A benefit is not payable in respect of a service that was rendered to a Member if the services can be claimable from any other source.
Each group of services within Extras and Package covers have an overall limit on the amount you can claim. Most limits are based on per person per calendar year, unless otherwise stated in our Extras table.
Benefits which attract a 3 and 5 year period are entitled to have the benefit renewed on the same date which the service was performed respectively.
Benefits which attract a 'lifetime' period; lifetime means the period commencing on the date the member was first insured and ceases to be insured by CBHS (irrespective of any suspension of membership or other period without cover).
Per service benefit
Most CBHS Extras benefits are subject to a Per Service Benefit. Generally, the maximum benefit for an individual Extras service is 70% of the service fee up to a Per Service Benefit within the overall category limit.
The maximum payment for the service 'extraction of a full tooth' is 70% of the cost up to the Per Service Benefit of $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 Per Service benefit for this service is $70 - the amount you would receive.
Extras waiting period
|Extras waiting period ||Calendar months |
|Crowns and bridges, orthodontia, artificial aids, healthcare appliances, oxygen apparatus and hearing aids ||12 months |
|Prescribed optical appliances, periodontics, endodontics, inlays/onlays, facings, dentures and implants ||6 months |
|All other services ||2 months |