Essential Extras

All category limits listed are per person.

Limit Bank periods are highlighted in the right column of the table

	MAXIMUM PAYMENT 70% of the cost up to:	Limit	Limit Bank period (years)
Essential Dental1
Periodic examination (012)	$33	$150	1
X-Ray (022)	$23
Removal of plaque (111)	$38
Removal of calculus (114)	$60
Flouride application (121)	$25
Mouthguard (151)	$85
Fissure sealing (161)	$27
Health Checks (Where not claimable from another source)
Mammograms	70%	$200	1
Bone density tests	70%
Skin cancer screening	70%
Bowel/prostate cancer screening	70%
CT gates scans	70%
Health Maintenance
Quit smoking programs2	70%	$100	1
Weight management programs3	70%
Stress management courses4	70%
Gym membership5	70%	$100
Blood glucose accessories	70%	$100
Dietician consultation	70%	$100
Essential Dental (2 month waiting period)
See ESSENTIALS above
General Dental1 (2 month waiting period)
Filling: 1 surface metallic (511)	$61	$150	1
Filling: 3 surface metallic (513)	$84
Filling: 1 surface tooth-coloured (531)	$68
Filling: 3 surface tooth-coloured (533)	$100
Consultations	$28-$40
X-rays	$19-$42
Frames
Frames	$70	$180	1
Lenses
Single vision (pair)	$60
Bifocal (pair)	$60
Trifocal (pair)	$60
Multifocal (pair)	$130
Contacts
Contact lenses	$130
Physiotherapy- initial                  - subsequent	$61 $35	$200	1
Chiropractic- initial                  - subsequent	$61 $35
Osteopathy- initial                  - subsequent	$61 $35
Pharmaceuticals6 (non-PBS drugs requiring prescription by law). NOTE: legislation requires CBHS to deduct the current prescribed charge	Prescribed charge up to $150	$200	1

1. The application of rules for dental services and related benefit payments can be a complex matter. The most accurate way to assess benefits in advance for a specific dental procedure is to fax or email your dental quote, including item numbers and itemised costs, or call us.
2. Quit smoking programs (including nicotine replacement therapy, certain brands of patches, inhalers and gums) must be approved by CBHS and received as part of a health management program intended to prevent or ameliorate a specific health condition.
3. Weight loss programs must be approved by CBHS and received as part of a health management program intended to prevent or ameliorate a specific health condition. NOTE: Benefits are not payable for meals or special food.
4. Stress management courses (including Hatha, Ashtanga, Iyengar and Bikram yoga: minimum 8 classes) must be approved by CBHS and received as part of a health management program intended to prevent or ameliorate a specific health condition.
5. Gym membership (minimum 3 months) must be approved by CBHS and received as part of a health management program intended to prevent or ameliorate a specific health condition. Per person, per calendar year.
6. Benefits for pharmaceuticals are paid per person, per calendar year.

Maximum Payment

All CBHS Extras benefits are subject to a Maximum Payment level. Generally, the Maximum Payment for an individual Extras service is 70% of the service cost up to a pre-determined maximum amount.

Example
The Maximum Payment for the service 'Extraction of a full tooth' is 70% of the cost up to $70.

If your dentist charges you $80 for this service, you would receive a benefit payment of $56 (70% of $80 is $56).

If your dentist charges you $110 for this service, you would receive a benefit payment of $70. While 70% of $110 is $77, the Maximum Payment available for this service is $70 - the amount you would receive.

1. Where referred by a doctor and recognised by CBHS as essential to a member's health care needs.
2. Where benefits are not payable from any other source.

 This information should be read carefully and retained.