Essential Extras
Essential Extras covers the basics, which is perfect for the young and healthy who are just starting out on their private health insurance journey. If you choose to upgrade your Extras later on, that’s easy to do.
Essential Extras will put a smile on your face each time you save on common treatments.
What’s included in CBHS Essential Extras cover?
Refer to the Essential Extras product sheet to help you understand your cover and benefits.
| Description | Overall limit |
|---|---|
| Preventative dental ^ | Unlimited |
| General dental ^ | Unlimited |
| Periodontic (gum treatment) | $630 |
| Endodontic (root canal treatment) | $660 |
| Inlays/onlays/facings/veneers 1 | $1440 |
| Dentures and implants 1 | $1350 |
| Occlusal therapy 2 | $920 |
| Crowns and bridges 1 | $3000 |
| Orthodontia 2 | $2800 |
| Prescribed optical appliances | $375 |
| Physiotherapy | $720 |
| Chiropractic | $720 |
| Osteopathy | $720 |
| Occupational therapy | $720 |
| Speech therapy | $1850 |
| Clinical psychology | $450 |
| Ante natal/post natal physiotherapy | $105 |
| Hypnotherapy | $360 |
| Podiatry (excluding artificial aids e.g. orthotics) | $400 |
| Audiology | $360 |
| Eye therapy (orthoptic) | $455 |
| Exercise physiology | $360 |
| Dietitian | $360 |
| Oriental therapies | $450 |
| Massage therapies | $450 |
| Blood glucose accessories | $320 |
| Home visits by registered nurse | $2800 |
| Non-PBS drugs requiring prescription | $1000 |
| Travel and accommodation 3 | $500 |
| Artificial aids 4 | $1000 |
| Hearing aids 4 | $1600 |
| Health care appliances (blood pressure monitor, nebuliser, glucometer) 4 | $500 |
| Health checks 5,# | $200 |
| Health management 5 | $100 |
| Gym membership/personal training 5 | $115 ($100 sub limit for personal training) |
- ^Benefits are not payable for Do-It-Yourself (DIY) dentistry including whitening kits, aligners and occlusal splints. Please contact us to confirm whether a benefit is payable.
- 1Benefit period over any 5 years
- 2Lifetime benefit
- 3Benefit per membership per year. Travel is only payable for a patient who requires essential medical and dental treatment, where it is not available at a facility within a 160km round trip of the member’s home. In order to claim travel a patient must be visiting a specialist and will require a referral letter. Excludes Ronald McDonald house.
- 4Benefit period over any 3 years
- 5Benefits are 90% of the cost up to maximum category limit
- #CBHS provides benefits towards scans, screenings and tests, where members take a pro-active way to manage their health, but only where these do not attract a benefit from Medicare. We are only able to pay a benefit for selected scans, screenings and tests when they are NOT covered by Medicare. Your GP or provider will be able to advise you if your scan, screen or test, meets Medicare’s criteria for benefits.
Each service we pay a benefit on has an overall limit, a benefit period and a waiting period.
Once you’ve become a CBHS member and served the relevant waiting period, you can claim benefits on services covered under your policy.
Waiting periods are designed to keep health insurance fair for all members in a fund.
| Extras waiting periods | Calendar months |
|---|---|
| Prescribed optical appliances | 6 months |
| All other services | 2 months |
What can I claim for?
If your chosen Extras cover includes them, you can claim for the following services. Check our product sheets to see the details on what each cover includes.
- Chiropractic
- Dental
- Dietary services
- Health care aids
- Occupational therapy
- Optical
- Osteopathy services
- Pharmaceuticals
- Physiotherapy
- Podiatry
- Psychology
- Speech therapy
- Wellness benefits for a variety of health checks and programs designed to assist you in better managing your health and wellbeing e.g gym membership, skin cancer screening, bone density screening and breast examinations.
If you’re planning to claim for a treatment or service under Extras, make sure you’re using a recognised provider. We can only pay benefits if you use a recognised provider.
How is my claims benefit calculated?
