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Doctors' Health Fund

Essential Extras

Restricted Insurer

$247.77 / month

(Before Rebate, Discount & Loading)

Available in All States

You may be entitled to an Australian Government Rebate on the above premium. Your premium may also include an insurer discount. Check with your insurer for details.

This policy covers: Two adults & dependants, including non-student dependants (3 or more people, only 2 of whom are adults).

Children (0 - 17), non-classified* dependant (18 - 20), students (21 - 31) and non-students (21 to 31). Disabled dependant person: Participants in the National Disability Insurance Scheme(NDIS) are considered persons with a disability. Insurers may have a broader definition of persons with a disability. Check with the insurer for details. *Non-classified dependant: A non-classified dependant is a child, stepchild or foster child between 18 and 21 years of age who does not have a partner and who may or may not be receiving full-time education at a school, college or university.

Restricted insurer: Membership of this insurer is restricted to Medical and allied health professionals, their families, medical students and AMA employees.

Policy ID: AMA/I4/ABDG2P

Source: Private Health Information Statement (PHIS)

Extras Cover

This health insurer does not operate a preferred provider scheme.

This policy includes General treatment (Extras) cover for

Treatment & waiting period (months)
Benefit limits per 12 months unless otherwise stated
Examples of maximum benefits
Acupuncture* 2

$200 per person up to $400 per policy

combined limit for acupuncture, health management / healthy lifestyle & other services

  • Initial visit: 75% of charge
  • Subsequent visit: 75% of charge
Ante-natal/Post-natal classes 2

$900 per person

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

sub-limits apply

  • Initial visit: $50
  • Subsequent visit: $30
Blood glucose monitors 12

$500 per person up to $250 per service

sub-limits apply

  • Per monitor: 75% of charge
Dietetics/dietary advice 2

$900 per person

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

sub-limits apply

  • Initial visit: $50
  • Subsequent visit: $35
Endodontic 12

$1,600 per person

combined limit for endodontic, general dental, major dental & orthodontic

  • Filling of one root canal: $131.75
Exercise physiology 2

$900 per person

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

  • Initial visit: $30
  • Subsequent visit: $30
Eye therapy (orthoptics) 2

$900 per person

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

sub-limits apply

  • Initial visit: $50
  • Subsequent visit: $35
General dental 2

$1,600 per person

combined limit for endodontic, general dental, major dental & orthodontic

  • Fluoride treatment: 100% of charge
  • Scale & clean: 100% of charge
  • Surgical tooth extraction: $153
  • Periodic oral examination: 100% of charge
Health management / Healthy lifestyle 2

$200 per person up to $400 per policy

combined limit for acupuncture, health management / healthy lifestyle & other services

  • Health management: 75% of charge
Hearing aids 24

$800 per person

  • Hearing aid: $400
Major dental 12

$1,600 per person

combined limit for endodontic, general dental, major dental & orthodontic

  • Full crown veneered: $765
Non PBS pharmaceuticals 2

$300 per person

combined limit for non pbs pharmaceuticals & vaccinations

sub-limits apply

  • Per eligible prescription: 85% of charge
Occupational therapy 2

$900 per person

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

sub-limits apply

  • Initial visit: $50
  • Subsequent visit: $40
Optical* 2

$500 per person

  • Multi-focal lenses & frames: 100% of charge
  • Single vision lenses & frames: 100% of charge
Orthodontic* 12

$1,600 per person

$1,600 lifetime limit

combined limit for endodontic, general dental, major dental & orthodontic

  • Braces for upper & lower teeth, including removal plus fitting of retainer: 100% of charge
Orthotics (podiatric orthoses) 12

$900 per person

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

sub-limits apply

  • Orthotics supply & fit: $150
Physiotherapy* 2

$900 per person

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

sub-limits apply

  • Initial visit: $50
  • Subsequent visit: $35
Podiatry 2

$900 per person

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

sub-limits apply

  • Initial visit: $50
  • Subsequent visit: $35
Psychology 2

$900 per person

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

sub-limits apply

  • Initial visit: $100
  • Subsequent visit: $100
Remedial massage 2

$900 per person

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

sub-limits apply

  • Initial visit: $40
  • Subsequent visit: $30
Speech therapy 2

$900 per person

combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services

sub-limits apply

  • Initial visit: $50
  • Subsequent visit: $40
Vaccinations 2

$300 per person

combined limit for non pbs pharmaceuticals & vaccinations

  • Per service: 85% of charge
Acupuncture*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person up to $400 per policy}

