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Factsheet
General Dental

General dental includes commonly used services such as consultations/oral examinations, scale and cleans, bleaching, x-rays, mouthguards, fillings and removal of permanent teeth

Included

Benefit: 
If you'd like to confirm the benefit payable, please complete our dental estimate form.

50% of each treatment or service.

Commonly claimed item numbers include:

Oral Examination (012)
Dental x-ray (022)
Scale and clean (114)
Fluoride treatment (121)
Surgical tooth extraction (322)
Filling/tooth restoration (531)

Annual Limit per person:
$400 

Annual Limit per policy:
$800 

Waiting Period:
2 months

Limits apply to the number of times some items (such as bleaching) attract a benefit. You may also not be able to claim benefits for services performed with another item in the same course of treatment.

Included

Benefit: 
If you'd like to confirm the benefit payable, please complete our dental estimate form.

Commonly claimed item numbers include:

Oral Examination (012)1
Benefit: $52.75

Dental x-ray (022)
Benefit: $21.60

Scale and clean (114)1
Benefit: $107.15

Fluoride treatment (121)1
Benefit: $31.60

Surgical tooth extraction (322)
Benefit: $121.00

Filling/tooth restoration (531)
Benefit: $74.80

Annual Limit per person:
$750

Annual Limit per policy:
No limit

Waiting Period:
2 months

Limits apply to the number of times some items (such as bleaching) attract a benefit. You may also not be able to claim benefits for services performed with another item in the same course of treatment.

1Subsequent visits for these item numbers within the calendar year are paid at a lower benefit.

Included

Benefit: 
If you'd like to confirm the benefit payable, please complete our dental estimate form.

60% of each treatment or service.

Commonly claimed item numbers include:

Oral Examination (012)
Dental x-ray (022)
Scale and clean (114)
Fluoride treatment (121)
Surgical tooth extraction (322)
Filling/tooth restoration (531)

Annual Limit per person:
$600

Annual Limit per policy:
$1,200

Waiting Period:
2 months

1Limits apply to the number of times some items (such as bleaching) attract a benefit. You may also not be able to claim benefits for services performed with another item in the same course of treatment.

Included

Benefit: 
If you'd like to confirm the benefit payable, please complete our dental estimate form.

Commonly claimed item numbers include:

Oral Examination (012)1
Benefit: $52.75

Dental x-ray (022)
Benefit: $22.80

Scale and clean (114)1
Benefit: $107.15

Fluoride treatment (121)1
Benefit: $31.60

Surgical tooth extraction (322)
Benefit: $133.10

Filling/tooth restoration (531)
Benefit: $79.90

Annual Limit per person:
$1,250

Annual Limit per policy:
No limit

Waiting Period:
2 months

Limits apply to the number of times some items (such as bleaching) attract a benefit. You may also not be able to claim benefits for services performed with another item in the same course of treatment.

1Subsequent visits for these item numbers within the calendar year are paid at a lower benefit.

The above annual limit is a combined limit for General Dental, Major Dental and Orthodontics.

Included

Benefit: 
If you'd like to confirm the benefit payable, please complete our dental estimate form.

Commonly claimed item numbers include:

Oral Examination (012)1
Benefit: $52.75

Dental x-ray (022)
Benefit: $24.60

Scale and clean (114)1
Benefit: $107.15

Fluoride treatment (121)1
Benefit: $31.60

Surgical tooth extraction (322)
Benefit: $145.20

Filling/tooth restoration (531)
Benefit: $87.20

Annual Limit per person:
$1,000

Annual Limit per policy:
No limit

Waiting Period:
2 months

Limits apply to the number of times some items (such as bleaching) attract a benefit. You may also not be able to claim benefits for services performed with another item in the same course of treatment.

1Subsequent visits for these item numbers within the calendar year are paid at a lower benefit.

Included

Benefit: 
If you'd like to confirm the benefit payable, please complete our dental estimate form.

Commonly claimed item numbers include:

Oral Examination (012)1
Benefit: $52.75

Dental x-ray (022)
Benefit: $27.30

Scale and clean (114)1
Benefit: $107.15

Fluoride treatment (121)1
Benefit: $31.60

Surgical tooth extraction (322)
Benefit: $157.30

Filling/tooth restoration (531)
Benefit: $92.55

Annual Limit per person:
Unlimited

Annual Limit per policy:
Unlimited

Waiting Period:
2 months

Limits apply to the number of times some items (such as bleaching) attract a benefit. You may also not be able to claim benefits for services performed with another item in the same course of treatment.

1Subsequent visits for these item numbers within the calendar year are paid at a lower benefit.

