Ancillary Cover
Ancillary Cover helps you take care of your health outside of hospital. It provides benefits for a wide range of health care services which are not covered by Medicare, such as dental, optical, physiotherapy, chiropractic, ambulance, pharmacy and natural therapies. These benefits available are described in more detail in the table below.
Unless otherwise stated, benefit limits apply per person per calendar year. Initial consultation benefits are paid only once per person per calendar year.
Benefit and limit amounts are effective from 1st April 2010.
Dental |
Benefit | Limit |
|
Inlays/Onlays & Veneers Crowns/Bridgework Implants |
For specific benefits, obtain ADA item numbers from your dentist and contact our office |
$1300 $1600 $1500 |
| Orthodontia | 80% of each orthodontic installment account submitted | $2400 per course of treatment |
| Dental Prosthetists | Benefits payable in those states where the prosthetist is authorised to deal directly with the public | |
Optical |
Benefit | Limit |
|
Contact Lenses Hard Soft |
$240 $270 |
$270 |
|
Frames Lenses Stock supply, single-sighted Specially ground, single-sighted Bi-focal Multi-focal |
$95 $95 $105 $125 $175 |
|
|
Artificial Eyes |
$500 | $500 |
|
Optical repairs |
$60 |
|
| Benefits are only payable for spectacles when sight correction is necessary. Benefits are not payable for non-prescription sunglasses. Your optometrist’s prescription must be submitted with your claim. | ||
Pharmaceutical |
Limit | |
| For pharmaceutical prescriptions not covered by PBS and excluding contraceptives and items normally available without prescriptions, you pay an amount equal to the maximum PBS Co-Payment charge for each item and Phoenix Health Fund will pay a benefit up to $60 towards the balance of that item. Diabetic aids included. | $500 | |
Ambulance |
||
|
The cost of joining your state’s Ambulance scheme is fully covered. |
||
Midwifery |
Benefit | Limit |
|
Per ante-natal visit Per post-natal visit |
$30 $50 |
10 per confinement |
|
Confinement delivery |
$600* |
|
| * Benefit not payable where a medical practitioner is required to intervene and take over the delivery | ||
Home NursingPer visitPer day (over 6 hours) |
$15$50 |
$500 |
| Benefit | Limit | |
Natural Therapy/Remedial MassageSpecific therapies and associations recognised |
$20 |
$200 |
AcupunctureSpecific therapies and associations recognised |
$25 |
$450 (including X-rays) |
Chiropractic/OsteopathicInitial consultationSubsequent consultations Chiropractic X-rays |
$33$25 $100 |
|
| Benefit | Limit | |
PhysiotherapyInitial consultationSubsequent consultations |
$45$34 |
$800 10 ante-natal classes per confinement |
Speech TherapyInitial consultationSubsequent consultations |
$85$45 |
|
Occupational TherapyInitial consultationSubsequent consultations |
$60$40 |
|
Orthoptic TherapyInitial consultationSubsequent consultations |
$45$44 |
|
Ante-Natal Classes(not related to midwifery claims) |
$40 |
|
Hearing Aids |
Benefit | Limit |
|
One appliance |
$900 |
One appliance every 5 years |
|
Where bilateral hearing loss is demonstrated – Second appliance |
$800 |
|
| Hearing Aid repairs, after 2 years from purchase (batteries not included) |
$100 |
|
| Benefit | Limit | |
PsychologyPer service (registered clinical psychologists) |
$75 |
$500 |
HypnotherapyPer service (registered clinical hypnotherapists) |
$50 |
|
Dietetics |
Benefit | Limit |
|
Initial consultation Subsequent consultations (D.A.A. registered) |
$60 $40 |
$300 |
Podiatric |
Benefit | Limit |
|
Initial consultation Subsequent consultations Podiatric devices |
$44 $34 80% cost |
$400 |
Prosthetic Appliances & Artificial Aids |
Benefit | Limit |
|
Contact our office for items payable from this category |
You pay the first $20 and we pay a benefit of 80% of the remaining balance |
$900 |
Travel & Accommodation |
Benefit | Limit |
| Travel – equivalent of economy rail fare for distance travelled or 10c per kilometre. Combined benefit patient and attendant. |
$120 |
|
| Overnight accommodation – per night, patient and attendant |
$65 |
$260 |
| Benefits payable where return distance is at least 200 kilometres | ||
Ex-Gratia PaymentsPhoenix Health Fund, at the absolute discretion of the Board, in special circumstances, may make ex-gratia payments on application. |
||
Compare products
Get a quote
Fine print – general information
