
| Simple extractions | $78 - $88 |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$100 limit per person max $200 per policy
| Service | Benefits |
|---|---|
| Spectacle frames | 100% of fee up to per person annual limit |
| Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting) | 100% of fee up to per person annual limit |
| Contact lenses - pair | 100% of fee up to per person annual limit |
| Optical | 2 months |
$200 limit per person $400 max per policy
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent | $42 / $36 |
$100 limit per person/max $200 per policy - combined limit
| Service | Benefits |
|---|---|
| Chiropractic - initial / subsequent | $33 / $25 |
| Osteopathy - initial / subsequent | $40 / $30 |
| Remedial massage and myotherapy - initial / subsequent | $30 / $25 |
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | $30 / $25 |
| Therapies (excluding foot orthotics) | 2 months |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
$650 combined limit with Therapies & Other
1 check up, 1 scale and clean and 1 fluoride treatment per person
| Service | Benefits |
|---|---|
| Examinations | 60% |
| Single film x-rays | 60% |
| Removal of plaque / calculus | 60% |
| Application of fluoride | 60% |
| Direct fillings (1-2 surfaces) | 60% |
| Simple extractions | 60% |
| Teeth whitening - In-chair (service limits apply) | 60% |
| Teeth whitening - Home application (service limits apply) | 60% |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$175 limit
| Service | Benefits |
|---|---|
| Spectacle frames | 60% |
| Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting) | 60% |
| Contact lenses - pair | 60% |
| Optical | 2 months |
$650 combined limit with Dental & Other
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent | 60% |
| Exercise physiology | 60% |
| HCF-approved Online Cognitive Behavioural Therapy courses | 60% |
$100 Limit
| Service | Benefits |
|---|---|
| Remedial massage and myotherapy - initial / subsequent | 60% |
$650 combined limit with Dental & Other
| Service | Benefits |
|---|---|
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | 60% |
$650 combined limit with Dental & Other
| Service | Benefits |
|---|---|
| Dietetics - initial / subsequent | 60% |
| Therapies (excluding foot orthotics) | 2 months |
Gap Bonus helps reduce or eliminate out-of-pocket costs by topping up the benefit we pay on services included in your Flex My Extras cover. You can use your Gap Bonus on any covered extras service up to your annual entitlement*. Gap Bonus kicks in after 12 months on your Flex My Extras cover and increases each year up to year 4. * Each member listed on the policy has their own Gap Bonus entitlement. Gap Bonus is non-transferable between members. Unused Gap Bonus cannot be rolled over into the following year.
| Service | Benefits |
|---|---|
| Gap Bonus | Year 1 N/A Year 2 $50, year 3 $75, year 4 $100 per person |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
$650 overall limit
Max 2 check ups, 2 scale and clean, and 1 fluoride treatment per person, per year
| Service | Benefits |
|---|---|
| Examinations | $32 - $73 |
| Single film x-rays | $29 |
| Removal of plaque / calculus | $36 - $62 |
| Application of fluoride | $27 |
| Direct fillings (1-2 surfaces) | $85 - $105 |
| Direct fillings (3 or more surfaces) | $128 - $177 |
| Simple extractions | $95 - $143 |
| Indirect fillings | $298 - $600 |
| Surgical extractions | $157 - $250 |
| Treatment of tissue surrounding teeth | $23 - $374 |
| Treatment of root canals | $27 - $248 |
| Placing of crowns and bridges | $238 - $600 |
| Dentures and/or components (partial and complete) - Limits renew every 3 years | $25 - $600 |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$200 limit
| Service | Benefits |
|---|---|
| Spectacle frames | 100% of fee up to annual limit |
| Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting) | 100% of fee up to annual limit |
| Contact lenses - pair | 100% of fee up to annual limit |
| Optical | 2 months |
$350 combined limit
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent (group / class consultations covered under Health Management Program) | $56 / $49 |
| Exercise physiology (group / class consultations covered under Health Management Program) | $33 |
$150 combined limit
| Service | Benefits |
|---|---|
| Chiropractic - initial / subsequent | $38 / $31 |
| Osteopathy - initial / subsequent | $46 / $36 |
| Remedial massage and myotherapy - initial / subsequent | $36 / $31 |
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | $36 / $31 |
| Therapies (excluding foot orthotics) | 2 months |
$50 limit per person max $100 per policy
| Service | Benefits |
|---|---|
| Health Management Programs (HCF approved e.g. exercise classes) | Up to $50 |
| Travel and Accommodation | 2 months |
| Vaccines and Immunisations | 2 months |
| Artificial aids | 12 months |
| Hearing aids | 12 months |
| Health Management Programs | 2 months |
| School Accident Benefit | 2 – 12 months |
| Foot orthotics | 12 months |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
Max 2 check ups, 2 scale and clean, and 1 fluoride treatment per person, per year
| Service | Benefits |
|---|---|
| Examinations | $32 - $73 |
| Single film x-rays | $31 |
| Removal of plaque / calculus | $36 - $64 |
| Application of fluoride | $28 |
Year 1 $800 limit
| Service | Benefits |
|---|---|
| Direct fillings (1-2 surfaces) | $85 - $105 |
| Direct fillings (3 or more surfaces) | $128 - $177 |
| Simple extractions | $95 - $143 |
| Indirect fillings | $298 - $671 |
| Surgical extractions | $165 - $260 |
| Treatment of tissue surrounding teeth | $23 - $374 |
| Treatment of root canals | $27 - $248 |
| Placing of crowns and bridges | $244 - $1,000 |
| Dentures and/or components (partial and complete) - Limits renew every 3 years | $25 - $1,100 |
$700 LIMIT for ORTHODONTISTS ($350 LIMIT if general dentist)
Lifetime limit $2,100 or $1,050 for services by dentists, other than orthodontists
| Service | Benefits |
|---|---|
| Orthodontics - orthodontist / other dentists | Up to $700/$350 |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$250 limit
| Service | Benefits |
|---|---|
| Spectacle frames | 100% of fee up to annual limit |
| Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting) | 100% of fee up to annual limit |
| Contact lenses - pair | 100% of fee up to annual limit |
| Optical | 2 months |
Year 1 $350 limit
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent (group / class consultations covered under Health Management Program) | $58 / $49 |
| Exercise physiology (group / class consultations covered under Health Management Program) | $33 |
Year 1 $350 limit
| Service | Benefits |
|---|---|
| Occupational therapy | $62 |
| Psychology (after Medicare Mental Health Treatment Plan used up) includes group consultations | $26/$85 |
| Psychology (when member does not have any unused Medicare Mental Health Treatment Plan in the calendar year) includes group consultations | $18/$49 |
| HCF-approved counselling & accredited mental health social worker includes group consultations | $15/$41 |
| HCF-approved Online Cognitive Behavioural Therapy courses | $35 - $59 |
Year 1 $250 limit
| Service | Benefits |
|---|---|
| Chiropractic - initial / subsequent | $40 / $33 |
| Osteopathy - initial / subsequent | $48 / $38 |
Year 1 $250 limit
Sub-limit $250 per therapy service
| Service | Benefits |
|---|---|
| Remedial massage and myotherapy - initial / subsequent | $36 / $31 |
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | $36 / $31 |
Year 1 $200 limit
| Service | Benefits |
|---|---|
| Dietetics - initial / subsequent | $45 |
| Audiology - initial / subsequent | $60 |
| Speech pathology - initial / subsequent | $60 |
| Podiatry (including 1 pair of foot orthotics per person per year) | $35 / $30 |
| Orthotist/Prosthetist and Pedorthist | $20-$100 |
| Therapies (excluding foot orthotics) | 2 months |
Max $200 per policy
| Service | Benefits |
|---|---|
| Travel and Accommodation (200km round trip) | $40 |
$180 limit
| Service | Benefits |