Major Dental

Major dental includes complex services such as crowns and bridges, root canals, dentures and most periodontic services.

Not Included

Not covered

Not Included

Not covered

Included

Benefit: 
If you'd like to confirm the benefit payable, please complete our dental estimate form.

60% of each treatment or service.

Commonly claimed item numbers include:

Filling of one root canal (417)
Full crown - non metallic (613)
Full crown - veneered (615)
Dentures - complete (719)2

Annual Limit per person:
$600

Annual Limit per policy:
$1,200

Waiting Period:
12 months

2Benefits for replacement dentures and partial dentures are not paid within three years of previous supply.

Included

Benefit: 
If you'd like to confirm the benefit payable, please complete our dental estimate form.

Commonly claimed item numbers include:

Filling of one root canal (417)
Benefit: $123.00

Full crown - non metallic (613)
Benefit: $722.70

Full crown - veneered (615)
Benefit: $685.95

Dentures - complete (719)2
Benefit: $955.65

Annual Limit per person:
$1,250

Annual Limit per policy:
No limit

Waiting Period:
12 months

2Benefits for replacement dentures and partial dentures are not paid within three years of previous supply.

The above annual limit is a combined limit for General Dental, Major Dental and Orthodontics.

Included

Benefit: 
If you'd like to confirm the benefit payable, please complete our dental estimate form.

Commonly claimed item numbers include:

Filling of one root canal (417)
Benefit: $135.30

Full crown - non metallic (613)
Benefit: $795.00

Full crown - veneered (615)
Benefit: $754.55

Dentures - complete (719)2
Benefit: $1,000

Annual Limit per person:
$1,000

Annual Limit per policy:
No limit

Waiting Period:
12 months

2Benefits for replacement dentures and partial dentures are not paid within three years of previous supply.

Included

Benefit: 
If you'd like to confirm the benefit payable, please complete our dental estimate form.

Commonly claimed item numbers include:

Filling of one root canal (417)
Benefit: $147.60

Full crown - non metallic (613)
Benefit: $867.25

Full crown - veneered (615)
Benefit: $852.20

Dentures- complete (719)2
Benefit: $1,218.50

Annual Limit per person:
$1,500

Annual Limit per policy:
No limit

Waiting Period:
12 months

2Benefits for replacement dentures and partial dentures are not paid within three years of previous supply.

Orthodontics

Orthodontics include the diagnosis, prevention and correction of jaw alignment issues. Common types of orthodontic services include braces, clear and removable aligners (e.g. Invisalign) and retainers.

Not Included

Not covered

Not Included

Not covered

Not Included

Not covered

Included

Benefit: 100%

If you'd like to confirm the benefit payable, please complete our dental estimate form.

Annual Limit per person:
$1,250

Annual Limit per policy:
No limit

Lifetime Limit:
$1,250

Waiting Period:
12 months

The above annual limit is a combined limit for General Dental, Major Dental and Orthodontics.

Included

Benefit: 100%

If you'd like to confirm the benefit payable, please complete our dental estimate form.

Annual Limit per person:
$800

Annual Limit per policy:
No limit

Lifetime Limit:
$2,000

Waiting Period:
12 months

Included

Benefit: 100% 

If you'd like to confirm the benefit payable, please complete our dental estimate form.

Annual Limit per person:
$1,000

Annual Limit per policy:
No limit

Lifetime Limit:
$2,500

Waiting Period:
12 months

Optical

Optical includes services such as glasses, contact lenses and prescription sunglasses. Even better, HIF members get bonus discounts of up to 25% from a range of retail and online optical stores - Find out more

Included

Benefit: 
100% for frames, prescription lenses and contact lenses

Annual Limit per person:
$150 

Annual Limit per policy:
$300 

Waiting Period:
2 months

Benefits are payable on prescription optical items.

Included

Benefit: 
100% for frames, prescription lenses and contact lenses

Annual Limit per person:
$150

Annual Limit per policy:
No limit

Waiting Period:
2 months

Benefits are payable on prescription optical items.

Included

Benefit:
100% for frames, prescription lenses and contact lenses

Annual Limit per person:
$200

Annual Limit per policy:
$400

Waiting Period:
2 months

Benefits are payable on prescription optical items.

Included

Benefit: 
100% for frames, prescription lenses and contact lenses

Annual Limit per person:
$200

Annual Limit per policy:
No limit

Waiting Period:
2 months

Benefits are payable on prescription optical items.

Included

Benefit: 
100% for frames, prescription lenses and contact lenses

Annual Limit per person:
$275

Annual Limit per policy:
No limit

Waiting Period:
2 months

Benefits are payable on prescription optical items.

