Extras Optical Cover
What is extras optical cover?
Extras cover with optical is private health insurance that helps members to save on everyday vision expenses like glasses and contacts. Extras cover helps reduce the cost of maintaining good eye health and makes eyewear more affordable.
With GMHBA, optical cover is available through selected combined hospital and SmartCare Extras products, as well as standalone extras cover under ClassicCare Mid Extras.
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What extras cover for optical includes
While extras cover doesn’t pay for eye health and vision checks (clinically necessary eye tests are covered under Medicare for eligible patients), cover for optical benefits like prescription lenses and frames, contact lenses and prescription sunglasses is available on selected extras covers and combined covers.
Some vision and eye conditions benefit from prescription medication. If you hold an extras cover that includes pharmacy, you may be eligible to claim benefits for these pharmaceuticals.
SmartCare extras with hospital cover
$500 flexible limit to spend your way on included services
- 100% back on checkups at any dentist and optical*
- 60% back on other included services
- Annual limit rollover (not including optical)#
- Covers chiro, general dental, osteo, physio and optical
Plus
Entry level hospital cover with some key inclusions and accident protection
- Includes 5 out of 38 clinical categories
- Upgraded cover in the event of an accident
- Excess waiver for same day stays
$1,000 flexible limit to spend your way on included services
- 100% back on checkups at any dentist and optical*
- 60% back on other included services
- Annual limit rollover (not including optical)#
- Covers chiro, general dental, osteo, physio and optical plus 9 other services.
Plus
Great value hospital cover for more than just the basics
- Includes 23 out of 38 clinical categories
- Includes back, neck and spine
- Excess waiver for same day stays.
- $1,500 flexible limit to spend your way on included services
- 100% back on checkups at any dentist and optical*
- 60% back on other claims
- Annual limit rollover (not including optical)#
- Covers chiro, general dental, osteo, physio and optical plus 19 other services.
Plus
A popular choice for hospital cover offering a range of inclusions
- Includes 29 out of 38 clinical categories
- Upgraded cover in the event of an accident
- Excess waiver for same day stays
*Preventative dental includes check-ups and cleans, excludes general & major dental and orthodontics. Must be with a recognised provider.
#Annual limit rollover excludes optical. Available after 12 months of continuous cover on SmartCare Boost Extras at the same level (Starter, Everyday or Complete). Unused eligible annual limits roll over on 1 January and expire after 12 months.
Understanding optical health insurance
Under eligible extras cover, members can receive between $150 and $250 a year toward prescription optical purchases like glasses, sunglasses and contact lenses.
Waiting periods of 6 months apply to optical benefits.
Prescription needs can change slowly over time, or quickly as a person grows, ages or their lifestyle changes. Wearing the right prescription glasses is important for not only eyesight but your overall eye health.
With GMHBA Health Insurance extras that include optical benefits, you can access support for updating your prescription and keeping your eyes healthy. Optical health insurance is designed to address vision-related needs, helping you manage costs for glasses, lenses, and other essential eye care.
Why choose optical extras insurance with GMHBA?
Having optical cover included in your extras health insurance lets you claim benefits toward a new pair of prescription glasses, sunglasses or contact lenses.
As a GMHBA member, you can make a purchase of prescription glasses or corrective lenses at any registered optometrist in Australia in store or online (alongside a valid prescription) and claim up to annual limits quickly and easily either at the point of purchase (where available) or via the app or member area.
Not only do we allow members to purchase their glasses through their choice of provider, GMHBA Health Insurance really cares about the eye health of our members. We offer special discounts and additional optical limits for even more optical cover benefits to spend at GMHBA Eye Care practices.
GMHBA Eye Care
20% off* products for GMHBA members.
*Exclusively at GMHBA Eye Care for GMHBA members. Discount cannot be used in conjunction with any other specials offer or be applied to government subsidised products, corporate package and sale items.
GMHBA Eye Care
Up to $150^ more to spend for GMHBA optical extras members.
^Additional spend amount is once limit is utilised and varies depending on level of extra's cover, check your individual policy for details. Additional benefit exclusive to GMHBA members with optical extras cover that purchase at GMHBA Eye Care. Benefit can be used towards prescription glasses, prescription sunglasses and contact lenses. Annual limits, sub-limits and waiting periods apply.
Optical benefits you can see
As a GMHBA member, you can visit one of these retailers to get some fantastic discounts.
Navigating optical cover:
Optical cover under extras benefits
What services are covered under extras benefits? When optical is included in your extras cover you can:
- Claim benefits toward prescription lenses or prescription glasses (frames and lenses). Lenses can be single-vision, bifocal or multifocal and can include coating and tinting.
- Claim prescription sunglasses (frames and lenses)
- Claim prescription contact lenses
- Claim personal safety goggles, protective glasses and diving or swimming goggles all fitted with prescription lenses
No gap eyewear
When purchasing prescription lenses that are ‘no gap’ this simply means that your health cover benefits cover the total cost of the frame and lenses. Check with your optical dispenser to see if they offer low-cost or ‘no-gap’ ranges. GMHBA’s range of extras covers have varying annual limits designed to meet member’s different optical needs.
Looking for special offers? GMHBA Eye Care practices have a range of no gap styles and offer increased benefits to members to minimise your out of pockets when buying your next pair of prescription glasses.
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How to claim your glasses
Claiming glasses on your extras cover with optical is easy with GMHBA Health Insurance.
Simply:
- Claim electronically using the optical dispenser’s electronic claiming system (if available)
- Or submit your receipt (and a copy of your prescription if you’ve purchased contact lenses online) through the GMHBA app, GMHBA member area, or visit your local branch.
Health insurance for major eye surgery with GMHBA hospital cover
There are many reasons a person would need to have eye surgery, including common treatments such as cataracts, and laser eye surgery.
‘Cataracts’ is a clinical category that includes surgery under select hospital covers. Other in-patient eye surgeries not related to cataracts are covered under eligible hospital covers. Learn more about hospital covers.
Benefits for these elective hospital treatments have a 2 month waiting period, however may be impacted by pre-existing conditions waiting period of 12 months.
Laser eye surgery is considered an elective cosmetic surgery and is not covered under Medicare, which means it cannot be covered under the hospital clinical categories.
About hospital coverFAQs about extras cover with optical
Unlike some types of insurance that you might get ‘just in case’ or for peace of mind, having private health insurance with optical cover is something you can pick for you, or your family’s needs. When you join or upgrade to a level of cover with optical benefits, you’ll have a six month waiting period to access benefits, so you can regularly check whether your current optical cover still suits your needs.
Keeping track of your use of optical benefits is easy using GMHBA’s remaining limits tracker in the app or member area.
Benefits toward glasses come under the optical category in extras or ancillary health insurance. If you are new to private health insurance, or upgrading, you’ll need to serve six month waiting periods to access your annual limit for claiming.