| Extras
Services |
Waiting
Periods |
Gold
Extras
GE |
Special
Care
Extras Ye^ |
Standard
Extras
Plus Te |
Silver
Extras
SDE |
Bronze
Extras
BE |
Young
Singles Start
Extras Ze* |
Young
Singles Start
Extras Zp > |
| Acupuncture see Naturopathy /
Homeopathy / Acupuncture |
2
months |
|
|
|
|
|
|
|
| Ambulance subscription / transport
1 |
2
months |
|
|
|
|
|
|
|
| Annual
subscription refund |
|
100% |
100% |
|
|
|
|
100% |
| Transport
benefit (per trip) |
|
$300 |
|
|
|
|
|
|
| Annual
limit per person each calendar year |
|
$500 |
|
|
|
|
|
|
| Audiology |
2
months |
|
|
|
|
|
|
|
| Initial
visit |
|
$25 |
$25 |
$25 |
$25 |
|
|
|
| Subsequent
visit |
|
$20 |
$20 |
$20 |
$20 |
|
|
|
| Annual
limit per person each calendar year |
|
$350 |
$400
2 |
$400 2 |
$400 2 |
|
|
|
| Blood
glucose monitor 3 |
12
months |
|
|
|
|
|
|
|
| Benefit: |
|
$200 |
$150 |
$150 |
$150 |
|
|
|
| Chiropractic /
Osteopathy 4 |
2
months |
|
|
|
|
|
|
|
| Initial
visit |
|
$26 |
$25 |
$25 |
$25 |
|
$17 |
$17 |
| 2-10
subsequent visits |
|
$21 |
$17 |
$17 |
$17 |
|
$17 |
$17 |
| Further
visits |
|
$17 |
$15 |
$15 |
|
|
$17 |
$17 |
| Chiropractic
x-ray (1 per person) |
|
$80 |
$40 |
$40 |
$40 |
|
|
|
| Annual
limit per person/single membership each calendar year |
|
$350 5 |
$350
6 |
$350 6 |
$100
7 |
|
$350
8 |
$350
8 |
| Annual
limit per family membership each calendar year |
|
$700 5 |
$600 6 |
$600 6 |
$150 7 |
|
|
|
| DENTAL |
|
|
|
|
|
|
|
|
| MAJOR DENTAL
(see important note
for dental) |
12
months |
|
|
|
|
|
|
|
Orthodontic
Benefits example: Fixed appliance treatment – upper and lower
jaw treatment by a registered specialist |
12
months |
|
|
|
|
|
|
|
| Maximum
benefits per calendar year |
|
85%
up to
$450 per
year incr.
to $850 at
10 years |
75%
up to
$320 per
year incr.
to $570 at
6 years |
75%
up
to $300 per year |
75%
up to $300 per year |
75%
up to $300 per year |
75%
up to $300 per year |
75%
up to $300 per year |
| Maximum
benefit per course of treatment |
|
$2,550 |
$1,710 |
$900 |
$900 |
$900 |
$900 |
$900 |
| Lifetime
benefit limit |
|
$2,900 |
$1,900 |
$1,050 |
$1,050 |
$1,050 |
$1,050 |
$1,050 |
| Dentures
(see important note for dental) |
12
months |
|
|
|
|
|
|
|
| New
full upper and lower dentures per 2 years |
|
$500 |
$420 |
$420 |
$420 |
$420 |
$420 |
$420 |
| Combined
crown and bridgework (see important note for dental) |
12
months |
|
|
|
|
|
|
|
| Annual
limit per person each calendar year |
|
$600 |
$450 |
$450 |
$450 |
$450 |
$450 |
$450 |
| Indirect
restorations (see important note for dental) |
12
months |
|
|
|
|
|
|
|
| Annual
limit per person/single membership each calendar year |
|
$400 |
$350 |
$350 |
$350 |
$350 |
$350 |
$350 |
| Annual
limit per family membership each calendar year |
|
$700 |
$700 |
$700 |
$700 |
$700 |
|
|
| Implants
(see important note for dental) |
12
months |
|
|
|
|
|
|
|
| Annual
limit per person each calendar year |
|
$400 |
$400 |
$400 |
$400 |
$400 |
$400 |
$400 |
| GENERAL DENTAL (% of
GMHBA schedule fee. For more information see general dental note) |
2
months |
|
|
|
|
|
|
|
| a)
Diagnostic services |
2
months |
100% |
70% |
70% |
70% |
70% |
70% |
70% |
| b)
Preventative services e.g. periodic examination 2 per 12 month period,