|---|---|
| HCF approved pharmacy (After PBS equivalent co-payment subtracted) | Up to $50 per script |
Max $150 per policy
| Service | Benefits |
|---|---|
| Artificial aids (HCF approved e.g. low vision aids) | $45 - $150 |
$600 - $1,600 limit
| Service | Benefits |
|---|---|
| Hearing aids | $600 (benefits accrue and renew every three years) |
$150 per person max $300 per policy
| Service | Benefits |
|---|---|
| Health Management Programs (HCF approved e.g. exercise classes) | Up to $150 per person |
$150 per eligible child
| Service | Benefits |
|---|---|
| School Accident Benefit | Up to $150 per eligible child |
| Travel and Accommodation | 2 months |
| Vaccines and Immunisations | 2 months |
| Artificial aids | 12 months |
| Hearing aids | 12 months |
| Health Management Programs | 2 months |
| School Accident Benefit | 2 – 12 months |
| Foot orthotics | 12 months |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
Max 2 check ups, 2 scale and clean, and 1 fluoride treatment per person, per year
| Service | Benefits |
|---|---|
| Examinations | $34 - $84 |
| Single film x-rays | $34 |
| Removal of plaque / calculus | $40 - $75 |
| Application of fluoride | $29 |
Year 1 $1,000 limit
| Service | Benefits |
|---|---|
| Direct fillings (1-2 surfaces) | $105 - $148 |
| Direct fillings (3 or more surfaces) | $177 - $256 |
| Simple extractions | $120 - $175 |
| Indirect fillings | $341 - $783 |
| Surgical extractions | $210 - $330 |
| Occlusal therapy | $38 - $400 |
| Treatment of tissue surrounding teeth | $27 - $430 |
| Treatment of root canals | $32 - $285 |
| Placing of crowns and bridges | $280 - $1,100 |
| Dentures and/or components (partial and complete) - Limits renew every 3 years | $33 - $1,300 |
$800 LIMIT for ORTHODONTISTS ($400 LIMIT if general dentist)
Lifetime limit $2,400 or $1,200 for services by dentists, other than orthodontists
| Service | Benefits |
|---|---|
| Orthodontics - orthodontist / other dentists | Up to $800/$400 |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$275 limit
| Service | Benefits |
|---|---|
| Spectacle frames | 100% of fee up to annual limit |
| Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting) | 100% of fee up to annual limit |
| Contact lenses - pair | 100% of fee up to annual limit |
| Optical | 2 months |
Year 1 $600 limit
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent (group / class consultations covered under Health Management Program) | $60 / $54 |
| Exercise physiology (group / class consultations covered under Health Management Program) | $40 |
Year 1 $600 limit
| Service | Benefits |
|---|---|
| Occupational therapy | $72 |
| Psychology (after Medicare Mental Health Treatment Plan used up) includes group consultations | $30/$100 |
| Psychology (when member does not have any unused Medicare Mental Health Treatment Plan in the calendar year) includes group consultations | $21/$58 |
| HCF-approved counselling & accredited mental health social worker includes group consultations | $18/$48 |
| HCF-approved Online Cognitive Behavioural Therapy courses | $35 - $59 |
Year 1 $300 limit
| Service | Benefits |
|---|---|
| Chiropractic - initial / subsequent | $45 / $35 |
| Osteopathy - initial / subsequent | $50 / $40 |
Year 1 $300 limit
Sub-limit $300 per therapy service
| Service | Benefits |
|---|---|
| Remedial massage and myotherapy - initial / subsequent | $40 / $35 |
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | $40 / $35 |
Year 1 $250
| Service | Benefits |
|---|---|
| Dietetics - initial / subsequent | $55 |
| Audiology - initial / subsequent | $70 |
| Speech pathology - initial / subsequent | $83 |
| Podiatry (including 1 pair of foot orthotics per person per year) | $40 / $35 |
| Orthotist/Prosthetist and Pedorthist | $25 - $135 |
| Therapies (excluding foot orthotics) | 2 months |
Max $250 per policy
| Service | Benefits |
|---|---|
| Travel and Accommodation (200km round trip) | $50 |
$280 limit
| Service | Benefits |
|---|---|
| HCF approved pharmacy (After PBS equivalent co-payment subtracted) | Up to $50 per script |
Max $200 per policy
| Service | Benefits |
|---|---|
| Artificial aids (HCF approved e.g. low vision aids) | $55 - $200 |
$800 - $1,800
| Service | Benefits |
|---|---|
| Hearing aids | $800 (benefits accrue and renew every three years) |
$200 per person max $400 per policy
| Service | Benefits |
|---|---|
| Health Management Programs (HCF approved e.g. exercise classes) | $200 per person/max $400 per policy |
$200 per eligible child
| Service | Benefits |
|---|---|
| School Accident Benefit | Up to $200 per eligible child |
| Travel and Accommodation | 2 months |
| Vaccines and Immunisations | 2 months |
| Artificial aids | 12 months |
| Hearing aids | 12 months |
| Health Management Programs | 2 months |
| School Accident Benefit | 2 – 12 months |
| Foot orthotics | 12 months |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
Included means services and treatments are covered and you'll have less out-of-pocket expenses.
For procedures identified as Minimum Benefits, we will pay the rate set out by the Commonwealth as the minimum shared room benefit and benefits for Government approved Prostheses List items, if applicable.
Waiting Period: 1 day
This is a service where Minimum Benefits apply, which means that we will pay the rate set out by the Commonwealth as the minimum shared room benefit, and benefits for Government approved Prostheses if applicable.
Waiting Period: 2 months
This is a service where Minimum Benefits apply, which means that we will pay the rate set out by the Commonwealth as the minimum shared room benefit, and benefits for Government approved Prostheses if applicable.
Members who have held hospital cover for at least 2 months and upgrade to HCF Hospital Gold to receive hospital psychiatric services as covered services may not be required to serve the waiting period for hospital psychiatric services. This exemption can only be accessed once in a member's lifetime.
Waiting Period: 2 months
This is a service where Minimum Benefits apply, which means that we will pay the rate set out by the Commonwealth as the minimum shared room benefit, and benefits for Government approved Prostheses if applicable.
Waiting Period: 2 months
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Minimum benefits covered
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
If you have hospital cover, you can claim benefits for things like accommodation and operating theatre fees when admitted to hospital as an inpatient for dental surgery. You may have out-of-pocket costs depending on the hospital and dental surgeon you choose.
If you have eligible extras, you can claim benefits for dental surgery received out of hospital. You may have out-of-pocket costs depending on your annual limits and the services and treatments included in your extras cover.
Waiting Period: 2 months
(12 months pre-existing)
Limited benefits apply. Minimum Benefit level payable by HCF for Hospital accommodation as determined under the Private Health Insurance Act and the cost of prosthesis (as listed on the Prosthesis List). No benefit is payable for podiatric surgeon fees. Ensure you have Informed Financial Consent prior to your treatment, for any out-of-pocket expenses.
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 12 months
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
Waiting Period: 2 months
(12 mths pre-existing)
In Australia, hospital cover is categorised as either Gold, Silver, Bronze or Basic. Hospital cover gives you more control if you need to go to hospital – like getting treated sooner by a doctor of your choice. We offer cover for singles, couples and families. If your situation changes down the track we can help you find cover that suits your new needs.
Hospital waiting periods vary according to the type of treatment or service. If you’re new to private health insurance, rejoining after a break in cover, upgrading to a higher level of cover, or changing your excess, you’ll have to wait before claiming on certain treatment and services.