Included

Benefit: 
100% for frames, prescription lenses and contact lenses

Annual Limit per person:
$300

Annual Limit per policy:
No limit

Waiting Period:
2 months

Benefits are payable on prescription optical items..

Physiotherapy

Physiotherapy consultations include the treatment of health conditions including sports injuries and musculoskeletal conditions.

Included

Benefit:
50% of each consultation

Annual Limit:
$300 

Annual Limit: 
$600 

Waiting period:
2 months

The above annual limit is combined for physiotherapy, chiropractic and osteopathy.

Included

Benefit:
Individual consulatation: $30

Group, hydrotherapy or antenatal: $15

Annual Limit per person: 
$350

Annual Limit per policy:
No limit

Waiting period:
2 months

The above annual limit is combined for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry and pharmacy.

Included

Benefit:
60% of each consultation

Annual Limit per person: 
$350

Annual Limit per policy:
$700

Waiting period:
2 months

The above annual limit is combined for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry, pharmacy, complementary therapies and healthy lifestyle (sub-limits apply for complementary therapies and healthy lifestyle).

Included

Benefit:
Individual consulatation: $35

Group, hydrotherapy or antenatal: $15

Annual Limit per person: 
$400

Annual Limit per policy:
No limit

Waiting period:
2 months

The above annual limit is combined for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry and dietetics.

Included

Benefit:
Individual consulatation: $45

Group, hydrotherapy or antenatal: $20

Annual Limit per person: 
$500

Annual Limit per policy:
No limit

Waiting period:
2 months

The above annual limit is combined for physiotherapy and exercise physiology.

Included

Benefit:
Individual consulatation: $50

Group, hydrotherapy or antenatal: $20

Annual Limit per person: 
$750

Annual Limit per policy:
No limit

Waiting period:
2 months

The above annual limit is combined for physiotherapy and exercise physiology.

Chiropractic

Chiropractic consultations includes services which use spinal adjustments to treat health problems that are related to nerves, skeleton and muscle.

Included

Benefit:
50% of each consultation

X-ray: 50% 

Annual Limit: 
$300 

Annual Limit:
$600

Waiting period:
2 months

The above annual limit is combined for physiotherapy, chiropractic and osteopathy.

Included

Benefit:
Individual consultation: $25

X-ray: $65 - Max 1 per year

Annual Limit per person: 
$350

Annual Limit per policy:
No limit

Waiting period:
2 months

The above annual limit is combined for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry and pharmacy.

Included

Benefit:
60% of each consultation

X-ray: 60% 

Annual Limit per person: 
$350

Annual Limit per policy:
$700

Waiting period:
2 months

The above annual limit is combined for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry, pharmacy, complementary therapies and healthy lifestyle (sub-limits apply for complementary therapies and healthy lifestyle).

Included

Benefit:
Individual consultation: $28

X-ray: $70 - Max 1 per year

Annual Limit per person: 
$400

Annual Limit per policy:
No limit

Waiting period:
2 months

The above annual limit is combined for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry and dietetics.

Included

Benefit:
Individual consultation: $32

X-ray: $85 - Max 1 per year

Annual Limit per person: 
$400

Annual Limit per policy:
No limit

Waiting period:
2 months

The above annual limit is combined for chiropractic and osteopathy.

Included

Benefit:
Individual consultation: $40

X-ray: $110 - Max 1 per year

Annual Limit per person: 
$550

Annual Limit per policy:
No limit

Waiting period:
2 months

The above annual limit is combined for chiropractic and osteopathy.

Osteopathy

Osteopathy is a holistic approach to health that stresses manual readjustments and physical manipulation of muscle tissue and bones. Osteopathy treatment may include individual exercise routines, relaxation techniques, or body awareness sessions.

Included

Benefit:
50% of each consultation

Annual Limit per person: 
$300 

Annual Limit per policy:
$600

Waiting period:
2 months

The above annual limit is combined for physiotherapy, chiropractic and osteopathy.

Included

Benefit:
Individual consultation: $25

Annual Limit per person: 
$350

Annual Limit per policy:
No limit

Waiting period:
2 months

The above annual limit is combined for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry and pharmacy.

Included

Benefit:
60% of each consultation

Annual Limit per person: 
$350

Annual Limit per policy:
$700

Waiting period:
2 months

The above annual limit is combined for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry, pharmacy, complementary therapies and healthy lifestyle (sub-limits apply for complementary therapies and healthy lifestyle).

Included

Benefit:
Individual consultation: $28

Annual Limit per person: 
$400

Annual Limit per policy:
No limit

Waiting period:
2 months

The above annual limit is combined for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry and dietetics.

