What's not covered?
We pay benefits in accordance with the law and our Fund Rules and policies. The items that we do not pay extras benefits for include, but are not limited to
services where a benefit is payable by Medicare
treatments by providers not recognised by us for benefit purposes
services that took place two years or more before the date you lodge the claim
telephone and email consultations or letters of advice by providers
pharmacy/vaccinations where the fee is less than the PBS amount or is not TGA-approved
treatment by a provider who is a family member, including (but not restricted to) treatment by yourself or your partner, parent, sibling, child, or other insured person on the policy
midwife services at a home birth
vitamins and supplements.
Restrictions may apply for multiple treatments on the same day.