When you take out hospital cover you’ll be asked to choose your excess. This is the amount you agree to pay if you’re admitted to hospital for planned treatment.
If you choose a higher excess, you’ll lower the cost of your cover. Choosing a lower, or zero excess, means you’ll pay less if you go to hospital, but the cost of your cover will be more.
$350 limit per person max $700 per policy
Max 1 check up, 1 scale and clean, and 1 fluoride treatment per person, per year
| Service | Benefits |
|---|---|
| Examinations | $29 - $60 |
| Single film x-rays | $24 |
| Removal of plaque / calculus | $36 - $55 |
| Application of fluoride | $25 |
| Direct fillings (1-2 surfaces) | $66 - $86 |
| Simple extractions | $78 - $88 |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$150 limit per person max $300 per policy
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent | $40 / $35 |
Combined with physiotherapy limit
| Service | Benefits |
|---|---|
| Chiropractic - initial / subsequent | $33 / $25 |
| Osteopathy - initial / subsequent | $40 / $30 |
| Remedial massage and myotherapy - initial / subsequent | $30 / $25 |
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | $30 / $25 |
| Therapies (excluding foot orthotics) | 2 months |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
$400 limit per person max $800 per policy
Max 1 check up, 1 scale and clean, and 1 fluoride treatment per person, per year
| Service | Benefits |
|---|---|
| Examinations | $29 - $60 |
| Single film x-rays | $24 |
| Removal of plaque / calculus | $36 - $55 |
| Application of fluoride | $25 |
| Direct fillings (1-2 surfaces) | $66 - $86 |
| Simple extractions | $78 - $88 |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$100 limit per person max $200 per policy
| Service | Benefits |
|---|---|
| Spectacle frames | 100% of fee up to per person annual limit |
| Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting) | 100% of fee up to per person annual limit |
| Contact lenses - pair | 100% of fee up to per person annual limit |
| Optical | 2 months |
$200 limit per person $400 max per policy
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent | $42 / $36 |
$100 limit per person/max $200 per policy - combined limit
| Service | Benefits |
|---|---|
| Chiropractic - initial / subsequent | $33 / $25 |
| Osteopathy - initial / subsequent | $40 / $30 |
| Remedial massage and myotherapy - initial / subsequent | $30 / $25 |
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | $30 / $25 |
| Therapies (excluding foot orthotics) | 2 months |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
$650 combined limit with Therapies & Other
1 check up, 1 scale and clean and 1 fluoride treatment per person
| Service | Benefits |
|---|---|
| Examinations | 60% |
| Single film x-rays | 60% |
| Removal of plaque / calculus | 60% |
| Application of fluoride | 60% |
| Direct fillings (1-2 surfaces) | 60% |
| Simple extractions | 60% |
| Teeth whitening - In-chair (service limits apply) | 60% |
| Teeth whitening - Home application (service limits apply) | 60% |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$175 limit
| Service | Benefits |
|---|---|
| Spectacle frames | 60% |
| Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting) | 60% |
| Contact lenses - pair | 60% |
| Optical | 2 months |
$650 combined limit with Dental & Other
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent | 60% |
| Exercise physiology | 60% |
| HCF-approved Online Cognitive Behavioural Therapy courses | 60% |
$100 Limit
| Service | Benefits |
|---|---|
| Remedial massage and myotherapy - initial / subsequent | 60% |
$650 combined limit with Dental & Other
| Service | Benefits |
|---|---|
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | 60% |
$650 combined limit with Dental & Other
| Service | Benefits |
|---|---|
| Dietetics - initial / subsequent | 60% |
| Therapies (excluding foot orthotics) | 2 months |
Gap Bonus helps reduce or eliminate out-of-pocket costs by topping up the benefit we pay on services included in your Flex My Extras cover. You can use your Gap Bonus on any covered extras service up to your annual entitlement*. Gap Bonus kicks in after 12 months on your Flex My Extras cover and increases each year up to year 4. * Each member listed on the policy has their own Gap Bonus entitlement. Gap Bonus is non-transferable between members. Unused Gap Bonus cannot be rolled over into the following year.
| Service | Benefits |
|---|---|
| Gap Bonus | Year 1 N/A Year 2 $50, year 3 $75, year 4 $100 per person |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
$650 overall limit
Max 2 check ups, 2 scale and clean, and 1 fluoride treatment per person, per year
| Service | Benefits |
|---|---|
| Examinations | $32 - $73 |
| Single film x-rays | $29 |
| Removal of plaque / calculus | $36 - $62 |
| Application of fluoride | $27 |
| Direct fillings (1-2 surfaces) | $85 - $105 |
| Direct fillings (3 or more surfaces) | $128 - $177 |
| Simple extractions | $95 - $143 |
| Indirect fillings | $298 - $600 |
| Surgical extractions | $157 - $250 |
| Treatment of tissue surrounding teeth | $23 - $374 |
| Treatment of root canals | $27 - $248 |
| Placing of crowns and bridges | $238 - $600 |
| Dentures and/or components (partial and complete) - Limits renew every 3 years | $25 - $600 |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$200 limit
| Service | Benefits |
|---|---|
| Spectacle frames | 100% of fee up to annual limit |
| Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting) | 100% of fee up to annual limit |
| Contact lenses - pair | 100% of fee up to annual limit |
| Optical | 2 months |
$350 combined limit
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent (group / class consultations covered under Health Management Program) | $56 / $49 |
| Exercise physiology (group / class consultations covered under Health Management Program) | $33 |
$150 combined limit
| Service | Benefits |
|---|---|
| Chiropractic - initial / subsequent | $38 / $31 |
| Osteopathy - initial / subsequent | $46 / $36 |
| Remedial massage and myotherapy - initial / subsequent | $36 / $31 |
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | $36 / $31 |
| Therapies (excluding foot orthotics) | 2 months |
$50 limit per person max $100 per policy
| Service | Benefits |
|---|---|
| Health Management Programs (HCF approved e.g. exercise classes) | Up to $50 |
| Travel and Accommodation | 2 months |
| Vaccines and Immunisations | 2 months |
| Artificial aids | 12 months |
| Hearing aids | 12 months |
| Health Management Programs | 2 months |
| School Accident Benefit | 2 – 12 months |
| Foot orthotics | 12 months |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
Max 2 check ups, 2 scale and clean, and 1 fluoride treatment per person, per year
| Service | Benefits |
|---|---|
| Examinations | $32 - $73 |
| Single film x-rays | $31 |
| Removal of plaque / calculus | $36 - $64 |
| Application of fluoride | $28 |
Year 1 $800 limit
| Service | Benefits |
|---|---|
| Direct fillings (1-2 surfaces) | $85 - $105 |
| Direct fillings (3 or more surfaces) | $128 - $177 |
| Simple extractions | $95 - $143 |
| Indirect fillings | $298 - $671 |
| Surgical extractions | $165 - $260 |
| Treatment of tissue surrounding teeth | $23 - $374 |
| Treatment of root canals | $27 - $248 |
| Placing of crowns and bridges | $244 - $1,000 |
| Dentures and/or components (partial and complete) - Limits renew every 3 years | $25 - $1,100 |
$700 LIMIT for ORTHODONTISTS ($350 LIMIT if general dentist)
Lifetime limit $2,100 or $1,050 for services by dentists, other than orthodontists
| Service | Benefits |
|---|---|
| Orthodontics - orthodontist / other dentists | Up to $700/$350 |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$250 limit
| Service | Benefits |
|---|---|
| Spectacle frames | 100% of fee up to annual limit |
| Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting) | 100% of fee up to annual limit |
| Contact lenses - pair | 100% of fee up to annual limit |
| Optical | 2 months |
Year 1 $350 limit
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent (group / class consultations covered under Health Management Program) | $58 / $49 |
| Exercise physiology (group / class consultations covered under Health Management Program) | $33 |
Year 1 $350 limit
| Service | Benefits |
|---|---|
| Occupational therapy | $62 |
| Psychology (after Medicare Mental Health Treatment Plan used up) includes group consultations | $26/$85 |
| Psychology (when member does not have any unused Medicare Mental Health Treatment Plan in the calendar year) includes group consultations | $18/$49 |
| HCF-approved counselling & accredited mental health social worker includes group consultations | $15/$41 |
| HCF-approved Online Cognitive Behavioural Therapy courses | $35 - $59 |
Year 1 $250 limit
| Service | Benefits |
|---|---|
| Chiropractic - initial / subsequent | $40 / $33 |
| Osteopathy - initial / subsequent | $48 / $38 |
Year 1 $250 limit
Sub-limit $250 per therapy service
| Service | Benefits |
|---|---|
| Remedial massage and myotherapy - initial / subsequent | $36 / $31 |
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | $36 / $31 |
Year 1 $200 limit
| Service | Benefits |
|---|---|
| Dietetics - initial / subsequent | $45 |
| Audiology - initial / subsequent | $60 |
| Speech pathology - initial / subsequent | $60 |
| Podiatry (including 1 pair of foot orthotics per person per year) | $35 / $30 |
| Orthotist/Prosthetist and Pedorthist | $20-$100 |
| Therapies (excluding foot orthotics) | 2 months |
Max $200 per policy
| Service | Benefits |
|---|---|
| Travel and Accommodation (200km round trip) | $40 |
$180 limit
| Service | Benefits |
|---|---|
| HCF approved pharmacy (After PBS equivalent co-payment subtracted) | Up to $50 per script |
Max $150 per policy
| Service | Benefits |
|---|---|
| Artificial aids (HCF approved e.g. low vision aids) | $45 - $150 |
$600 - $1,600 limit
| Service | Benefits |
|---|---|
| Hearing aids | $600 (benefits accrue and renew every three years) |
$150 per person max $300 per policy
| Service | Benefits |
|---|---|
| Health Management Programs (HCF approved e.g. exercise classes) | Up to $150 per person |
$150 per eligible child
| Service | Benefits |
|---|---|
| School Accident Benefit | Up to $150 per eligible child |
| Travel and Accommodation | 2 months |
| Vaccines and Immunisations | 2 months |
| Artificial aids | 12 months |
| Hearing aids | 12 months |
| Health Management Programs | 2 months |
| School Accident Benefit | 2 – 12 months |
| Foot orthotics | 12 months |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
Max 2 check ups, 2 scale and clean, and 1 fluoride treatment per person, per year
| Service | Benefits |
|---|---|
| Examinations | $34 - $84 |
| Single film x-rays | $34 |
| Removal of plaque / calculus | $40 - $75 |
| Application of fluoride | $29 |
Year 1 $1,000 limit
| Service | Benefits |
|---|---|
| Direct fillings (1-2 surfaces) | $105 - $148 |
| Direct fillings (3 or more surfaces) | $177 - $256 |
| Simple extractions | $120 - $175 |
| Indirect fillings | $341 - $783 |
| Surgical extractions | $210 - $330 |
| Occlusal therapy | $38 - $400 |
| Treatment of tissue surrounding teeth | $27 - $430 |
| Treatment of root canals | $32 - $285 |
| Placing of crowns and bridges | $280 - $1,100 |
| Dentures and/or components (partial and complete) - Limits renew every 3 years | $33 - $1,300 |
$800 LIMIT for ORTHODONTISTS ($400 LIMIT if general dentist)
Lifetime limit $2,400 or $1,200 for services by dentists, other than orthodontists
| Service | Benefits |
|---|---|
| Orthodontics - orthodontist / other dentists | Up to $800/$400 |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$275 limit
| Service | Benefits |
|---|---|
| Spectacle frames | 100% of fee up to annual limit |
| Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting) | 100% of fee up to annual limit |
| Contact lenses - pair | 100% of fee up to annual limit |
| Optical | 2 months |
Year 1 $600 limit
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent (group / class consultations covered under Health Management Program) | $60 / $54 |
| Exercise physiology (group / class consultations covered under Health Management Program) | $40 |
Year 1 $600 limit
| Service | Benefits |
|---|---|
| Occupational therapy | $72 |
| Psychology (after Medicare Mental Health Treatment Plan used up) includes group consultations | $30/$100 |
| Psychology (when member does not have any unused Medicare Mental Health Treatment Plan in the calendar year) includes group consultations | $21/$58 |
| HCF-approved counselling & accredited mental health social worker includes group consultations | $18/$48 |
| HCF-approved Online Cognitive Behavioural Therapy courses | $35 - $59 |
Year 1 $300 limit
| Service | Benefits |
|---|---|
| Chiropractic - initial / subsequent | $45 / $35 |
| Osteopathy - initial / subsequent | $50 / $40 |
Year 1 $300 limit
Sub-limit $300 per therapy service
| Service | Benefits |
|---|---|
| Remedial massage and myotherapy - initial / subsequent | $40 / $35 |
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | $40 / $35 |
Year 1 $250
| Service | Benefits |
|---|---|
| Dietetics - initial / subsequent | $55 |
| Audiology - initial / subsequent | $70 |
| Speech pathology - initial / subsequent | $83 |
| Podiatry (including 1 pair of foot orthotics per person per year) | $40 / $35 |
| Orthotist/Prosthetist and Pedorthist | $25 - $135 |
| Therapies (excluding foot orthotics) | 2 months |
Max $250 per policy
| Service | Benefits |
|---|---|
| Travel and Accommodation (200km round trip) | $50 |
$280 limit
| Service | Benefits |
|---|---|
| HCF approved pharmacy (After PBS equivalent co-payment subtracted) | Up to $50 per script |
Max $200 per policy
| Service | Benefits |
|---|---|
| Artificial aids (HCF approved e.g. low vision aids) | $55 - $200 |
$800 - $1,800
| Service | Benefits |
|---|---|
| Hearing aids | $800 (benefits accrue and renew every three years) |
$200 per person max $400 per policy
| Service | Benefits |
|---|---|
| Health Management Programs (HCF approved e.g. exercise classes) | $200 per person/max $400 per policy |
$200 per eligible child
| Service | Benefits |
|---|---|
| School Accident Benefit | Up to $200 per eligible child |
| Travel and Accommodation | 2 months |
| Vaccines and Immunisations | 2 months |
| Artificial aids | 12 months |
| Hearing aids | 12 months |
| Health Management Programs | 2 months |
| School Accident Benefit | 2 – 12 months |
| Foot orthotics | 12 months |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
Restricted means hospital benefits are limited and you may have higher out-of-pocket expenses for these services and treatments.
The waiting period for pre-existing ailments is 12 months. The waiting period for hospital psychiatric services, rehabilitation services and palliative care is 2 months. A pre-existing ailment, illness or condition is one where the signs or symptoms existed in the six months before joining HCF or upgrading your cover.
Waiting Period: 12 months
In Australia, hospital cover is categorised as either Gold, Silver, Bronze or Basic. Hospital cover gives you more control if you need to go to hospital – like getting treated sooner by a doctor of your choice. We offer cover for singles, couples and families. If your situation changes down the track we can help you find cover that suits your new needs.
Hospital waiting periods vary according to the type of treatment or service. If you’re new to private health insurance, rejoining after a break in cover, upgrading to a higher level of cover, or changing your excess, you’ll have to wait before claiming on certain treatment and services.