Included

Benefit:
Individual consultation: $32

Annual Limit per person: 
$400

Annual Limit per policy:
No limit

Waiting period:
2 months

The above annual limit is combined for chiropractic and osteopathy.

Included

Benefit:
Individual consultation: $40

Annual Limit per person: 
$550

Annual Limit per policy:
No limit

Waiting period:
2 months

The above annual limit is combined for chiropractic and osteopathy.

Podiatry consultations

Podiatry consultations include the diagnosis, and medical treatment of ailments of the foot, ankle and lower limbs.

Not Included

Not covered.

Included

Benefit: 
Individual consultation: $25

Annual Limit per person:
$350

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry and pharmacy.

Benefits are not payable on podiatry surgery or orthotics. 

Included

Benefit: 
60% of each consultation

Annual Limit per person:
$350

Annual Limit per policy:
$700

Waiting Period:
2 months

The above annual limit is combined for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry, pharmacy, complementary therapies and healthy lifestyle (sub-limits apply for complementary therapies and healthy lifestyle).

Benefits are not payable on podiatry surgery or orthotics. 

Included

Benefit: 
Individual consultation: $28

Annual Limit per person:
$400

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry and dietetics.

Benefits are not payable on podiatry surgery or orthotics.  

Included

Benefit: 
Individual consultation: $32

Annual Limit per person:
$350

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for podiatry consultations includes podiatry surgery (performed in podiatrist’s registered rooms only).

Please note: A 12 month waiting period applies for podiatry surgery which is performed in the podiatrist’s registered rooms. Benefits are paid at 80% of the charge up to a maximum of $150 per item.

 

 
Included

Benefit: 
Individual consultation: $40

Annual Limit per person:
$400

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for podiatry consultations includes podiatry surgery (performed in podiatrist’s registered rooms only).

Please note: A 12 month waiting period applies for podiatry surgery which is performed in the podiatrist’s registered rooms. Benefits are paid at 80% of the charge up to a maximum of $150 per item. 

Pharmaceuticals (non-PBS) Drugs

The Pharmaceutical Benefits Scheme (PBS) is an Australian Government program that provides subsidised prescription medicines to residents of Australia. The Non-PBS includes prescription pharmaceuticals which are not listed on the Australian government’s Pharmaceutical Benefits Schemes (PBS).

Pharmacy includes pharmaceuticals (non-PBS drugs), flu vaccinations and assisted reproductive drugs on selected covers)


 

Not Included

Not covered.

Included

Benefit: 
100% of the balance up to $80 per script item, once the PBS amount has been paid.

Annual Limit per person:
$350

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry and pharmacy.

Benefits are not payable on contraceptives, PBS (Pharmaceutical Benefit Scheme) prescription or over the counter items purchased with or without a prescription. 

Included

Benefit: 
60% of the balance, once the PBS amount has been paid

Annual Limit per person:
$350

Annual Limit per policy:
$700

Waiting Period:
2 months

The above annual limit is combined for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry, pharmacy, complementary therapies and healthy lifestyle (sub-limits apply for complementary therapies and healthy lifestyle).

Benefits are not payable on contraceptives, PBS (Pharmaceutical Benefit Scheme) prescription or over the counter items purchased with or without a prescription. 

 

Included

Benefit: 
100% of the balance up to $80 per script item, once the PBS amount has been paid.

Annual Limit per person:
$200

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for pharmacy.

Benefits are not payable on contraceptives, PBS (Pharmaceutical Benefit Scheme) prescription or over the counter items purchased with or without a prescription. 

 

Included

Benefit: 
100% of the balance up to $80 per script item, once the PBS amount has been paid.

Annual Limit per person:
$300

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for pharmacy.

Benefits are not payable on contraceptives, PBS (Pharmaceutical Benefit Scheme) prescription or over the counter items purchased with or without a prescription. 

Included

Benefit: 
100% of the balance up to $80 per script item, once the PBS amount has been paid.

Annual Limit per person:
$400

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for pharmacy.

Benefits are not payable on contraceptives, PBS (Pharmaceutical Benefit Scheme) prescription or over the counter items purchased with or without a prescription. 

Assisted Reproductive Drugs


Pharmacy includes pharmaceuticals (non-PBS drugs), flu vaccinations and assisted reproductive drugs on selected covers)

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Included

Benefit: 
100% of the balance up to $80 per script item, once the PBS amount has been paid.

Annual Limit per person:
$300

Annual Limit per policy:
No limit

Waiting Period:
12 months

The above annual limit is combined for pharmacy.

Included

Benefit: 
100% of the balance up to $80 per script item, once the PBS amount has been paid.

