Essential Extras

Essential Extras

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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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All the essentials to keep being your best

Your smile. Your sight. There are some things that are worth looking after – and our Essential Extras cover is an affordable way to help you do that.

You’ll be able to get some money back on a range of things from preventative and general dental, to optical, physiotherapy and massage therapies and more. You can pair Essential Extras with any of our hospital covers – so you’re covered for the not-so-everyday too.

Essential Extras

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More Information

Click on the service to learn more
Services
Benefit
Yearly Limits
Periodic oral examination (012) - limit of 2 services, per person/year
$40
Benefits
Yearly Limit
Yearly Limit

$500 per person.

Intraoral radiograph - per exposure (022)
$30
Benefits
Yearly Limit
Yearly Limit

$500 per person.

Removal of calculus (114) - limit of 2 services, per person/year
$70
Benefits
Yearly Limit
Yearly Limit

$500 per person.

Topical application of remineralising agent (121) - limit of 2 services per year
$25
Benefits
Yearly Limit
Yearly Limit

$500 per person.

Removal of tooth (311)
$90
Benefits
Yearly Limit
Yearly Limit

$500 per person.

Filling: 1 surface metallic (511)
$63
Benefits
Yearly Limit
Yearly Limit

$500 per person.

Filling: 3 surface metallic (513)
$109
Benefits
Yearly Limit
Yearly Limit

$500 per person.

Filling: 1 surface adhesive restoration (531)
$80
Benefits
Yearly Limit
Yearly Limit

$500 per person.

Filling: 3 surface adhesive restoration (533)
$115
Benefits
Yearly Limit
Yearly Limit

$500 per person.

Services
Benefit
Yearly Limits
Orthodontia - Lifetime limit of $2,500 per person
$300
Benefits
Yearly Limit
Yearly Limit

$300 per person.

Surgical removal of a tooth requiring bone removal (324)
$240
Benefits
Yearly Limit
Yearly Limit

$300 per person.

Inlays/Onlays - tooth coloured 1 surface (551)
$273
Benefits
Yearly Limit
Yearly Limit

$300 per person.

Inlay/Onlays - tooth coloured 2 surfaces (552)
$300
Benefits
Yearly Limit
Yearly Limit

$300 per person.

Crown - veneered (615)
$300
Benefits
Yearly Limit
Yearly Limit

$300 per person.

Bridge pontic - direct (642)
$300
Benefits
Yearly Limit
Yearly Limit

$300 per person.

Dentures - upper and lower (719)
$300
Benefits
Yearly Limit
Yearly Limit

$300 per person.

Services
Benefit
Yearly Limits
Frames
$100
Benefits
Yearly Limits
Yearly Limits

$200 per person.

Single vision lens - pair
$100
Benefits
Yearly Limits
Yearly Limits

$200 per person.

Bifocal lens - pair
$100
Benefits
Yearly Limits
Yearly Limits

$200 per person.

Multifocal lens - pair
$100
Benefits
Yearly Limits
Yearly Limits

$200 per person.

Contact lenses - rigid or soft
$165
Benefits
Yearly Limits
Yearly Limits

$200 per person.

Contact lenses - disposable
$165
Benefits
Yearly Limits
Yearly Limits

$200 per person.

Services
Benefit
Yearly Limits
Chiropractic & Osteopathy - Visits 1-6
$40
Benefits
Yearly Limits
Yearly Limits

$250 per person (sub-limits apply).

Chiropractic & Osteopathy - Visits 7+
$32
Benefits
Yearly Limits
Yearly Limits

$250 per person (sub-limits apply).

Physiotherapy - Visits 1-6
$40
Benefits
Yearly Limits
Yearly Limits

$300 per person (sub-limits apply).

Physiotherapy - Visits 7+
$32
Benefits
Yearly Limits
Yearly Limits

$300 per person (sub-limits apply).

$20
Benefits
Yearly Limits
Yearly Limits

$300 per person (sub-limits apply).