When you take out hospital cover you’ll be asked to choose your excess. This is the amount you agree to pay if you’re admitted to hospital for planned treatment.
If you choose a higher excess, you’ll lower the cost of your cover. Choosing a lower, or zero excess, means you’ll pay less if you go to hospital, but the cost of your cover will be more.
$350 limit per person max $700 per policy
Max 1 check up, 1 scale and clean, and 1 fluoride treatment per person, per year
| Service | Benefits |
|---|---|
| Examinations | $29 - $60 |
| Single film x-rays | $24 |
| Removal of plaque / calculus | $36 - $55 |
| Application of fluoride | $25 |
| Direct fillings (1-2 surfaces) | $66 - $86 |
| Simple extractions | $78 - $88 |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$150 limit per person max $300 per policy
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent | $40 / $35 |
Combined with physiotherapy limit
| Service | Benefits |
|---|---|
| Chiropractic - initial / subsequent | $33 / $25 |
| Osteopathy - initial / subsequent | $40 / $30 |
| Remedial massage and myotherapy - initial / subsequent | $30 / $25 |
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | $30 / $25 |
| Therapies (excluding foot orthotics) | 2 months |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
$400 limit per person max $800 per policy
Max 1 check up, 1 scale and clean, and 1 fluoride treatment per person, per year
| Service | Benefits |
|---|---|
| Examinations | $29 - $60 |
| Single film x-rays | $24 |
| Removal of plaque / calculus | $36 - $55 |
| Application of fluoride | $25 |
| Direct fillings (1-2 surfaces) | $66 - $86 |
| Simple extractions | $78 - $88 |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$100 limit per person max $200 per policy
| Service | Benefits |
|---|---|
| Spectacle frames | 100% of fee up to per person annual limit |
| Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting) | 100% of fee up to per person annual limit |
| Contact lenses - pair | 100% of fee up to per person annual limit |
| Optical | 2 months |
$200 limit per person $400 max per policy
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent | $42 / $36 |
$100 limit per person/max $200 per policy - combined limit
| Service | Benefits |
|---|---|
| Chiropractic - initial / subsequent | $33 / $25 |
| Osteopathy - initial / subsequent | $40 / $30 |
| Remedial massage and myotherapy - initial / subsequent | $30 / $25 |
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | $30 / $25 |
| Therapies (excluding foot orthotics) | 2 months |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
$650 combined limit with Therapies & Other
1 check up, 1 scale and clean and 1 fluoride treatment per person
| Service | Benefits |
|---|---|
| Examinations | 60% |
| Single film x-rays | 60% |
| Removal of plaque / calculus | 60% |
| Application of fluoride | 60% |
| Direct fillings (1-2 surfaces) | 60% |
| Simple extractions | 60% |
| Teeth whitening - In-chair (service limits apply) | 60% |
| Teeth whitening - Home application (service limits apply) | 60% |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$175 limit
| Service | Benefits |
|---|---|
| Spectacle frames | 60% |
| Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting) | 60% |
| Contact lenses - pair | 60% |
| Optical | 2 months |
$650 combined limit with Dental & Other
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent | 60% |
| Exercise physiology | 60% |
| HCF-approved Online Cognitive Behavioural Therapy courses | 60% |
$100 Limit
| Service | Benefits |
|---|---|
| Remedial massage and myotherapy - initial / subsequent | 60% |
$650 combined limit with Dental & Other
| Service | Benefits |
|---|---|
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | 60% |
$650 combined limit with Dental & Other
| Service | Benefits |
|---|---|
| Dietetics - initial / subsequent | 60% |
| Therapies (excluding foot orthotics) | 2 months |
Gap Bonus helps reduce or eliminate out-of-pocket costs by topping up the benefit we pay on services included in your Flex My Extras cover. You can use your Gap Bonus on any covered extras service up to your annual entitlement*. Gap Bonus kicks in after 12 months on your Flex My Extras cover and increases each year up to year 4. * Each member listed on the policy has their own Gap Bonus entitlement. Gap Bonus is non-transferable between members. Unused Gap Bonus cannot be rolled over into the following year.
| Service | Benefits |
|---|---|
| Gap Bonus | Year 1 N/A Year 2 $50, year 3 $75, year 4 $100 per person |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
$650 overall limit
Max 2 check ups, 2 scale and clean, and 1 fluoride treatment per person, per year
| Service | Benefits |
|---|---|
| Examinations | $32 - $73 |
| Single film x-rays | $29 |
| Removal of plaque / calculus | $36 - $62 |
| Application of fluoride | $27 |
| Direct fillings (1-2 surfaces) | $85 - $105 |
| Direct fillings (3 or more surfaces) | $128 - $177 |
| Simple extractions | $95 - $143 |
| Indirect fillings | $298 - $600 |
| Surgical extractions | $157 - $250 |
| Treatment of tissue surrounding teeth | $23 - $374 |
| Treatment of root canals | $27 - $248 |
| Placing of crowns and bridges | $238 - $600 |
| Dentures and/or components (partial and complete) - Limits renew every 3 years | $25 - $600 |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$200 limit
| Service | Benefits |
|---|---|
| Spectacle frames | 100% of fee up to annual limit |
| Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting) | 100% of fee up to annual limit |
| Contact lenses - pair | 100% of fee up to annual limit |
| Optical | 2 months |
$350 combined limit
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent (group / class consultations covered under Health Management Program) | $56 / $49 |
| Exercise physiology (group / class consultations covered under Health Management Program) | $33 |
$150 combined limit
| Service | Benefits |
|---|---|
| Chiropractic - initial / subsequent | $38 / $31 |
| Osteopathy - initial / subsequent | $46 / $36 |
| Remedial massage and myotherapy - initial / subsequent | $36 / $31 |
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | $36 / $31 |
| Therapies (excluding foot orthotics) | 2 months |
$50 limit per person max $100 per policy
| Service | Benefits |
|---|---|
| Health Management Programs (HCF approved e.g. exercise classes) | Up to $50 |
| Travel and Accommodation | 2 months |
| Vaccines and Immunisations | 2 months |
| Artificial aids | 12 months |
| Hearing aids | 12 months |
| Health Management Programs | 2 months |
| School Accident Benefit | 2 – 12 months |
| Foot orthotics | 12 months |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
Max 2 check ups, 2 scale and clean, and 1 fluoride treatment per person, per year
| Service | Benefits |
|---|---|
| Examinations | $32 - $73 |
| Single film x-rays | $31 |
| Removal of plaque / calculus | $36 - $64 |
| Application of fluoride | $28 |
Year 1 $800 limit
| Service | Benefits |
|---|---|
| Direct fillings (1-2 surfaces) | $85 - $105 |
| Direct fillings (3 or more surfaces) | $128 - $177 |
| Simple extractions | $95 - $143 |
| Indirect fillings | $298 - $671 |
| Surgical extractions | $165 - $260 |
| Treatment of tissue surrounding teeth | $23 - $374 |
| Treatment of root canals | $27 - $248 |
| Placing of crowns and bridges | $244 - $1,000 |
| Dentures and/or components (partial and complete) - Limits renew every 3 years | $25 - $1,100 |
$700 LIMIT for ORTHODONTISTS ($350 LIMIT if general dentist)
Lifetime limit $2,100 or $1,050 for services by dentists, other than orthodontists
| Service | Benefits |
|---|---|
| Orthodontics - orthodontist / other dentists | Up to $700/$350 |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$250 limit
