SERVICE TYPE | BENEFITS |
PHYSIOTHERAPY/EXERCISE PHYSIOLOGY/OCCUPATIONAL THERAPY (2 month waiting period ) |
Limit per calendar year | $650 per person $1,300 per family |
Initial Consultation | $50 |
Subsequent Consultation | $45 |
Group Therapy - sub limits apply | $10 |
Group Therapy Sub Limit - Physiotherapy & Exercise Physiology | $100 |
PODIATRY (2 month waiting period ) |
Limit per calendar year | $650 per person $1,300 per family |
Initial Consultation | $42 |
Subsequent Consultation | $38 |
Foot Orthotics ( 12 month waiting period ) | As per fund benefit schedule |
DIETICIAN (2 month waiting period ) |
Limit per calendar year | $650 per person $1,300 per family |
Initial Consultation | $42 |
Subsequent Consultation | $38 |
SPEECH THERAPY (2 month waiting period ) |
Limit per calendar year | $650 per person $1,300 per family |
Initial Consultation | $50 |
Subsequent Consultation | $45 |
EYE THERAPY/HEARING TESTS (2 month waiting period ) |
Limit per calendar year | $650 per person $1,300 per family |
Initial Consultation | $42 |
Subsequent Consultation | $38 |
NATUROPATHY/REMEDIAL MASSAGE/ACUPUNCTURE/MYOTHERAPY (2 month waiting period ) |
Limit per calendar year | $600 per person $1,200 per family |
Initial Consultation | $36 |
Subsequent Consultation | $34 |
CHIROPRACTIC/OSTEOPATHIC (2 month waiting period ) |
Limit per calendar year | $600 per person $1,200 per family |
CHIROPRATIC (Combined with Osteopathic yearly limit) |
Initial Consultation | $36 |
Subsequent Consultation | $34 |
OSTEOPATHIC (Combined with Chiropractic yearly limit) |
Initial Consultation | $50 |
Subsequent Consultation | $45 |
DISTRICT VISITING NURSE (Excluding Midwifery Services) (2 month waiting period ) |
Limit per calendar year | $600 per person $1,200 per family |
Per Visit | $12 |
CLINICAL PSYCHOLOGY (2 month waiting period ) |
Limit per calendar year | $650 per person $1,300 per family |
Initial Consultation | $60 |
Subsequent Consultation | $50 |
Group Therapy | $10 |
AMBULANCE (2 month waiting period ) |
Limit per calendar year | Equal to benefit |
Family Refund | $90 |
Single Refund | $45 |
GLASSES (12 month waiting period ) |
Limit per person per calendar year | $250 |
Frames/ Lenses/ Contact Lenses | $250 |
PHARMACEUTICALS (2 month waiting period ) |
Limit per calendar year | $200 per person $400 per family |
Benefit per non PBS prescription | $30 |
Benefit payable for non PBS prescription after deducting co-payment. Amount equal to the current non-concessional PBS co-payment amount effective 1 January. |
HEALTH AIDS/APPLIANCES |
Limit per calendar year | $1200 per person $2400 per family |
(36 month waiting period) |
Limit per person every 3 years
|
Blood Glucose Monitor | $260 |
Blood Pressure Monitor | $200 |
TENS Machine | $200 |
Nebuliser | $200 |
Constant Air Pressure Monitor (CPAP) | $520 |
Limit per person every 5 years
|
Hearing Aid | $1,000 |
(12 month waiting period) |
Braces/Splints | 85% up to $600 claimable every 3 years
|
CAM Boot | 85% up to $600 claimable every 3 years
|
Artificial Limbs & Prosthesis | 85% up to $600 claimable every 2 years
|
Wigs** | 85% up to $300 claimable every 2 years
|
Crutches/Walking Frame | 85% up to $50 claimable every 2 years
|
Compression Garments** | 85% up to $300 claimable every 2 years
|
**Require an approval form before benefits payable. Mildura Health Fund benefit approval form is available from our office upon request or can be downloaded here. Health Aids & Appliances must be medically necessary and for the treatment of a specific condition. |
FIVE STAR HEALTH MANAGEMENT BENEFITS (6 month waiting period) |
Limit per calendar year | $150 per person $300 per family |
Benefit | 70% of cost |
Benefits for approved programs to manage or treat a specific health condition such as Pilates, Yoga, Mole Mapping, Bowel Cancer tests, Weight Management and Quit Smoking Programs. Please contact the Fund for details or see the detailed Five Star Health Management fact sheet here. |
GENERAL AND MAJOR DENTAL (2 month waiting period) |
Maximum benefit payable per person in first membership year (once 2 months waiting period completed) | $390 |
Maximum benefit payable per person per calendar year once first membership year completed | $1,200 |
Percentage benefit of fees as per Fund Dental Schedule, unless otherwise stated | 85% |
Preventative Dental | 100%* |
*100% of fee where service provided by a Super Dental provider. See the Preventative Dental section of our brochure for more information. |
INLAY/ONLAY, CROWN AND BRIDGE (2 month waiting period) |
Sublimit per person per calendar year (by membership year) |
1st calendar year of membership | $390 |
2nd calendar year of membership | $510 |
3rd calendar year of membership | $570 |
4th calendar year of membership | $630 |
5th calendar year of membership | $690 |
6th calendar year of membership | $750 |
ORTHODONTICS (24 month waiting period) |
Sublimit per person per calendar year | $800
|
Lifetime limit per person | $2,400 |