Each service we pay a benefit on has an overall limit, sometimes an annual, multi-year or lifetime 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. 

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 9,000 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?