|
ITEM
|
LIMITS
|
BENEFITS PAID
|
|
General dental services
|
$600
|
100% paid for ten general check up items up to two times per year, so long as the charges are within the range of usual, customary and reasonable charges. Fixed benefits paid for all other items.
|
|
Major dental services
|
|
|
|
- Periodontic
|
Periodontic services are included in the general dental limit
|
Fixed benefits paid per item
|
|
- Orthodontics
|
Orthodontic services are included in the general dental limit, up to $125 per year of membership with a lifetime limit of $1,250
|
|
Optical category limit
|
$500 limit over 2 years
|
|
|
- Frames
|
|
$220
|
|
- Single vision lenses
|
|
$200
|
|
- Bi-focal lenses
|
|
$250
|
|
- Multi-focal lenses
|
|
$320
|
|
- Contact lenses
|
|
$500
|
|
- Repairs
|
|
$50
|
|
Non-PBS pharmaceuticals, mammograms, ThinPrep tests, bone density tests
|
$300
Tests, one each per year
|
After the current PBS cost, benefits paid are 85% of the remaining cost of a non-PBS script. $60 per test.
|
|
Physiotherapy, Psychology, Occupational therapy, Speech therapy, Orthoptics, Podiatry, Dietetics, Midwifery services, and remedial massage with specifically qualified practitioners
|
$900
|
$100 per visit for psychology, all other therapies $30 per visit with calendar year sublimits per therapy type of $500
|
|
Aids & appliances including hearing aids
|
$500
Benefits paid for replacement items 2 years after the first supply.
One set of hearing aids every 3 calendar years
|
75% of the cost of the item, except hearing aids
Single hearing aid $200
Two hearing aids $400
Hearing aid repairs $50
where use of the item was ordered by a registered practitioner
|
