What is covered? |
 General Dental
|
Benefits you receive
| Services |
Members First |
Other Providers |
Benefit examples
|
| Comprehensive oral examination |
$29.70 |
$22.00 |
| Scale and clean |
$51.00 |
$41.00 |
| Mouthguard |
$94.20 |
$37.50 |
|
General Dental features 'No Gap dental' at Members First dentists for kids up to 25 years old on family, family plus and single parent memebership when taken along with a HBA hospital cover. Hospital costs relating to general dental treatment are not fully covered.
|
| Annual Maximums
| |
Per person |
| Every year |
Unlimited |
|
|
Major Dental
|
Benefits you receive
| Services |
Members First |
Other Providers |
Benefit examples
|
| Complete Denture |
$846.90 |
$450.00 |
| Full crown - veneered - indirect |
$735.30 |
$450.00 |
|
Major Dental features 'No Gap dental' at members First dentists for kids up to 25 years old on family, family plus and single parent membership when taken along with a HBA hospital cover. Hospital costs relating to major dental treatment are not fully covered. Limit of one set of dentures every 3 years.
Please note: Set benefits are payable up to your annual maximums.
|
| Annual Maximums
| |
Per person |
| Year 1 |
No Cover |
| Year 2 |
$500.00 |
| Year 3 |
$600.00 |
| Year 4 |
$700.00 |
| Year 5 |
$800.00 |
| Year 6 |
$900.00 |
| Year 7+ |
$1,000.00 |
|
|
Orthodontics
|
Benefits you receive
| Services |
All Providers |
Benefit examples
|
| Complete course of orthodontic treatment |
Refer to special comments below. |
|
A lifetime limit of $1,800 per person applies. Members transferring from other funds will have the amount of orthodontic benefits paid at any previous funds deducted from their lifetime limit with HBA.
|
| Annual Maximums
| |
Per person |
| Year 1 |
No Cover |
| Year 2 |
$400.00 |
| Year 3 |
$480.00 |
| Year 4 |
$560.00 |
| Year 5 |
$640.00 |
| Year 6 |
$720.00 |
| Year 7+ |
$800.00 |
|
|
Optical
|
Benefits you receive
| Services |
Members First |
Other Providers |
Lenses
|
| Single Vision Stock |
$58.00 |
$45.00 |
| Bifocal lenses |
$77.20 |
$60.00 |
| Trifocal/progressive lenses |
$123.30 |
$95.00 |
Contact lenses
|
| Non Disposable |
$128.50 |
$100.00 |
| Disposable contact lenses, 1 month supply |
$43.00 |
$32.00 |
| Disposable contact lenses, 3 month supply |
$71.00 |
$50.00 |
Frames
|
| Frames for prescription lenses |
$136.80 |
$105.00 |
|
20% discount off frames at Members First optical providers (not with any other offer). Frames for prescription lenses, limited to one pair every 12 months.
|
| Annual Maximums
| |
Members First |
Other Providers |
| Every Year |
$220.00 |
$180.00 |
|
|
Physiotherapy
|
Benefits you receive
| Services |
Members First |
Other Providers |
Benefit examples
|
| Group therapy |
$13.10 |
$9.00 |
| Initial attendance |
$38.70 |
$25.00 |
| Subsequent attendance |
$30.90 |
$17.00 |
| Ante natal services |
$13.50 |
$12.00 |
| Hydrotherapy |
$13.10 |
$9.00 |
| Annual Maximums
| |
Per person |
| Year 1 |
$450.00 |
| Year 2 |
$540.00 |
| Year 3 |
$630.00 |
| Year 4 |
$720.00 |
| Year 5 |
$810.00 |
| Year 6 |
$900.00 |
|
|
Chiropractic and Osteopathy
|
Benefits you receive
| Services |
Members First |
Other Providers |
Benefit examples
|
| Initial attendance |
$41.10 |
$25.00 |
| Subsequent attendance |
$26.70 |
$17.00 |
|
Chiropratic Services: Examples refer to the first 10 consultations per person per calendar year. 50% of applicable benefit applies after 10 consultations.
|
| Annual Maximums
| |
Per person |
Per family |
| Year 1 |
$350.00 |
$500.00 |
| Year 2 |
$420.00 |
$600.00 |
| Year 3 |
$490.00 |
$700.00 |
| Year 4 |
$560.00 |
$800.00 |
| Year 5 |
$630.00 |
$900.00 |
| Year 6 |
$700.00 |
$1,000.00 |
|
|
Speech Therapy
|
Benefits you receive
| Services |
All Providers |
Benefit examples
|
| Initial attendance |
$40.00 |
| Subsequent attendance |
$25.00 |
| Group attendance |
$9.00 |
| Annual Maximums
| |
Per person |
| Year 1 |
$300.00 |
| Year 2 |
$360.00 |
| Year 3 |
$420.00 |
| Year 4 |
$480.00 |
| Year 5 |
$540.00 |
| Year 6 |
$600.00 |
|
|
Eye Therapy
|
Benefits you receive
| Services |
All Providers |
Benefit examples
|
| Initial attendance |
$25.00 |
| Subsequent attendance |
$17.00 |
| Annual Maximums
| |
Per person |
| Year 1 |
$300.00 |
| Year 2 |
$360.00 |
| Year 3 |
$420.00 |
| Year 4 |
$480.00 |
| Year 5 |
$540.00 |
| Year 6 |
$600.00 |
|
|
Occupational Therapy
|
Benefits you receive
| Services |
All Providers |
Benefit examples
|
| Initial attendance |
$25.00 |
| Subsequent attendance |
$17.00 |
| Group attendance |
$9.00 |
| Annual Maximums
| |
Per person |
| Year 1 |
$300.00 |
| Year 2 |
$360.00 |
| Year 3 |
$420.00 |
| Year 4 |
$480.00 |
| Year 5 |
$540.00 |
| Year 6 |
$600.00 |
|
|
Natural Therapies
|
Benefits you receive
| Services |
All Providers |
Benefit examples
|
| Acupuncture - Initial Attendance |
$17.00 |
| Acupuncture - Subsequent Attendance |
$17.00 |
| Naturopathy - Initial Attendance |
$17.00 |
Massage benefit examples
|
| Massage -per attendance |
$12.00 |
Naturopathy benefit examples
|
| Naturopathy - Subsequent Attendance |
$17.00 |
|
Includes acupuncture, chinese herbalism, homoeopathy, massage, naturopathy and Western herbalism. Combined annual limits apply across all the natural therapies.
