Extras Cover

You can choose from two levels of Extras cover. Please note, Extras products can only be purchased as a combination (with a hospital cover).

Extras Plus

The top Extras cover providing exceptional benefits for a comprehensive range of services.

Key Features

  • Competitively priced
  • Extensive range of benefit categories
  • Exceptional benefits with generous limits
  • No annual limits for general dental services
  • Loyalty bonuses apply after five years on high cost dental
  • Health management benefits to support your good health

Basic Extras

An economically priced Extras option providing benefits for a select range of the most popular extras items.

Key Features

  • Economically priced
  • Targeted at the most popular extras services
  • Guaranteed minimum 75% benefit level (subject to limits and conditions)
  • Health management benefits to support your good health

Extras Benefits as at 1 April 2017

Extras covers Extras Plus Basic Extras
Service Benefit
(Limit - single / family)
General Dental Basic Restoration (fillings)
Diagnostic Services
Extractions
Oral Surgery
Periodontics
Endodontics
Set benefits per item
No annual limit
75% of cost
Limit - $550
High Cost Dental Crowns & Bridges Set benefits per item
Limit - $1,000
($1,500 loyalty limit)
X
Dentures Limit - $650
($800 loyalty limit)
X
Implants Limit - $1,000 X
Orthodontics Lifetime Limit - $2,100
($2,600 loyalty limit)
X
Optical Glasses / Frames & Contact Lenses 100% of cost
Limit - $275
100% of cost
Limit - $180
Laser Eye Surgery 100% of cost ($500 per eye)
Limit - $1,000 every 2 years
X
Pharmacy Prescriptions only 100% of cost
$65 per script
Limit - $500 / $1,000
75% of cost
$50 per script
Limit - $500 / $1,000

Note: Benefit applies after the maximum PBS amount has been deducted.
The PBS amount is $38.80 as at 1/1/17.

Physiotherapy and other therapy Physiotherapy Initial Consultation:                      $60
Standard consult (first 10):         $40
Standard consult (11+):               $30
75% of cost
Occupational Therapy Initial Consultation:             $60
Standard consults:              $40
X
Hydrotherapy 80% of cost to $15
Limit - $200 / $400
X
Overall physio limit Limit - $550 / $1,100 Limit - $350 / $700
Complementary therapies Chiropractic x-rays 80% of cost
Limit - $115 / $230 
 
75% of cost
Chiropractic
Remedial Massage
Osteopathy
Myotherapy
Homeopathy
Naturopathy
Herbal Medicine
(Chinese or Western consultation only)
Acupuncture
Podiatry

 

Initial Consultation: $40
Standard consult (first 10): $30
Standard consult (11+):  $20
Limit - $435 / $870

Dietetics X
Orthotics
(limit each 2 years)
80% of cost
Limit - $250 / $500
X
Overall complementary therapies limit $750 / $1,500 $350 / $700
Additional Benefits Pre / Post Natal Classes 80% of cost
Limit - $150
X
Home Nursing 80% of cost up to $45 per visit / $90 per day
Limit - $1, 000
X
Speech Therapy 80% of cost
$800 per year
X
Hearing Aids
80% of cost
Limit - $1,500 per 5 years
X
Psychology

80% of cost to $120 (initial)
            or $80 (subsequent)
Limit - $500 / $650

X
Allergy Treatment 80% of cost
Limit - $100
X
Surgical Equipment / Health Aids 50% of cost to $400
Loyalty benefits apply - 80% up to $1,000 after 5 years cover. 
Contact the fund for details.
X
Health Management Programs
(from 1 July 2010)

100% of cost
Limit - $150 / $300

75% of cost
Limit - $100 / $200
Travel Expenses (for in-patient services)

20c/km
Limit - $100 / $200

X
Ambulance National ambulance cover 100% of cost. No annual limits

 All benefits are per person unless stated otherwise.

 

Important information

  • Optical benefits apply when prescribed by a registered optometrist or opthalmic surgeon. Benefits will only be paid where sight correction is necessary. No benefit is payable for sunglasses.
  • Each service has a limit
  • Annual limits are per person unless otherwise specified
  • Waiting periods may apply
  • onemedifund runs on the financial year (1 July to 30 June)
  • Loyalty bonuses for some high cost dental services apply after 5 continuous years of Extras Plus cover (refer to page 3 for more details)
  • Benefits can only be paid towards recognised providers. To find your nearest recognised provider, visit www.onemedifund.com.au/providers

What we will not pay for

  • Treatment you have not been charged for
  • Services not recognised by onemedifund
  • Services from providers that are not recognised by onemedifund
  • Services provided outside of Australia
  • Services that can be claimed through compensation, third party or sports club cover
  • Claims submitted more than 2 years after the service date
  • Non-prescription contacts, glasses and sunglasses
  • Claims with a benefit less than $5
  • Services provided by family members, relatives, business partners or yourself
  • Goods or services primarily used for sport, recreation or entertainment

Registered Providers

It is a requirement that any extras provider is registered and recognised by the fund before benefits will be paid. Our aim is to ensure the safety and appropriateness of treatment to our contributors and we will only pay benefits for providers who are deemed to have met the fund’s recognition criteria.

We reserve the right to refuse payment for services rendered by a provider who does not satisfy the fund criteria. To ensure that the provider you are attending is covered by the fund you can search for registered providers here.

Loyalty Bonuses

For Extras Plus cover, higher annual benefits are payable after 5 years continuous cover. These Loyalty Limits are payable for crowns and bridgework, dentures and orthodontic treatment.