| Service | Benefits |
|---|---|
| Spectacle frames | 100% of fee up to annual limit |
| Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting) | 100% of fee up to annual limit |
| Contact lenses - pair | 100% of fee up to annual limit |
| Optical | 2 months |
Year 1 $350 limit
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent (group / class consultations covered under Health Management Program) | $58 / $49 |
| Exercise physiology (group / class consultations covered under Health Management Program) | $33 |
Year 1 $350 limit
| Service | Benefits |
|---|---|
| Occupational therapy | $62 |
| Psychology (after Medicare Mental Health Treatment Plan used up) includes group consultations | $26/$85 |
| Psychology (when member does not have any unused Medicare Mental Health Treatment Plan in the calendar year) includes group consultations | $18/$49 |
| HCF-approved counselling & accredited mental health social worker includes group consultations | $15/$41 |
| HCF-approved Online Cognitive Behavioural Therapy courses | $35 - $59 |
Year 1 $250 limit
| Service | Benefits |
|---|---|
| Chiropractic - initial / subsequent | $40 / $33 |
| Osteopathy - initial / subsequent | $48 / $38 |
Year 1 $250 limit
Sub-limit $250 per therapy service
| Service | Benefits |
|---|---|
| Remedial massage and myotherapy - initial / subsequent | $36 / $31 |
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | $36 / $31 |
Year 1 $200 limit
| Service | Benefits |
|---|---|
| Dietetics - initial / subsequent | $45 |
| Audiology - initial / subsequent | $60 |
| Speech pathology - initial / subsequent | $60 |
| Podiatry (including 1 pair of foot orthotics per person per year) | $35 / $30 |
| Orthotist/Prosthetist and Pedorthist | $20-$100 |
| Therapies (excluding foot orthotics) | 2 months |
Max $200 per policy
| Service | Benefits |
|---|---|
| Travel and Accommodation (200km round trip) | $40 |
$180 limit
| Service | Benefits |
|---|---|
| HCF approved pharmacy (After PBS equivalent co-payment subtracted) | Up to $50 per script |
Max $150 per policy
| Service | Benefits |
|---|---|
| Artificial aids (HCF approved e.g. low vision aids) | $45 - $150 |
$600 - $1,600 limit
| Service | Benefits |
|---|---|
| Hearing aids | $600 (benefits accrue and renew every three years) |
$150 per person max $300 per policy
| Service | Benefits |
|---|---|
| Health Management Programs (HCF approved e.g. exercise classes) | Up to $150 per person |
$150 per eligible child
| Service | Benefits |
|---|---|
| School Accident Benefit | Up to $150 per eligible child |
| Travel and Accommodation | 2 months |
| Vaccines and Immunisations | 2 months |
| Artificial aids | 12 months |
| Hearing aids | 12 months |
| Health Management Programs | 2 months |
| School Accident Benefit | 2 – 12 months |
| Foot orthotics | 12 months |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
Max 2 check ups, 2 scale and clean, and 1 fluoride treatment per person, per year
| Service | Benefits |
|---|---|
| Examinations | $34 - $84 |
| Single film x-rays | $34 |
| Removal of plaque / calculus | $40 - $75 |
| Application of fluoride | $29 |
Year 1 $1,000 limit
| Service | Benefits |
|---|---|
| Direct fillings (1-2 surfaces) | $105 - $148 |
| Direct fillings (3 or more surfaces) | $177 - $256 |
| Simple extractions | $120 - $175 |
| Indirect fillings | $341 - $783 |
| Surgical extractions | $210 - $330 |
| Occlusal therapy | $38 - $400 |
| Treatment of tissue surrounding teeth | $27 - $430 |
| Treatment of root canals | $32 - $285 |
| Placing of crowns and bridges | $280 - $1,100 |
| Dentures and/or components (partial and complete) - Limits renew every 3 years | $33 - $1,300 |
$800 LIMIT for ORTHODONTISTS ($400 LIMIT if general dentist)
Lifetime limit $2,400 or $1,200 for services by dentists, other than orthodontists
| Service | Benefits |
|---|---|
| Orthodontics - orthodontist / other dentists | Up to $800/$400 |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$275 limit
| Service | Benefits |
|---|---|
| Spectacle frames | 100% of fee up to annual limit |
| Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting) | 100% of fee up to annual limit |
| Contact lenses - pair | 100% of fee up to annual limit |
| Optical | 2 months |
Year 1 $600 limit
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent (group / class consultations covered under Health Management Program) | $60 / $54 |
| Exercise physiology (group / class consultations covered under Health Management Program) | $40 |
Year 1 $600 limit
| Service | Benefits |
|---|---|
| Occupational therapy | $72 |
| Psychology (after Medicare Mental Health Treatment Plan used up) includes group consultations | $30/$100 |
| Psychology (when member does not have any unused Medicare Mental Health Treatment Plan in the calendar year) includes group consultations | $21/$58 |
| HCF-approved counselling & accredited mental health social worker includes group consultations | $18/$48 |
| HCF-approved Online Cognitive Behavioural Therapy courses | $35 - $59 |
Year 1 $300 limit
| Service | Benefits |
|---|---|
| Chiropractic - initial / subsequent | $45 / $35 |
| Osteopathy - initial / subsequent | $50 / $40 |
Year 1 $300 limit
Sub-limit $300 per therapy service
| Service | Benefits |
|---|---|
| Remedial massage and myotherapy - initial / subsequent | $40 / $35 |
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | $40 / $35 |
Year 1 $250
| Service | Benefits |
|---|---|
| Dietetics - initial / subsequent | $55 |
| Audiology - initial / subsequent | $70 |
| Speech pathology - initial / subsequent | $83 |
| Podiatry (including 1 pair of foot orthotics per person per year) | $40 / $35 |
| Orthotist/Prosthetist and Pedorthist | $25 - $135 |
| Therapies (excluding foot orthotics) | 2 months |
Max $250 per policy
| Service | Benefits |
|---|---|
| Travel and Accommodation (200km round trip) | $50 |
$280 limit
| Service | Benefits |
|---|---|
| HCF approved pharmacy (After PBS equivalent co-payment subtracted) | Up to $50 per script |
Max $200 per policy
| Service | Benefits |
|---|---|
| Artificial aids (HCF approved e.g. low vision aids) | $55 - $200 |
$800 - $1,800
| Service | Benefits |
|---|---|
| Hearing aids | $800 (benefits accrue and renew every three years) |
$200 per person max $400 per policy
| Service | Benefits |
|---|---|
| Health Management Programs (HCF approved e.g. exercise classes) | $200 per person/max $400 per policy |
$200 per eligible child
| Service | Benefits |
|---|---|
| School Accident Benefit | Up to $200 per eligible child |
| Travel and Accommodation | 2 months |
| Vaccines and Immunisations | 2 months |
| Artificial aids | 12 months |
| Hearing aids | 12 months |
| Health Management Programs | 2 months |
| School Accident Benefit | 2 – 12 months |
| Foot orthotics | 12 months |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
Excluded means no hospital benefits are payable and you'll pay all out-of-pocket expenses for these services and treatments.
In Australia, hospital cover is categorised as either Gold, Silver, Bronze or Basic. Hospital cover gives you more control if you need to go to hospital – like getting treated sooner by a doctor of your choice. We offer cover for singles, couples and families. If your situation changes down the track we can help you find cover that suits your new needs.
Hospital waiting periods vary according to the type of treatment or service. If you’re new to private health insurance, rejoining after a break in cover, upgrading to a higher level of cover, or changing your excess, you’ll have to wait before claiming on certain treatment and services.
When you take out hospital cover you’ll be asked to choose your excess. This is the amount you agree to pay if you’re admitted to hospital for planned treatment.
