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Benefit Review 2016

We aim to continuously improve the benefits provided to our members. With this in mind, we are making changes to the maximum claimable amount on a long list of dental items.

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Extras 2.1
Extras 3.1
As a member-based organisation, we aim to continuously improve the benefits provided to our members. However, we must also balance the cost of these benefits so as to maintain fair value for money. With this in mind, we are making changes to the maximum claimable amount on a long list of dental items and also updating our Health Benefit Fund Rules to ensure we continue to be transparent and fair to all members.

Changes to the maximum claimable amount per item

The changes set out below apply to Top, Intermediate and Essentials Extras cover and Prestige, LiveLife and StepUp package cover and Overseas Visitors Extras. If you hold KickStart, please click here to see changes relevant to your cover. Not all products cover all items listed below. If the item is not listed below, no change will occur for that benefit. When you make a claim, you will receive 70% of the cost of that item from CBHS up to the maximum claimable amount for each item listed below.   

These changes should, overall, provide members with more benefits for dental services received after 1 January 2016. In addition to these changes, our rules will change on 1 January and 1 February. Click here for more details.

To download a PDF version of this table, please click here.

 

    Maximum Claimable Amount Per Item
Item# Description  Current  From 1-Jan-16 Increase 
 General Dental - Diagnostic
 14 Consultation   35.00  40.00  5.00
 37 X-ray: panoramic  42.80  60.00  17.20
 71 Diagnostic model - per model  24.50   40.00  15.50
Preventative Dental
161 Fissure sealing - per tooth  27.00  34.00  7.00
Major Dental - Periodontics
222 Root planning and subgingival curettage - per tooth  24.00  30.00  6.00
281 Course of non-surgical periodontal treatment
 160.00  180.00  20.00
282 Continuation of periodontal treatment subsequent to 281
 130.00  150.00  20.00
General Dental - Extractions or Surgical dental
311 Removal of all or part tooth  76.00  97.00  21.00
314 Sectional removal of a tooth  89.00  130.00  41.00
322 Surgical removal of tooth

(No change for Essential Extras - $170)

 167.00   177.00  10.00
323 Surgical removal of tooth - Bone Removal

(No change for Essential Extras - $160)

 175.00  195.00  20.00
324 Surgical removal of tooth - Removal of bone and tooth division 

(No change for Essential Extras - $170)

 190.00   250.00  60.00
Major Dental - Endodontics
416 Chemo-mechanical prep of root canal - additional canal
 65.00  85.00 20.00
General Dental - Fillings
511 1 surface metallic restoration
 61.00  81.00  20.00
512 2 surface metallic restoration  65.00  85.00  20.00
513 3 surface metallic restoration  84.00  124.00  40.00
514 4 surface metallic restoration  82.00  135.00  53.00
515 5 surface metallic restoration  86.00  145.00  59.00
521 1 surface adhesive restoration  80.00  90.00  10.00
523 3 surface adhesive restoration 
 115.00  125.00  5.00
524 4 surface adhesive restoration
 120.00  130.00  10.00
525 5 surface adhesive restoration
 130.00  150.00  20.00
531
1 surface posterior adhesive restoration
 85.00  90.00  5.00
532 2 surface posterior adhesive restoration
 100.00  110.00  10.00
533 3 surface posterior adhesive restoration
 125.00  135.00  10.00
534 4 surface posterior adhesive restoration
 135.00  145.00  10.00
535 5 surface posterior adhesive restoration
 140.00  150.00  10.00
575 Pin retention - per pin
 12.30  17.30  5.00
Major Dental - Inlays/onlays/facings
583 Veneer - indirect 
 360.00  600.00  240.00
Major Dental - Crowns & bridges
655 Removal of crown
 10.00  60.00  50.00
656 Removal of bridge or splint
 10.00  60.00  50.00

 

Item# Description  Current  From 1-Jan-16 Decrease 
Major Dental - Periodontics
121 Fluoride. Topical application of remineralising agent   30.00  25.00  -5.00
221 Clinical periodontal analysis and recording 
 70.00  40.00  -30.00
577
Cusp capping - per cusp - posterior teeth
 32.80  26.00  -6.80
578 Restoration of an incisal corner - per corner anterior
 32.80  27.00  -5.80
Major Dental - Inlays/onlays/facings
582 Veneer - direct
 360.00  260.00  -100.00
Major Dental - Crowns & bridges
627 Preliminary restoration for crown - direct
 165.00  150.00  -15.00
642 Bridge pontic - direct - per pontic
 680.00 380.00  -300.00