Exercise physiology – Visits 1-6
$40
Benefits
Yearly Limits
Yearly Limits

Combined limit - see Physiotherapy

Exercise physiology – Visits 7+
$32
Benefits
Yearly Limits
Yearly Limits

Combined limit - see Physiotherapy

$20
Benefits
Yearly Limits
Yearly Limits

Combined limit - see Physiotherapy

Podiatry - Visits 1-6
$40
Benefits
Yearly Limits
Yearly Limits

$300 per person

Podiatry - Visits 7+
$32
Benefits
Yearly Limits
Yearly Limits

$300 per person

Psychology assessment
$100
Benefits
Yearly Limits
Yearly Limits

$350 per person. Sub-limits apply.

Psychology - initial consultation
$72
Benefits
Yearly Limits
Yearly Limits

$350 per person. Sub-limits apply.

Psychology - subsequent consultation
$72
Benefits
Yearly Limits
Yearly Limits

$350 per person. Sub-limits apply.

Natural Therapies (Remedial Massage, Acupuncture, Chinese herbal medicine consultations, Myotherapy)
$34
Benefits
Yearly Limit
Yearly Limit

$400 per person

Benefits are for face-to-face consultation only. No benefits for remedies, medicines or food preparation

Services
Benefit
Yearly Limits
100%
Benefits
Yearly Limits
Yearly Limits

$150 per person. See more info on programs and claiming.

(Sub-limit of $30 for flu vaccine. See more info on how to claim.)

100%
Benefits
Yearly Limits
Yearly Limits

$150 per person. See more info on programs and claiming.

(Sub-limit of $30 for flu vaccine. See more info on how to claim.)

100%
Benefits
Yearly Limits
Yearly Limits

$150 per person. See more info on programs and claiming.

(Sub-limit of $30 for flu vaccine. See more info on how to claim.)

100%
Benefits
Yearly Limits
Yearly Limits

$150 per person. See more info on programs and claiming.

(Sub-limit of $30 for flu vaccine. See more info on how to claim.)

National Healthy Eating Activity and Lifestyle (HEAL) program
100%
Benefits
Yearly Limits
Yearly Limits

$150 per person. See more info on programs and claiming.

(Sub-limit of $30 for flu vaccine. See more info on how to claim.)

Flu vaccine (until 31 December 2023)
100%
Benefits
Yearly Limits
Yearly Limits

$150 per person. See more info on programs and claiming.

(Sub-limit of $30 for flu vaccine. See more info on how to claim.)

Services
Benefit
Yearly Limits
$60
Benefits
Yearly Limits
Yearly Limits

$300 per person. Sub-limits apply.

$280 sub-limit for erectile dysfunction products. No sub-limit for vaccines.

Services
Benefit
Yearly Limits
Emergency ambulance transport (using State Government ambulance service)
100%
Benefits
Yearly Limits
Yearly Limits

$6000 per person.

Important info

Waiting periods

Like all health funds, waiting periods may apply when you take out your cover.

You may have to wait if:

  • You’re new to private health insurance
  • You increase your benefit limits or upgrade your cover to include things that weren’t covered before
  • You switch health funds and increase your cover to include things that weren’t covered before.
If you’ve cancelled your membership with another health fund, you’ll need to join us within 60 days to keep up your continuity of cover and not re-serve any applicable waiting periods.

 

Extras waiting periods

Orthodontia 12 months
Major dental, medical appliances 12 months
Optical, healthy lifestyle 6 months
All other services 2 months
Emergency ambulance transport 1 day

 

DIY dentistry

Please be aware you can claim for face-to-face dental consultations only. You can’t claim for home (DIY) dentistry – this includes teeth whitening kits, orthodontic aligners and occlusal splints. If unsure, contact us to find out whether a benefit is payable – we’re here to help.

Make sure you claim with a recognised provider

We can only pay benefits if you’ve taken up the service through a provider who’s recognised by Nurses & Midwives Health at the time. To find out if your provider’s one of them, just call us on 1300 344 000.