Massage includes Bowen Technique, kinesiology, reflexology, shiatsu, Therapeutic Massage. An annual sub-limit of $100 per person or $200 per family can be claimed per calendar year.
|
| Annual Maximums
| |
Per person |
| Year 1 |
$400.00 |
| Year 2 |
$480.00 |
| Year 3 |
$560.00 |
| Year 4 |
$640.00 |
| Year 5 |
$720.00 |
| Year 6 |
$800.00 |
|
|
Pharmacy
|
Benefits you receive
| Services |
All Providers |
Benefit examples
|
| Pharmacy |
Up to $20.00 |
|
Benefits for items not covered by the Government Pharmaceutical Benefits Scheme (PBS), except for those items specifically excluded by HBA. You pay an amount equal to the maximum patient contribution set by the Government under the PBS. HBA refunds 100% of the balance of up to $20 per script.
|
| Annual Maximums
| |
Per person |
| Year 1 |
$350.00 |
| Year 2 |
$420.00 |
| Year 3 |
$490.00 |
| Year 4 |
$560.00 |
| Year 5 |
$630.00 |
| Year 6 |
$700.00 |
|
|
Dietary
|
Benefits you receive
| Services |
All Providers |
Benefit examples
|
| Initial attendance |
$21.00 |
| Subsequent attendance |
$13.00 |
| Group attendance |
$9.00 |
| Annual Maximums
| |
Per person |
| Year 1 |
$300.00 |
| Year 2 |
$360.00 |
| Year 3 |
$420.00 |
| Year 4 |
$480.00 |
| Year 5 |
$540.00 |
| Year 6 |
$600.00 |
|
|
Psychology
|
Benefits you receive
| Services |
All Providers |
Benefit examples
|
| Initial attendance |
$40.00 |
| Subsequent attendance |
$35.00 |
| Group attendance |
$10.00 |
| Annual Maximums
| |
Per person |
| Year 1 |
$300.00 |
| Year 2 |
$360.00 |
| Year 3 |
$420.00 |
| Year 4 |
$480.00 |
| Year 5 |
$540.00 |
| Year 6 |
$600.00 |
|
|
Podiatry
|
Benefits you receive
| Services |
All Providers |
Benefit examples
|
| Initial attendance |
$23.00 |
| Subsequent attendance |
$17.00 |
| Annual Maximums
| |
Per person |
| Year 1 |
$300.00 |
| Year 2 |
$360.00 |
| Year 3 |
$420.00 |
| Year 4 |
$480.00 |
| Year 5 |
$540.00 |
| Year 6 |
$600.00 |
|
|
Health appliances
|
Benefits you receive
| Services |
All Providers |
Benefit examples
|
| Asthma pumps |
60% of cost up to $200 per person every 3 years. |
| Blood Glucose Monitors |
60% of cost up to $200 per person every 3 years. |
| Defined appliances |
60% of cost up to $300 per person per calendar year for all Defined Appliances. |
| CPAP/BPAP devices |
60% of cost up to $500 per person every 3 years. Limit of one claim every 3 years. |
| Surgical Stockings |
60% of cost up to $100 per person per calendar year. |
| Hearing Aid and Repairs |
60% of cost up to $500 per person every 3 years. Limit of one claim every 3 years. |
|
Defined Appliances include insoles, orthopaedic and corrective footware, pressure garments, braces, artificial limbs. Limits apply per item. CPAP Devices subject to eligibility. (No benefits payable on hearing aids where subsidised elsewhere.)
|
| Annual Maximums
| |
Per person |
| Every year |
$500.00 |
|
|
Travel and accommodation
|
Benefits you receive
| Services |
All Providers |
Benefit examples
|
| Travel and accommodation benefits for essential medical treatment |
$100 for travel expenses and $40 per night up to $150 for accommodation expenses per year. |
|
Travelling benefits are payable for expenses associated with essential medical or hospital treatment where the total return distance travelled is at least 300 kilometres. Overnight non-hospital accommodation benefits are payable for the patient and an attendant for travel away from home for treatment unable to be provided by the patient's own doctor.
|
|
Annual Maximums
| |
Per person |
| Every year |
Up to sub-limits per item |
|
| |