Annual Limit per person:
$400

Annual Limit per policy:
No limit

Waiting Period:
12 months

The above annual limit is combined for pharmacy.

Orthotics

Orthotics refers to a support, brace or splint used to support, align, prevent or correct the function of movable parts of the body.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Included

Benefit: 
75%

Annual Limit per person:
$200

Annual Limit per policy:
No limit

Waiting Period:
12 months

Benefits are paid on items carried out by a registered podiatrist or orthotic supplier, approved by HIF. Benefits are not available for orthotics which are not specifically modified and fitted for the individual member’s condition.

Included

Benefit: 
75% 

Annual Limit per person:
$250

Annual Limit per policy:
No limit

Waiting Period:
12 months

Benefits are paid on items carried out by a registered podiatrist or orthotic supplier, approved by HIF. Benefits are not available for orthotics which are not specifically modified and fitted for the individual member’s condition.

Complementary therapies

Complementary therapies includes commonly used services such as acupuncture, traditional chinese medicine, remedial massage and myotherapy.

Not Included

Not covered.

Included

Benefit: 
Individual consultation: $25

Annual Limit per person:
$100

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for acupuncture, myotherapy, remedial massage and traditional chinese medicine.

Benefits are not payable on medicines.

Included

Benefit: 
60% of each consultation

Annual Limit per person:
$150

Annual Limit per policy:
$300

Waiting Period:
2 months

The limits detailed above are subject to a combined overall person limit of $350 and policy limit of $700 for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry, pharmacy, complementary therapies and healthy lifestyle.

Benefits are not payable on medicines.

Included

Benefit: 
Individual consultation: $28

Annual Limit per person:
$150

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for acupuncture, myotherapy, remedial massage and traditional chinese medicine.

Benefits are not payable on medicines.

Included

Benefit: 
Individual consultation: $32

Annual Limit per person:
$250

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for acupuncture, myotherapy, remedial massage and traditional chinese medicine.

Benefits are not payable on medicines.

Included

Benefit: 
Individual consultation: $40

Annual Limit per person:
$500

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for acupuncture, myotherapy, remedial massage and traditional chinese medicine.

Benefits are not payable on medicines.

Dietetics

Dietetics includes consultations with a dietitician or nutritionist who provide guidance on how to manage diets for people who may be affected by health conditions such as diabetes, weight managment, cancer, heart disease, renal disease, gastro-intestinal diseases and food allergies.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Included

Benefit: 
Individual consultation: $30

Annual Limit per person:
$400

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry and dietetics.

Included

Benefit: 
Individual consultation: $40

Annual Limit per person:
$350

Annual Limit per policy:
No limit

Waiting Period:
2 months

Included

Benefit: 
Individual consultation: $45

Annual Limit per person:
$400

Annual Limit per policy:
No limit

Waiting Period:
2 months

Healthy Lifestyle

Healthy Lifestyle includes services such as Gym Memberships, Weight Management Programs, Health Assessments, Health Management Programs, Quit Smoking Plans and Skin Cancer Screenings

Not Included

Not covered.

Included

Benefit: 
100% of the fee for each individual treatment or service

Annual Limit per person:
$50

Annual Limit per policy:
No limit

Waiting Period:
2 months

Benefits are payable for HIF approved programs delivered by registered providers only. Please contact us prior to commencing a program to confirm your eligibility. 

Included

Benefit: 
60% of the fee for each individual treatment or service

Annual Limit per person:
$150

Annual Limit per policy:
$300

Waiting Period:
2 months

The limits detailed above are subject to a combined overall person limit of $350 and policy limit of $700 for physiotherapy, chiropractic, osteopathy, podiatry, pharmacy, complementary therapies and healthy lifestyle.

Benefits are payable for HIF approved programs delivered by registered providers only. Please contact us prior to commencing a program to confirm your eligibility. 

Included

Benefit: 
100% of the fee for each individual treatment or service

Annual Limit per person:
$75

Annual Limit per policy:
No limit

Waiting Period:
2 months

Benefits are payable for HIF approved programs delivered by registered providers only. Please contact us prior to commencing a program to confirm your eligibility. 

Included

Benefit: 
100% of the fee for each individual treatment or service

Annual Limit per person:
$100

Annual Limit per policy:
No limit

Waiting Period:
2 months

Benefits are payable for HIF approved programs delivered by registered providers only. Please contact us prior to commencing a program to confirm your eligibility. 

Included

Benefit: 
100% of the fee for each individual treatment or service

Annual Limit per person:
$150

Annual Limit per policy:
No limit

Waiting Period:
2 months

Benefits are payable for HIF approved programs delivered by registered providers only. Please contact us prior to commencing a program to confirm your eligibility. 

