Changes to your Top Extras cover

Changes to your Top Extras cover

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* Based on an Australian Government Rebate of %, % LHC loading, $ excess for a in . Please note the amount quoted may vary after 1 April due to base price changes and rounding adjustment.

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Effective 1 April 2019

With the Federal Government’s Private Health Insurance Reforms coming into effect on 1 April 2019, we’ve made some changes to your Top Extras cover.

While there are some changes we’ve been required to make, there are also many positive changes that we’ve chosen to include in your cover.

Your waiting period for Orthodontia will decrease to 12 months

The waiting period for Orthodontia will decrease from 24 months to 12 months.

Any time that you’ve held continuous Top Extras cover will count towards the waiting period. If you’ve already had Top Extras for 12 months on 1 April 2019, you’ll be eligible to claim for Orthodontic services straight away.

We’re also changing the loyalty tier structure, so everyone who’s served the waiting period has an annual limit of $2,500 (lifetime limit of $2,500).

You’ll have a higher limit for Chiro and Osteo

We’re increasing the benefit for your first visit to $45, and we’re also increasing the combined annual limit from $450 to $480 per person.

Updated benefit for Chiropractic or Osteopathic consultation

First visit: $45

Visits 2-4: $40

Visits 5+: $32

New annual limit

$480 per person (combined annual limit for chiropractic and osteopathic – sub-limits apply)

You’ll get a higher benefit for your initial Physio and Exercise Physiology consults

We’re increasing the benefit for your first visit to $45. Physiotherapy and Exercise Physiology have a combined annual limit, which remains the same at $800 per person.

Physiotherapy or Exercise Physiology consultation

First visit: $45

Visits 2-4: $40

Visits 5+: $32

You’ll be able to use your Artificial Aids limit for more

We’ve listened to your feedback. We’re removing the sub-limit for surgical stockings and we’re also adding a benefit for pregnancy-related compression garments.

Remember, you’ll need to complete the Aids and Appliances form to claim for these items. You can access the form here.

 

Updated benefit for surgical stockings

75% of cost up to $400 (subject to $400 sub-limit for Jobst/Compression/Lymphoedema garments and overall limit of $1,200 for Artificial Aids)

 

New benefit for pregnancy-related compression garments

75% of cost up to $90 per person (subject to overall limit of $1,200 for Artificial Aids)

We’re required to remove some Natural Therapies

Due to the Federal Government’s Private Health Insurance Reforms, health funds are no longer permitted to cover some natural therapy services from 1 April 2019.

See below for information on what will be removed and what will still be covered after 1 April 2019.

If you claim for a service that will be removed, we encourage you to make the most of your benefits while they’re available. The service must be provided by 31 March 2019, but you can submit your claim up to two years after the service date.

Natural Therapies

Removed:

  • Alexander technique
  • Aromatherapy
  • Bowen therapy
  • Buteyko
  • Feldenkrais
  • Homeopathy
  • Kinesiology
  • Naturopathy
  • Reflexology
  • Shiatsu
  • Western herbal medicine

You can still use your Natural Therapies limit to claim for:

  • Remedial massage
  • Acupuncture
  • Chinese herbal medicine consultations
  • Myotherapy

Healthy Lifestyle

Removed:

  • Pilates (including Pilates classes run by a physiotherapist or exercise physiologist)
  • Yoga

You can still use your Healthy Lifestyle limit to claim for:

  • Gym membership*
  • Recognised weight management programs*^
  • Disease management subscriptions/memberships
  • Recognised health screening services/preventative screenings (where a Medicare benefit is not payable)