General Dental
|
Benefits you receive
| Services |
Members First |
Other Providers |
|
Benefit examples
|
| Comprehensive oral examination |
$34.15
|
$25.90
|
| Scale and clean |
$67.90
|
$50.80
|
| Mouthguard |
$125.65
|
$93.60
|
|
General 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 Mutual Community hospital cover. Hospital costs relating to general dental treatment are not fully covered.
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Annual Maximums
| |
Per person |
| Every year |
Unlimited |
|
|
Major Dental
|
Benefits you receive
| Services |
Members First |
Other Providers |
|
Benefit examples
|
| Complete Denture |
$1,046.65
|
$778.30
|
| Full crown - veneered - indirect |
$927.40
|
$689.50
|
|
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 Mutual Community 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.
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|
Annual Maximums
| |
Per person |
| Every year |
$1,100.00 |
|
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Orthodontics
|
Benefits you receive
| Services |
All Providers |
|
Benefit examples
|
| Complete course of orthodontic treatment |
Refer to special comments below.
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|
A lifetime limit of $2,600 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 Mutual Community.
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Annual Maximums
| |
Per person |
| Every year |
$800.00 |
|
|
Living Well
|
Benefits you receive
| Services |
All Providers |
| Living Well programs provide cover for courses and treatments which help you to live a healthier lifestyle. |
50% of cost up to a limit of $100 per person, per year
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|
|
|
Annual Maximums
| |
Per person |
| Every year |
$100.00 |
|
|
Home Nursing
|
Benefits you receive
| Services |
All Providers |
| Home Nursing will cover you for general care services, Stomal Therapy and Palliative Care Services. |
$35 per day, capped at 10 visits per year up to an annual limit of $350
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|
|
|
Annual Maximums
| |
Per person |
| Every year |
$350.00 |
|
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Optical
|
Benefits you receive
| Services |
Members First |
Other Providers |
|
Lenses
|
| Single Vision Stock |
$86.25
|
$57.90
|
| Bi-focal lenses |
$116.25
|
$77.40
|
| Tri-focal/progressive lenses |
$159.00
|
$122.40
|
|
Contact lenses
|
| Non Disposable |
$160.80
|
$128.60
|
| Disposable contact lenses, 3 month supply |
100% of cost up to annual limit
|
$72.20
|
|
Frames
|
| Frames for prescription lenses |
$180.70
|
$144.60
|
|
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. Gap free optical packages
Visit our Members First optical providers (Blink Optical, National Pharmacies Optical Stores and other selected independent optometrists) to receive better value and higher benefits on your optical purchases.
| No-gap optical packages | | | Kid's glasses with safety lens plus any frame up to $249. | | | Glasses with single vision lens† | | | Glasses with single vision grind lens† | | | Glasses with bi-focal lens† | | | Glasses with tri-focal lens† | | | Glasses with progressive lens† | | | Optial add on services covering tinting, coatings and UV protection (subject to your remianing Annual Limit) | | | Disposable contacts on selected 12 months supply (purchased in store) | | | Disposable contacts on selected 12 months supply (purchased online) | | *Annual maximums and normal waiting periods apply. † Includes any frames valued up to $199.
Blink Optical benefits also available at Kevin Paisley Fashion Eyewear.
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|
Annual Maximums
| |
Members First |
Other Providers |
| Every Year |
$300.00 |
$240.00 |
|
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Physiotherapy
|
Benefits you receive
| Services |
Members First |
Other Providers |
|
Benefit examples
|
| Initial attendance |
$51.00
|
$38.70
|
| Subsequent attendance |
$41.25
|
$30.90
|
| Ante natal services |
|
$9.00
|
|
|
|
Annual Maximums
| |
Per person |
| Every year |
$800.00 |
|
|
Chiropractic and Osteopathy
|
Benefits you receive
| Services |
Members First |
Other Providers |
|
Benefit examples
|
| Initial attendance |
$56.25
|
$42.70
|
| Subsequent attendance |
$35.65
|
$26.08
|
|
Chiropratic Services: Examples refer to the first 10 consultations per person per calendar year. 50% of applicable benefit applies after 10 consultations.