If you choose a higher excess, you’ll lower the cost of your cover. Choosing a lower, or zero excess, means you’ll pay less if you go to hospital, but the cost of your cover will be more.
$350 limit per person max $700 per policy
Max 1 check up, 1 scale and clean, and 1 fluoride treatment per person, per year
| Service | Benefits |
|---|---|
| Examinations | $29 - $60 |
| Single film x-rays | $24 |
| Removal of plaque / calculus | $36 - $55 |
| Application of fluoride | $25 |
| Direct fillings (1-2 surfaces) | $66 - $86 |
| Simple extractions | $78 - $88 |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$150 limit per person max $300 per policy
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent | $40 / $35 |
Combined with physiotherapy limit
| Service | Benefits |
|---|---|
| Chiropractic - initial / subsequent | $33 / $25 |
| Osteopathy - initial / subsequent | $40 / $30 |
| Remedial massage and myotherapy - initial / subsequent | $30 / $25 |
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | $30 / $25 |
| Therapies (excluding foot orthotics) | 2 months |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
$400 limit per person max $800 per policy
Max 1 check up, 1 scale and clean, and 1 fluoride treatment per person, per year
| Service | Benefits |
|---|---|
| Examinations | $29 - $60 |
| Single film x-rays | $24 |
| Removal of plaque / calculus | $36 - $55 |
| Application of fluoride | $25 |
| Direct fillings (1-2 surfaces) | $66 - $86 |
| Simple extractions | $78 - $88 |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$100 limit per person max $200 per policy
| Service | Benefits |
|---|---|
| Spectacle frames | 100% of fee up to per person annual limit |
| Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting) | 100% of fee up to per person annual limit |
| Contact lenses - pair | 100% of fee up to per person annual limit |
| Optical | 2 months |
$200 limit per person $400 max per policy
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent | $42 / $36 |
$100 limit per person/max $200 per policy - combined limit
| Service | Benefits |
|---|---|
| Chiropractic - initial / subsequent | $33 / $25 |
| Osteopathy - initial / subsequent | $40 / $30 |
| Remedial massage and myotherapy - initial / subsequent | $30 / $25 |
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | $30 / $25 |
| Therapies (excluding foot orthotics) | 2 months |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
$650 combined limit with Therapies & Other
1 check up, 1 scale and clean and 1 fluoride treatment per person
| Service | Benefits |
|---|---|
| Examinations | 60% |
| Single film x-rays | 60% |
| Removal of plaque / calculus | 60% |
| Application of fluoride | 60% |
| Direct fillings (1-2 surfaces) | 60% |
| Simple extractions | 60% |
| Teeth whitening - In-chair (service limits apply) | 60% |
| Teeth whitening - Home application (service limits apply) | 60% |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$175 limit
| Service | Benefits |
|---|---|
| Spectacle frames | 60% |
| Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting) | 60% |
| Contact lenses - pair | 60% |
| Optical | 2 months |
$650 combined limit with Dental & Other
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent | 60% |
| Exercise physiology | 60% |
| HCF-approved Online Cognitive Behavioural Therapy courses | 60% |
$100 Limit
| Service | Benefits |
|---|---|
| Remedial massage and myotherapy - initial / subsequent | 60% |
$650 combined limit with Dental & Other
| Service | Benefits |
|---|---|
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | 60% |
$650 combined limit with Dental & Other
| Service | Benefits |
|---|---|
| Dietetics - initial / subsequent | 60% |
| Therapies (excluding foot orthotics) | 2 months |
Gap Bonus helps reduce or eliminate out-of-pocket costs by topping up the benefit we pay on services included in your Flex My Extras cover. You can use your Gap Bonus on any covered extras service up to your annual entitlement*. Gap Bonus kicks in after 12 months on your Flex My Extras cover and increases each year up to year 4. * Each member listed on the policy has their own Gap Bonus entitlement. Gap Bonus is non-transferable between members. Unused Gap Bonus cannot be rolled over into the following year.
| Service | Benefits |
|---|---|
| Gap Bonus | Year 1 N/A Year 2 $50, year 3 $75, year 4 $100 per person |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
$650 overall limit
Max 2 check ups, 2 scale and clean, and 1 fluoride treatment per person, per year
| Service | Benefits |
|---|---|
| Examinations | $32 - $73 |
| Single film x-rays | $29 |
| Removal of plaque / calculus | $36 - $62 |
| Application of fluoride | $27 |
| Direct fillings (1-2 surfaces) | $85 - $105 |
| Direct fillings (3 or more surfaces) | $128 - $177 |
| Simple extractions | $95 - $143 |
| Indirect fillings | $298 - $600 |
| Surgical extractions | $157 - $250 |
| Treatment of tissue surrounding teeth | $23 - $374 |
| Treatment of root canals | $27 - $248 |
| Placing of crowns and bridges | $238 - $600 |
| Dentures and/or components (partial and complete) - Limits renew every 3 years | $25 - $600 |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$200 limit
| Service | Benefits |
|---|---|
| Spectacle frames | 100% of fee up to annual limit |
| Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting) | 100% of fee up to annual limit |
| Contact lenses - pair | 100% of fee up to annual limit |
| Optical | 2 months |
$350 combined limit
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent (group / class consultations covered under Health Management Program) | $56 / $49 |
| Exercise physiology (group / class consultations covered under Health Management Program) | $33 |
$150 combined limit
| Service | Benefits |
|---|---|
| Chiropractic - initial / subsequent | $38 / $31 |
| Osteopathy - initial / subsequent | $46 / $36 |
| Remedial massage and myotherapy - initial / subsequent | $36 / $31 |
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | $36 / $31 |
| Therapies (excluding foot orthotics) | 2 months |
$50 limit per person max $100 per policy
| Service | Benefits |
|---|---|
| Health Management Programs (HCF approved e.g. exercise classes) | Up to $50 |
| Travel and Accommodation | 2 months |
| Vaccines and Immunisations | 2 months |
| Artificial aids | 12 months |
| Hearing aids | 12 months |
| Health Management Programs | 2 months |
| School Accident Benefit | 2 – 12 months |
| Foot orthotics | 12 months |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
Max 2 check ups, 2 scale and clean, and 1 fluoride treatment per person, per year
| Service | Benefits |
|---|---|
| Examinations | $32 - $73 |
| Single film x-rays | $31 |
| Removal of plaque / calculus | $36 - $64 |
| Application of fluoride | $28 |
Year 1 $800 limit
| Service | Benefits |
|---|---|
| Direct fillings (1-2 surfaces) | $85 - $105 |
| Direct fillings (3 or more surfaces) | $128 - $177 |
| Simple extractions | $95 - $143 |
| Indirect fillings | $298 - $671 |
| Surgical extractions | $165 - $260 |
| Treatment of tissue surrounding teeth | $23 - $374 |
| Treatment of root canals | $27 - $248 |
| Placing of crowns and bridges | $244 - $1,000 |
| Dentures and/or components (partial and complete) - Limits renew every 3 years | $25 - $1,100 |
$700 LIMIT for ORTHODONTISTS ($350 LIMIT if general dentist)
Lifetime limit $2,100 or $1,050 for services by dentists, other than orthodontists
| Service | Benefits |
|---|---|
| Orthodontics - orthodontist / other dentists | Up to $700/$350 |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$250 limit
| Service | Benefits |
|---|---|
| Spectacle frames | 100% of fee up to annual limit |
| Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting) | 100% of fee up to annual limit |
| Contact lenses - pair | 100% of fee up to annual limit |
| Optical | 2 months |
Year 1 $350 limit
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent (group / class consultations covered under Health Management Program) | $58 / $49 |
| Exercise physiology (group / class consultations covered under Health Management Program) | $33 |
Year 1 $350 limit
| Service | Benefits |
|---|---|
| Occupational therapy | $62 |
| Psychology (after Medicare Mental Health Treatment Plan used up) includes group consultations | $26/$85 |
| Psychology (when member does not have any unused Medicare Mental Health Treatment Plan in the calendar year) includes group consultations | $18/$49 |
| HCF-approved counselling & accredited mental health social worker includes group consultations | $15/$41 |
| HCF-approved Online Cognitive Behavioural Therapy courses | $35 - $59 |
Year 1 $250 limit
| Service | Benefits |
|---|---|
| Chiropractic - initial / subsequent | $40 / $33 |
| Osteopathy - initial / subsequent | $48 / $38 |
Year 1 $250 limit
Sub-limit $250 per therapy service
| Service | Benefits |
|---|---|
| Remedial massage and myotherapy - initial / subsequent | $36 / $31 |
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | $36 / $31 |
Year 1 $200 limit
| Service | Benefits |
|---|---|
| Dietetics - initial / subsequent | $45 |
| Audiology - initial / subsequent | $60 |
| Speech pathology - initial / subsequent | $60 |
| Podiatry (including 1 pair of foot orthotics per person per year) | $35 / $30 |
| Orthotist/Prosthetist and Pedorthist | $20-$100 |
| Therapies (excluding foot orthotics) | 2 months |
Max $200 per policy
| Service | Benefits |
|---|---|
| Travel and Accommodation (200km round trip) | $40 |
$180 limit
| Service | Benefits |
|---|---|
| HCF approved pharmacy (After PBS equivalent co-payment subtracted) | Up to $50 per script |
Max $150 per policy
| Service | Benefits |
|---|---|
| Artificial aids (HCF approved e.g. low vision aids) | $45 - $150 |
$600 - $1,600 limit
| Service | Benefits |
|---|---|
| Hearing aids | $600 (benefits accrue and renew every three years) |
$150 per person max $300 per policy
| Service | Benefits |
|---|---|
| Health Management Programs (HCF approved e.g. exercise classes) | Up to $150 per person |
$150 per eligible child
| Service | Benefits |
|---|---|
| School Accident Benefit | Up to $150 per eligible child |
| Travel and Accommodation | 2 months |
| Vaccines and Immunisations | 2 months |
| Artificial aids | 12 months |
| Hearing aids | 12 months |
| Health Management Programs | 2 months |
| School Accident Benefit | 2 – 12 months |
| Foot orthotics | 12 months |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
Max 2 check ups, 2 scale and clean, and 1 fluoride treatment per person, per year
| Service | Benefits |
|---|---|
| Examinations | $34 - $84 |
| Single film x-rays | $34 |
| Removal of plaque / calculus | $40 - $75 |
| Application of fluoride | $29 |
Year 1 $1,000 limit
| Service | Benefits |
|---|---|
| Direct fillings (1-2 surfaces) | $105 - $148 |
| Direct fillings (3 or more surfaces) | $177 - $256 |
| Simple extractions | $120 - $175 |
| Indirect fillings | $341 - $783 |
| Surgical extractions | $210 - $330 |
| Occlusal therapy | $38 - $400 |
| Treatment of tissue surrounding teeth | $27 - $430 |
| Treatment of root canals | $32 - $285 |
| Placing of crowns and bridges | $280 - $1,100 |
| Dentures and/or components (partial and complete) - Limits renew every 3 years | $33 - $1,300 |
$800 LIMIT for ORTHODONTISTS ($400 LIMIT if general dentist)
Lifetime limit $2,400 or $1,200 for services by dentists, other than orthodontists
| Service | Benefits |
|---|---|
| Orthodontics - orthodontist / other dentists | Up to $800/$400 |
| General Dental | 2 months |
| Major Dental | 12 months |
| Orthodontic | 12 months |
$275 limit
| Service | Benefits |
|---|---|
| Spectacle frames | 100% of fee up to annual limit |
| Spectacle lenses - pair (excludes add-ons such as high index material, coatings and tinting) | 100% of fee up to annual limit |
| Contact lenses - pair | 100% of fee up to annual limit |
| Optical | 2 months |
Year 1 $600 limit
| Service | Benefits |
|---|---|
| Physiotherapy – initial / subsequent (group / class consultations covered under Health Management Program) | $60 / $54 |
| Exercise physiology (group / class consultations covered under Health Management Program) | $40 |
Year 1 $600 limit
| Service | Benefits |
|---|---|
| Occupational therapy | $72 |
| Psychology (after Medicare Mental Health Treatment Plan used up) includes group consultations | $30/$100 |
| Psychology (when member does not have any unused Medicare Mental Health Treatment Plan in the calendar year) includes group consultations | $21/$58 |
| HCF-approved counselling & accredited mental health social worker includes group consultations | $18/$48 |
| HCF-approved Online Cognitive Behavioural Therapy courses | $35 - $59 |
Year 1 $300 limit
| Service | Benefits |
|---|---|
| Chiropractic - initial / subsequent | $45 / $35 |
| Osteopathy - initial / subsequent | $50 / $40 |
Year 1 $300 limit
Sub-limit $300 per therapy service
| Service | Benefits |
|---|---|
| Remedial massage and myotherapy - initial / subsequent | $40 / $35 |
| Acupuncture and Chinese herbal medicine consultation - initial / subsequent | $40 / $35 |
Year 1 $250
| Service | Benefits |
|---|---|
| Dietetics - initial / subsequent | $55 |
| Audiology - initial / subsequent | $70 |
| Speech pathology - initial / subsequent | $83 |
| Podiatry (including 1 pair of foot orthotics per person per year) | $40 / $35 |
| Orthotist/Prosthetist and Pedorthist | $25 - $135 |
| Therapies (excluding foot orthotics) | 2 months |
Max $250 per policy
| Service | Benefits |
|---|---|
| Travel and Accommodation (200km round trip) | $50 |
$280 limit
| Service | Benefits |
|---|---|
| HCF approved pharmacy (After PBS equivalent co-payment subtracted) | Up to $50 per script |
Max $200 per policy
| Service | Benefits |
|---|---|
| Artificial aids (HCF approved e.g. low vision aids) | $55 - $200 |
$800 - $1,800
| Service | Benefits |
|---|---|
| Hearing aids | $800 (benefits accrue and renew every three years) |
$200 per person max $400 per policy
| Service | Benefits |
|---|---|
| Health Management Programs (HCF approved e.g. exercise classes) | $200 per person/max $400 per policy |
$200 per eligible child
| Service | Benefits |
|---|---|
| School Accident Benefit | Up to $200 per eligible child |
| Travel and Accommodation | 2 months |
| Vaccines and Immunisations | 2 months |
| Artificial aids | 12 months |
| Hearing aids | 12 months |
| Health Management Programs | 2 months |
| School Accident Benefit | 2 – 12 months |
| Foot orthotics | 12 months |
Extras cover helps reduce out-of-pocket expenses that come with managing or improving your health. Depending on which extras cover you choose, you can claim on a range of services like dental, optical, physio, weight management programs and more. Waiting periods apply and vary according to the type of service.
If you have extras cover, we’ll pay up to a set amount for extras services (like dental or optical), depending on your annual limits. The amount we’ll pay also varies depending on your level of cover. You’ll need to pay the difference between what your extras provider charges and the benefits we pay: this is an extras gap.
Getting the most out of your extras cover means more money saved, and a boost to your family’s health and wellbeing. Preventive health checks are important at any age and our wide network of extras providers makes accessing care easy. Depending on your level of cover and which service you choose, you could get 100% back** through our no-gap providers.