Occupational therapy

Occupational therapy consultations help people with developmental, physical and psychological conditions.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Included

Benefit: 
$40 per consultation

Annual Limit per person:
$500

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for occupational therapy, orthoptics (eye therapy) and speech therapy.

Included

Benefit: 
$45 per consultation

Annual Limit per person:
$600

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for occupational therapy, orthoptics (eye therapy) and speech therapy.

Orthoptics (eye therapy)

Orthoptics is the study or treatment of irregularities of the eyes, especially those of the eye muscles that prevent normal binocular vision.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Included

Benefit: 
$40 per consultation

Annual Limit per person:
$500

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for occupational therapy, orthoptics (eye therapy) and speech therapy.

Included

Benefit: 
$45 per consultation

Annual Limit per person:
$600

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for occupational therapy, orthoptics (eye therapy) and speech therapy.

Speech therapy

Speech therapy is the study, diagnosis and treatment for communication disorders, including difficulties with speaking, listening, understanding language, and reading, and writing, social skills, stuttering and using voice.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Included

Benefit: 
$60 per consultation

Annual Limit per person:
$500

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for occupational therapy, orthoptics (eye therapy) and speech therapy.

Included

Benefit: 
$65 per consultation

Annual Limit per person:
$600

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for occupational therapy, orthoptics (eye therapy) and speech therapy.

Psychology

Psychology is the science of 
behaviour & mind, embracing all aspects of conscious and unconscious 
experience as well as thought. Clinical psychologists diagnose and treat mental health, behavioural and emotional disorders such an anxiety, depression and chronic illness.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Included

Benefit: 
$80 per consultation

Annual Limit per person:
$700

Annual Limit per policy:
No limit

Waiting Period:
2 months

Included

Benefit: 
$90 per consultation

Annual Limit per person:
$700

Annual Limit per policy:
No limit

Waiting Period:
2 months

Hearing Aids

Hearing aids are a device to amplify and change sound to assist with hearing impairments.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Included

Benefit: 
100% 

Replacement every 3 years from previous date of supply

Annual Limit per person:
$550

Annual Limit per policy:
No limit

Waiting Period:
12 months

Included

Benefit: 
100% 

Replacement every 3 years from previous date of supply

Annual Limit per person:
$1,000

Annual Limit per policy:
No limit

Waiting Period:
12 months

Emergency ambulance

Emergency ambulance refers to the cost of emergency ambulance transport and emergency treatment by paramedics.

Included

Benefit: 
100% for one emergency ambulance service per person

Annual Limit per person:

Annual Limit per policy:
No limit 

Waiting Period:
1 day

Not covered:
- Transportation from a hospital to your home, nursing home or other hospital.
- Transportation for ongoing medical treatment.
- Off road or air ambulance (e.g. plane, helicopter or boat).

Included

Benefit: 
100% of the fee for each emergency ambulance service

Annual Limit per person:
Unlimited

Annual Limit per policy:
Unlimited

Waiting Period:
1 day

Not covered:
- Transportation from a hospital to your home, nursing home or other hospital.
- Transportation for ongoing medical treatment.
- Off road or air ambulance (e.g. plane, helicopter or boat).

Included

Benefit: 
100% of the fee for each emergency ambulance service.

Annual Limit per person:
Unlimited

Annual Limit per policy:
Unlimited

Waiting Period:
1 day

Not covered:
- Transportation from a hospital to your home, nursing home or other hospital.
- Transportation for ongoing medical treatment.
- Off road or air ambulance (e.g. plane, helicopter or boat).

Included

Benefit: 
100% of the fee for each emergency ambulance service.

Annual Limit per person:
Unlimited

Annual Limit per policy:
Unlimited

Waiting Period:
1 day

Not covered:- Transportation from a hospital to your home, nursing home or other hospital.
- Transportation for ongoing medical treatment.
- Off road or air ambulance (e.g. plane, helicopter or boat).

Included

Benefit: 
100% of the fee for each emergency ambulance service.

Annual Limit per person:
Unlimited

Annual Limit per policy:
Unlimited

Waiting Period:
1 day

Not covered:
- Transportation from a hospital to your home, nursing home or other hospital.
- Transportation for ongoing medical treatment.
- Off road or air ambulance (e.g. plane, helicopter or boat).

Included

Benefit: 
100% of the fee for each emergency ambulance service.

Annual Limit per person:
Unlimited

Annual Limit per policy:
Unlimited

Waiting Period:
1 day

Not covered:
- Transportation from a hospital to your home, nursing home or other hospital.
- Transportation for ongoing medical treatment.
- Off road or air ambulance (e.g. plane, helicopter or boat).