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Annual Maximums
| |
Per person |
Per family |
| Every year |
$600.00 |
$1,200.00 |
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|
Speech Therapy
|
Benefits you receive
| Services |
All Providers |
|
Benefit examples
|
| Initial attendance |
$70.00
|
| Subsequent attendance |
$43.00
|
| Group attendance |
$15.00
|
|
|
|
Annual Maximums
| |
Per person |
| Every year |
$500.00 |
|
|
Eye Therapy
|
Benefits you receive
| Services |
All Providers |
|
Benefit examples
|
| Initial attendance |
$24.00
|
| Subsequent attendance |
$21.00
|
|
|
|
Annual Maximums
| |
Per person |
| Every year |
$500.00 |
|
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Occupational Therapy
|
Benefits you receive
| Services |
All Providers |
|
Benefit examples
|
| Initial attendance |
$48.00
|
| Subsequent attendance |
$35.00
|
| Group attendance |
$12.00
|
|
|
|
Annual Maximums
| |
Per person |
| Every year |
$500.00 |
|
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Natural Therapies
|
Benefits you receive
| Services |
All Providers |
|
Benefit examples
|
| Acupuncture - Initial Attendance |
$28.00
|
| Acupuncture - Subsequent Attendance |
$21.00
|
|
Massage benefit examples
|
| Massage -per attendance |
$21.00
|
|
Naturopathy benefit examples
|
| Naturopathy - Initial Attendance |
$28.00
|
| Naturopathy - Subsequent Attendance |
$21.00
|
|
Includes acupuncture, Alexander Technique, Chinese herbalism, exercise physiology, Feldenkrais, homoeopathy, naturopathy and Western herbalism. Massage includes aromatherapy, Bowen Technique, kinesiology, reflexology, shiatsu and therapeutic massage. A combined annual sub-limit of $200 per person or $400 per family for massage can be claimed per calendar year.
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Annual Maximums
| |
Per person |
| Every year |
$500.00 |
|
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Pharmacy
|
Benefits you receive
| Services |
All Providers |
|
Benefit examples
|
| Pharmacy |
Up to $40.00
|
|
Benefits for items that are S4 or S8 scripts, TGA approved and not covered by the Government Pharmaceutical Benefits Scheme (PBS). You pay an amount equal to the maximum patient contribution set by the Government under the PBS. Mutual Community refunds 100% of the balance of up to $40 per script.
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Annual Maximums
| |
Per person |
| Every year |
$600.00 |
|
|
Dietary
|
Benefits you receive
| Services |
All Providers |
|
Benefit examples
|
| Initial attendance |
$45.00
|
| Subsequent attendance |
$22.00
|
| Group attendance |
$12.00
|
|
|
|
Annual Maximums
| |
Per person |
| Every year |
$500.00 |
|
|
Psychology
|
Benefits you receive
| Services |
All Providers |
|
Benefit examples
|
| Initial attendance |
$78.00
|
| Subsequent attendance |
$73.00
|
| Family attendance |
$30.00
|
|
|
|
Annual Maximums
| |
Per person |
| Every year |
$500.00 |
|
|
Podiatry
|
Benefits you receive
| Services |
All Providers |
|
Benefit examples
|
| Initial attendance |
$35.00
|
| Subsequent attendance |
$25.00
|
|
|
|
Annual Maximums
| |
Per person |
| Every year |
$500.00 |
|
|
Health appliances
|
Benefits you receive
| Services |
All Providers |
|
Benefit examples
|
| Asthma pumps |
75% of cost up to a limit of $300, 1 claim every 2 years.
|
| Blood Glucose Monitors or INR Blood Testing Device (Coaguchek) |
75% of cost up to a limit of $500, 1 claim every 2 years.
|
| Defined appliances |
75% of cost, annual combined total of $800 for all defined appliances per calendar year.
|
| CPAP/BPAP devices |
75% of cost up to a limit of $750, 1 claim every 2 years.
|
| Surgical Stockings |
75% of cost up to sublimit of $100.
|
| Hearing Aids |
75% of cost up to a limit of $800 and 75% of repair cost up to $100. Limit 1 claim every 3 years.
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Defined Appliances include TENS Machines, blood pressure monitors, insoles, orthopaedic and corrective footware, pressure garments, braces, artificial limbs. Limits apply per item. CPAP Devices subject to eligibility. To receive benefits for health aids and appliances you'll need to visit a recognised provider. You will also need to meet the eligibility criteria, provide proof of purchase and a clinical referral where required. A benefit is also payable for the hire, repair and maintenance of health appliances. Restrictions apply. Benefits are not payable in the first 12 months after purchasing an item, within 12 months following the repair, or on items where hire and repair is deemed inappropriate.
|
|
Annual Maximums
| |
Per person |
| Every year |
$1,000 combined annual limit. |
|
|
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 |
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