{combined limit for acupuncture, health management / healthy lifestyle & other services}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Ante-natal/Post-natal classes

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $30}

Blood glucose monitors

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$500 per person up to $250 per service}

{sub-limits apply}

Examples of maximum benefits

{Per monitor: 75% of charge}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $35}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,600 per person}

{combined limit for endodontic, general dental, major dental & orthodontic}

Examples of maximum benefits

{Filling of one root canal: $131.75}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $30}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $35}

General dental

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,600 per person}

{combined limit for endodontic, general dental, major dental & orthodontic}

Examples of maximum benefits

{Fluoride treatment: 100% of charge}

{Scale & clean: 100% of charge}

{Surgical tooth extraction: $153}

{Periodic oral examination: 100% of charge}

Health management / Healthy lifestyle

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$200 per person up to $400 per policy}

{combined limit for acupuncture, health management / healthy lifestyle & other services}

Examples of maximum benefits

{Health management: 75% of charge}

Hearing aids

Waiting period:  24 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

Examples of maximum benefits

{Hearing aid: $400}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,600 per person}

{combined limit for endodontic, general dental, major dental & orthodontic}

Examples of maximum benefits

{Full crown veneered: $765}

Non PBS pharmaceuticals

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

{combined limit for non pbs pharmaceuticals & vaccinations}

{sub-limits apply}

Examples of maximum benefits

{Per eligible prescription: 85% of charge}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $40}

Optical*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

Examples of maximum benefits

{Multi-focal lenses & frames: 100% of charge}

{Single vision lenses & frames: 100% of charge}

Orthodontic*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,600 per person}

{$1,600 lifetime limit}

{combined limit for endodontic, general dental, major dental & orthodontic}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: 100% of charge}

Orthotics (podiatric orthoses)

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Orthotics supply & fit: $150}

Physiotherapy*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $35}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $35}

Psychology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $100}

{Subsequent visit: $100}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $30}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

{combined limit for ante-natal/post-natal classes, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), physiotherapy, podiatry, psychology, remedial massage, speech therapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $40}

Vaccinations

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per service: 85% of charge}

Major dental paid at fixed benefits per item. Combined annual limit of $900 for physiotherapy, exercise physiology, dietetics, occupational therapy, speech therapy, podiatry, massage and more (sub-limits of $700 for mental health and $500 for other therapies). Group physiotherapy and hydrotherapy $20 per session. Benefit of $400 each for one left and one right hearing aid every 5 years. Pharmacy benefits paid at 85% of charge above the PBS co-payment to a maximum of $40 per prescription (sub-limit applies for weight loss medications).

This policy does not include General treatment (Extras) cover for
Audiology
Chinese medicine
Chiropractic
Home nursing
Osteopathy

Other features of this general treatment cover: Superior mid-range extras cover with substantial benefits including major dental and high-level optical cover. 100% back for 2 dental checkups per year (fixed benefits thereafter) at the provider of your choice. No sub-limits on optical benefits – use the full $500 limit on contact lenses or frames fitted with prescription lenses. Claim up to $700 per year (as part of the $900 overall limit for therapies) for mental health services. Health management includes services such as acupuncture, weight loss classes and class physiotherapy for the treatment of a specific diagnosed condition.

For further information about this policy see: https://www.doctorshealthfund.com.au/extras-cover-essential-extras

Ambulance cover

Ambulance cover is provided by the State government in Tasmania (https://www.health.tas.gov.au/ambulance/fees_and_accounts) and Queensland (https://www.ambulance.qld.gov.au). In other states concession card holders may have free cover and there are subscription services in several states (https://privatehealth.gov.au/health_insurance/what_is_covered/ambulance.htm).

For further information about this policy see: https://www.doctorshealthfund.com.au/extras-cover-essential-extras

Insurer Details

Doctors' Health Fund

Essential Extras

Restricted Insurer

$247.77 / month

(Before Rebate, Discount & Loading)

Available in All States

Disclaimer: This document is not a Private Health Information Statement (PHIS), and it is not intended to replace that document. The details contained in the healthslips.com.au Policy Information was provided by the insurer to the Australian Government. It is intended as general information. It may not take into account your circumstances. For further information contact the insurer. Information used is Licensed from the Commonwealth of Australia under a Creative Commons 3.0 licence.Private Health Information Statement is available from the Private Health Insurance Ombudsman website at https://privatehealth.gov.au/dynamic/Premium/PHIS/AMA/I4/ABDG2P

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