Non-emergency ambulance

Non-emergency ambulance refers to the cost of non-urgent emergency ambulance transport and emergency treatment by paramedics.

Not Included

Not covered.

Included

Benefit
100% of the fee for each emergency ambulance service.

A $50 co-payment (to be paid by the member) will apply.

Annual Limit per person:
Unlimited

Annual Limit per policy:
Unlimited

Waiting Period:
30 days

Not covered:
- Transportation from a hospital to your home, nursing home or other hospital.
- Transportation for ongoing medical treatment.
- Off road or air ambulance (e.g. plane, helicopter or boat).

Included

Benefit: 
100% of the fee for each emergency ambulance service.

A $50 co-payment (to be paid by the member) will apply.

Annual Limit per person:
Unlimited

Annual Limit per policy:
Unlimited

Waiting Period:
30 days

Not covered:
- Transportation from a hospital to your home, nursing home or other hospital.
- Transportation for ongoing medical treatment.
- Off road or air ambulance (e.g. plane, helicopter or boat).

Included

Benefit: 
100% of the fee for each emergency ambulance service.

A $50 co-payment (to be paid by the member) will apply.

Annual Limit per person:
Unlimited

Annual Limit per policy:
Unlimited

Waiting Period:
30 days

Not covered:
- Transportation from a hospital to your home, nursing home or other hospital.
- Transportation for ongoing medical treatment.
- Off road or air ambulance (e.g. plane, helicopter or boat).

Included

Benefit: 
100% of the fee for each emergency ambulance service.

A $50 co-payment (to be paid by the member) will apply.

Annual Limit per person:
Unlimited

Annual Limit per policy:
Unlimited

Waiting Period:
30 days

Not covered:
- Transportation from a hospital to your home, nursing home or other hospital.
- Transportation for ongoing medical treatment.
- Off road or air ambulance (e.g. plane, helicopter or boat).

Included

Benefit: 
100% of the fee for each emergency ambulance service.

A $50 co-payment (to be paid by the member) will apply.

Annual Limit per person:
Unlimited

Annual Limit per policy:
Unlimited

Waiting Period:
30 days

Not covered:
- Transportation from a hospital to your home, nursing home or other hospital.
- Transportation for ongoing medical treatment.
- Off road or air ambulance (e.g. plane, helicopter or boat).

Exercise physiology

Exercise physiologists specialise in clinical exercise interventions for people with a broad range of health issues. The aims of exercise physiology interventions are to prevent or manage acute, sub-acute or chronic disease or injury, and assist in restoring one’s optimal physical function, health or wellness.

Not Included

Not covered.

Included

Benefit: 
Individual consultation: $20

Annual Limit per person:
$350

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry and pharmacy.

Included

Benefit: 
60% of each consultation

Annual Limit per person:
$350

Annual Limit per policy:
$700

Waiting Period:
2 months

The above annual limit is combined for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry, pharmacy, complementary therapies and healthy lifestyle.

Included

Benefit: 
Individual consultation: $25

Annual Limit per person:
$400

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry and dietetics.

Included

Benefit: 
Individual consultation: $30

Annual Limit per person:
$500

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for physiotherapy and exercise physiology.

Included

Benefit: 
Individual consultation: $35

Annual Limit per person:
$750

Annual Limit per policy:
No limit

Waiting Period:
2 months

The above annual limit is combined for physiotherapy and exercise physiology.

Health Aids, Appliances and External Prothesis

Health Aids, Appliances and External Prothesis include items such as circulation boosters, TENS machines, CAM Walker, Artificial limbs, Wigs and Mammary Prothesis

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Included

Benefit: 
75% 

Annual Limit per person:
$500

Annual Limit per policy:
No limit

Waiting Period:
12 months

This includes the purchase of appliance or prosthetics only.

Benefits are paid on HIF approved prosthetics items such as artificial limbs, wigs and external mammary prostheses and approved medical devices such as a TENS machine, CPAP Machine, Circulation Booster and CAM Walker. Sub-limits apply depending on the item, and other conditions apply. Please contact us for details prior to purchasing.

Included

Benefit: 
75% 

Annual Limit per person:
$800

Annual Limit per policy:
No limit

Waiting Period:
12 months

This includes the purchase of appliance or prosthetics only.

Benefits are paid on HIF approved prosthetics items such as artificial limbs, wigs and external mammary prostheses and approved medical devices such as a TENS machine, CPAP Machine, Circulation Booster and CAM Walker. Sub-limits apply depending on the item, and other conditions apply. Please contact us for details prior to purchasing.

