Phoenix’s Mid Extras provides members with a moderate level of extras coverage, to cover you for services that you claim from time to time.

Mid Extras provides benefits for most health care services, but removes high cost items that younger people tend not to use) for a more affordable policy price.

Services covered under this policy include dental, optical, physiotherapy, chiropractic, Ambulance, pharmacy natural therapies, and more.

To get the most of out of your Health Insurance, this policy can also be purchased together with an hospital policy (covering medical expenses in hospital) to give you a diverse range of coverage in hospital and at your health service provider.

Inclusions in the Extras Cover

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 2017.

Please also note that this page does not include the full detail of all services covered, and that sublimits apply for some services.  It is recommended that you contact the fund before your treatment to check exactly what you are covered for.

Treatment Benefit (for commonly claimed items) Annual Limit
General Dental 011 – Periodic oral examination – $32.85
114 – Scale & clean – $62.10
121 – Fluoride treatment – $21.60
$1,500
Sublimits include:
Inlays, onlays & Veneers- $1,000
Crowns/bridgework – $1,000
Implants – $1,000
Dentures – $1,000
Orthodontia – $1,000 ($1,000 Lifetime limit)
Major Dental and Endodontic 615 – Full crown veneered – $787.50
417 – Filling of one root canal – $153.00
Orthodontic Braces for upper/lower teeth – 80% of charge
Removal/ fitting of retainer  – 80% of charge
Optical
* No benefit paid for sunglasses, where no sight correction is needed.
Single vision lenses & frames – $198.00
Multi-focal lenses & frames – $200.00
Frame – $90.00
Single Vision Lenses – $108.00
Multifocal Lenses – $189.00
$200
Non PBS Pharmaceuticals
* No benefit paid for contraceptives and items purchased over the counter.
Per eligible prescription – $45.00
(Paid after General PBS copayment has been paid)
$250
Chiropractic/Osteopathic

 

Acupuncture
* Benefits paid for approved acupuncture associations only.

Chiro/Osteo Initial visit – $36.00
Chiro/Osteo Subsequent visit – $27.00
Chiropractic X-rays – $90
Acupuncture visits- $22.50
$400
Physiotherapy
Orthoptic Therapy
Speech Therapy
Occupational Therapy
Physiotherapy Initial visit – $45.00
Physiotherapy Subsequent visit – $33.30
Orthoptic Therapy Initial visit – $40.50
Orthoptic Therapy Subsequent visit – $39.60
Speech Therapy Initial visit – $76.50
Speech Therapy Subsequent visit – $40.50
Occupational Therapy Initial visit – $54.00
Occupational Therapy Subsequent visit – $36.00
$400
Natural Therapies* Including Myotherapy, Homeopathy, Naturopathy and Chinese Herbal Medicine (consultation only)

Remedial Massage

* Benefits paid for approved associations only. Click here for approved alternative therapy services.

Natural Therapies visits – $22.50
Remedial Massage visits – $22.50
$200
Healthy Lifestyle Program
Approved Health Education, Health Screening, Health Management programs and Exercise Physiology only. Please contact the fund before you make a claim to check that the service provided is an approved program.  Click here for more information
Exercise Physiology  visits – $27.00
All other services – 80% of charge
$100
Podiatry Initial visit – $39.60
Subsequent visit – $30.60
Podiatric devices – 80% of cost
$200
Aids and Appliances
* Contact the fund for items payable in this category.
80% of charge
(after $20 copayment is made)
$150

Ambulance Coverage

Phoenix Health Fund covers all medically necessary transport from a State Emergency Ambulance service. This also includes when an Ambulance is called to attend to you, but you do not subsequently need to be taken to hospital. Coverage is not offered when it is not medically necessary for you to be transported by an Ambulance.

Mid Extras waiting periods

  • 2 month waits for General Dental claims
  • 12 month waits Major Dental and Orthodontic claims
  • 6 month waits for Optical claims
  • Nil waiting periods for Ambulance coverage
  • 2 month waits for all other extras item claims

Fund Rules

For the complete description of the Fund rules, relating this product, please refer to the General Information section on our website.

Please ensure you have read and retained the information relating to your policy of choice before applying for membership.