removal of plaque 3 per 12 month period |
2
months |
100% |
70% |
70% |
70% |
70% |
70% |
70% |
| c)
Simple extractions (not including surgical extractions of wisdom teeth) |
2
months |
85% |
70% |
70% |
70% |
70% |
70% |
70% |
| d)
Restorative services (limited benefits apply to precious restorations) |
2
months |
85% |
70% |
70% |
70% |
70% |
70% |
70% |
| ANNUAL LIMIT (see
important note for Dental
note) |
12
months |
|
|
|
|
|
|
|
| Annual
limit per person each calendar year |
|
$2,000 |
$1,000 |
$1,000 |
$1,000 |
$1,000 |
$500 |
$500 |
| Dietetics |
2
month |
|
|
|
|
|
|
|
| Initial
visit |
|
$54 |
$27 |
$27 |
$27 |
|
|
|
| Subsequent
visit |
|
$25 |
$21 |
$21 |
$21 |
|
|
|
| Class
attendance |
|
$10 |
$10 |
$10 |
$10 |
|
|
|
| Annual
limit per person each calendar year |
|
$350 |
$350 |
$350 |
$350 |
|
|
|
| Extremity
pump 9 |
12
months |
|
|
|
|
|
|
|
| Benefit |
|
$300 |
$300 |
$300 |
$300 |
|
|
|
| Eye therapy and speech therapy
|
2
months |
|
|
|
|
|
|
|
| Initial
visit |
|
$54 |
$27 |
$27 |
$27 |
|
|
|
| Subsequent
visit |
|
$25 |
$21 |
$21 |
$21 |
|
|
|
| Annual
limit per person each calendar year |
|
$500
10 |
$400
11 |
$400 11 |
$400 11 |
|
|
|
| Fluoride
dietary supplement 12 |
2
months |
|
|
|
|
|
|
|
| Benefit
of up to |
|
85% |
85% |
85% |
85% |
85% |
|
|
| Maximum
benefit per person each calendar year |
|
$45 |
$45 |
$45 |
$45 |
$45 |
|
|
| Hearing
aids |
12
months |
|
|
|
|
|
|
|
| Benefit
of up to |
|
100% |
80% |
80% |
80% |
|
|
|
| Maximum
benefit per person every 3 years |
|
$800 |
$400 |
$400 |
$400 |
|
|
|
| Homeopathy see Naturopathy/Homeopathy/Acupuncture |
2
months |
|
|
|
|
|
|
|
| Incontinence
aids 13 |
2
months |
|
|
|
|
|
|
|
| Benefit
of up to |
|
|
100% |
|
|
|
|
|
| Maximum
benefit - 1 item per membership each calendar year |
|
|
$150 |
|
|
|
|
|
| Medical
aids 14 |
6
months |
|
|
|
|
|
|
|
| Benefit
of up to |
|
|
50% |
|
|
|
|
|
| Maximum
benefit per person each calendar year |
|
|
$100
|
|
|
|
|
|
| Myotherapy see Physiotherapy/Myotherapy/
Hydrotherapy |
2
months |
|
|
|
|
|
|
|
| Naturopathy
/ Homeopathy / Acupuncture 15 |
2
months |
|
|
|
|
|
|
|
| Initial
visit |
|
$25 |
$19 |
$19 |
$19 |
|
$17 |
$17 |
| 2-10
subsequent visits |
|
$20 |
$17 |
$17 |
$17 |
|
$17 |
$17 |
| Further
visits |
|
$17 |
$14 |
$14 |
|
|
$17 |
$17 |
| Annual
limit per person/single membership each calendar year |
|
$350
16 |
$350
17 |
$350 17 |
$100
18 |
|
$350
19 |
$350
19 |
| Annual
limit per family membership each calendar year |
|
$700 16 |
$600 17 |
$600 17 |
$150 18 |
|
|
|
| Nebuliser
pump 20 |
12
months |
|
|
|
|
|
|
|
| Benefit |
|
$150 |
$150 |
$150 |
$150 |
|
|
|
| Nursing
– Visiting / Home / Registered Nurse (Private Practice) 21 |
2
months |
|
|
|
|
|
|
|
| Home
(bush) nursing benefit for each visit |
|
$8 |
$8 |
$8 |
$8 |
|
|
|
| Visiting
/ Registered nurse (private practice) benefit per hour |
|
$8 |
$8 |
$8 |
$8 |
|
|
|
| Maximum
benefit for each day |
|
$48 |
$48 |
$48 |
$48 |
|
|
|
| Annual
limit per person each calendar year |
|
$1,000 |
$1,000 |
$1,000 |
$1,000 |
|
|
|
| Nursing
aids - Home and domestic |
6
months |
|
|
|
|
|
|
|
| Equipment
hire following a hospital stay – benefit of up to |
|
|
|