We automatically calculate your claims benefit for you when you lodge a claim at your provider’s practice or when you lodge a claim online. If you claim through your provider, you’ll receive the benefit as a deduction in the cost of the service. Your benefit will be based on the percentage you’re entitled to under your chosen Extras cover, as well as the per service limit (see the product sheet) as well as much of your limit entitlement you have left available to use.
You can also find out your benefit using the Online Benefit Quote tool in the Member Centre.
How long does it take CBHS to pay Extras claims?
If your service provider has HICAPS or iSOFT facilities, all you need to do is give them your membership card and the benefit will be automatically deducted from the total service fee. If you’re visiting one of our Choice Network providers, you may not have any out-of-pocket expenses to pay.
Members who claim online typically receive their benefits within 1 – 2 business days. Once you have lodged your eClaim, you will receive an email confirmation. Once your claim has been assessed, you will receive a benefit remittance confirming your claim benefit.
What is the CBHS Choice Network?
This is a group of over 7,500 providers who are committed to reducing or removing the gap for Extras services on selected preventative dental and optical frames, lenses and contact lenses.
Find a CBHS Choice Network provider near you.
When do my benefits renew?
Most benefits for services are based on per person per calendar year, unless otherwise stated in the product sheet. They will renew on 1 January.
For services with a ‘three year’ or ‘five year’ period attached, the benefit will renew on the same date which you received the service in three or five years respectively.
For services which attract a ‘lifetime’ benefit period, the benefit limits only useable once only.
What do I need to claim for health management services?
If you’re claiming for health management services such as gym memberships and personal training, you’ll need to have your GP, specialist, or allied health service provider complete a Health Management Program (HMP) Authorisation Form. The, simply provide this to us when submitting your claim.
What types of services do I need a referral for?
We need a referral from your medical practitioner for artificial aids, health care appliances, contraceptives and some pharmacy items in certain circumstances.
How can I claim on travel and accommodation?
Under Top Extras cover, we pay benefits towards travel and accommodation if you need essential medical or dental treatment that is not available within a 160km round trip from your home. We only pay benefits for the member receiving treatment.
Essential medical treatment means:
- Your registered medical practitioner has referred you for the treatment; and
- You have a medical certificate from the registered medical practitioner, which states that the treatment is essential.
We also require the following:
- A medical certificate from the treatment location you travelled to e.g. the medical practitioner/a copy of the doctor’s invoice
- A copy of the receipt from the hotel, motel, etc. (for accommodation only)
- A completed and signed CBHS claim form.
Do I need to send the original receipts?
No. We accept scanned or duplicate receipts.Once you’ve been a CBHS member and served the relevant waiting period, you can claim benefits on services covered under your policy. In some instances, there’s a limit to how much you can claim.
A benefit is not payable in respect of a service that was rendered to a members if the services can be claimable from any other source.
| Extras waiting periods | Calendar Months |
|---|---|
| Prescribed optical appliances | 6 Months |
| All other services | 2 Months |
Download the product sheet
Refer to the Essential Extras product sheet to help you understand your cover and benefits.
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What our members say
Dental became much more affordable for us. We switched to your preferred providers and we had no out of pocket expense for the children's mouth guards, along with several other dental services 👌. Safe sports, cool-coloured mouths and sustainability - and my daughter chose a biodegradable tree green mouth guard! Thanks CBHS.
They (Best Doctors) always called when they said they would, they made sure (my son) Jake’s complete file was returned safely to us and their communication was always clear, polite and caring. Someone from CBHS rang one day, just to see how Jake was doing, and I so appreciated that call. When people sound like they genuinely care it makes such a difference.
Our family has full private health with CBHS − always have and definitely always will now. CBHS helped my family immensely, mainly my mother who died of brain cancer a few years ago. Without the help of CBHS we would have lost our family home to pay for all the hospital and medical bills and my dad would have been forced to work rather than care for my mother in her final days. CBHS not only gave us peace of mind with finances but peace of mind with life, freeing us up to be with Mum.