Breathing appliances

Breathing appliances include services such as Asthmatic spacers, Peak Flow Meter, Humidifier and Nebulisers.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Included

Benefit: 
75% 

Annual Limit per person:
$200

Annual Limit per policy:
No limit

Waiting Period:
12 months

Included

Benefit: 
75%

Annual Limit per person:
$200

Annual Limit per policy:
No limit

Waiting Period:
12 months

Blood glucose monitor and blood pressure monitor

A blood glucose monitor is a device to measure the concentration of glucose in the blood. A blood pressure monitor is a device used to measure blood pressure.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Included

Benefit: 
75% 

1 device every 3 years.

Annual Limit per person:
$200

Annual Limit per policy:
No limit

Waiting Period:
12 months

Purchase per monitor only.

Included

Benefit: 
75% 

1 device every 3 years.

Annual Limit per person:
$200

Annual Limit per policy:
No limit

Waiting Period:
12 months

Purchase per monitor only.

Diabetes Education

Diabetes Educators teach, coach and guide patients so they understand their diabetes and how it affects their personal lives, and work with them to set (and meet) behaviour change goals to improve their health.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Included

Benefit: 
$25 per consultation

Annual Limit per person:
$150

Annual Limit per policy:
No limit

Waiting Period:
2 months

Included

Benefit: 
$30 per consultation

Annual Limit per person:
$180

Annual Limit per policy:
No limit

Waiting Period:
2 months

Auxillary Home Nursing

Auxillary Home Nursing includes services for people that require a registered nurse to assess, initiate and oversea nursing interventions in a home setting where appropriate.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Included

Benefit: 
$75 per visit

Annual Limit per person:
$450

Annual Limit per policy:
No limit

Waiting Period:
2 months

Included

Benefit: 
$100 per visit

Annual Limit per person:
$500

Annual Limit per policy:
No limit

Waiting Period:
2 months

Flu Vaccinations

Flu vaccinations include a benefit towards your annual flu vaccination.

Pharmacy includes pharmaceuticals (non-PBS drugs), flu vaccinations and assisted reproductive drugs on selected covers)

Not Included

Not covered.

Included

Benefit: 
$20 (1 per person, per calendar year)

Annual Limit per person:
$350

Annual Limit per policy:
No limit

Waiting Period:
2 months

Benefits are only payable from a registered pharmacy.

The above annual limit is combined for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry and pharmacy.

Included

Benefit: 
$20 (1 per person, per calendar year)

Annual Limit per person:
$350

Annual Limit per policy:
$700

Waiting Period:
2 months

Benefits are only payable from a registered pharmacy.

The above annual limit is combined for physiotherapy, exercise physiology, chiropractic, osteopathy, podiatry, pharmacy, complementary therapies and healthy lifestyle (sub-limits apply for complementary therapies and healthy lifestyle).

Included

Benefit: 
$20 (1 per person, per calendar year)

Annual Limit per person:
$200

Annual Limit per policy:
No limit

Waiting Period:
2 months

Benefits are only payable from a registered pharmacy.

The above annual limit is combined for pharmacy.

Included

Benefit: 
$20 (1 per person, per calendar year)

Annual Limit per person:
$300

Annual Limit per policy:
No limit

Waiting Period:
2 months

Benefits are only payable from a registered pharmacy.

The above annual limit is combined for pharmacy.

Included

Benefit: 
$20 (1 per person, per calendar year)

Annual Limit per person:
$400

Annual Limit per policy:
No limit

Waiting Period:
2 months

Benefits are only payable from a registered pharmacy.

The above annual limit is combined for pharmacy.

Mental Health Navigator

Mental Health Navigator includes an expert review of a mental health diagnosis and ongoing treatment plan with support.

Included

Annual Limit per person:
Unlimited

Annual Limit per policy:
Unlimited

Included

Annual Limit per person:
Unlimited

Annual Limit per policy:
Unlimited

Included

Annual Limit per person:
Unlimited

Annual Limit per policy:
Unlimited

Included

Annual Limit per person:
Unlimited

Annual Limit per policy:
Unlimited

Included

Annual Limit per person:
Unlimited

Annual Limit per policy:
Unlimited

Included

Annual Limit per person:
Unlimited

Annual Limit per policy:
Unlimited

HIF Second Opinion

HIF Second Opinion provides an expert review of your physical health diagnosis and ongoing treatment plan with support.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Not Included

Not covered.

Included

Annual Limit per person:
Unlimited

Annual Limit per policy:
Unlimited

 

*Price is based on your chosen policy in Western Australia with a 24.608% Australian Government Rebate on private health insurance.

^Price is based on your chosen policy in Western Australia with a 24.608% Australian Government Rebate on private health insurance from 1 April 2022. Read more about these changes here