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Why Five Star Extras cover? With our Extras cover you’ll get great benefits on a whole range of healthcare services and treatments not covered by your hospital cover or by Medicare. As well as being able to claim your regular dental check-up, we provide benefits for prescription glasses and contact lenses, physiotherapy and remedial massage to name a few. For a full list of services covered, and benefits paid, refer to the benefits table below.

 

Effective 1 April 2017

Our most comprehensive extras cover. This level of cover includes Dental and offers the highest  benefits and yearly limits of our extras and dental covers.

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
ORTHOPTIC (EYE THERAPY) (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 $25
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 36 months
Blood Glucose Monitor $260
Blood Pressure Monitor $200
TENS Machine $200
Nebuliser $200
Constant Air Pressure Monitor (CPAP) $520
Limit per person every 60 months
Hearing Aid $1,000
(12 month waiting period)
Braces/Splints 85% up to $600 every 36 months
CAM Boot 85% up to $600 every 36 months
Artificial Limbs & Prosthesis 85% up to $600 every 24 months
Wigs** 85% up to $300 every 24 months
Crutches/Walking Frame 85% up to $50 every 24 months
Compression Garments** 85% up to $300 every 24 months
**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) $360
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 $360
2nd calendar year of membership $480
3rd calendar year of membership $540
4th calendar year of membership $600
5th calendar year of membership $660
6th calendar year of membership $720
ORTHODONTICS (24 month waiting period)
Sublimit per person per calendar year $720
Lifetime limit per person $2,000

 

Benefit Examples
Items Waiting Periods Benefits Paid
General Dental Services
011 - Comprehensive oral examination 2 months $56.30
012 – Periodic oral examination $46.80
114 – Removal of calculus (first visit) $95.90
022 – Bitewing xray – first exposure $39.65
022 - Subsequent exposures (same day) $32.60
513 – Metallic restoration – three surfaces - direct $138.60
311 – Extraction – removal of tooth or part(s) thereof $118.65
323 – Surgical Extraction $221.00
Major Dental
Orthodontics
821 – Active removable appliance – per arch 24 months 50% with max. benefit of $462.90
831 – Full banding – per arch 50% with max. benefit of $396.75
Inlay, Onlay, Crown & Bridge
556 – Veneer – indirect 2 months 75% with max. benefit of $720.00
615 – Full Crown – veneered - indirect 50% with max. benefit of $720.00
Dentures
719 – Complete set of dentures 12 months $1,200.00
Inlay/onlay, crown and bridge and orthodontics are subject to the general and major dental calendar year limits.
Click here for our orthodontics fact sheet.

 

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Why Ancillary Plus cover? With our Ancillary Plus cover you’ll get great benefits on a whole range of healthcare services and treatments not covered by your hospital cover or by Medicare. We provide benefits for prescription glasses and contact lenses, physiotherapy and remedial massage to name a few. For a full list of services covered, and benefits paid, refer to the benefits table below.

 

Effective 1 April 2017

Our mid-range extras cover. Includes benefits for Natural Therapies and Clinical Psychology. Can be combined with Dental for a more rounded extras cover.

SERVICE TYPE BENEFITS
PHYSIOTHERAPY/EXERCISE PHYSIOLOGY/OCCUPATIONAL THERAPY (2 month waiting period )
Limit per calendar year $540 per person
$1080 per family
Initial Consultation $36
Subsequent Consultation $32
Group Therapy - sub limits apply $9
Group Therapy Sub Limit - Physiotherapy & Exercise Physiology $90
PODIATRY (2 month waiting period )
Limit per calendar year $540 per person
$1080 per family
Initial Consultation $36
Subsequent Consultation $32
Foot Orthotics ( 12 month waiting period ) As per fund benefit schedule
DIETICIAN (2 month waiting period )
Limit per calendar year $540 per person
$1080 per family
Initial Consultation $36
Subsequent Consultation $32
SPEECH THERAPY (2 month waiting period )
Limit per calendar year $540 per person
$1080 per family
Initial Consultation $36
Subsequent Consultation $32
ORTHOPTIC (EYE THERAPY) (2 month waiting period )
Limit per calendar year $500 per person
$1000 per family
Initial Consultation $29
Subsequent Consultation $27
NATUROPATHY/REMEDIAL MASSAGE/ACUPUNCTURE/MYOTHERAPY (2 month waiting period )
Limit per calendar year $500 per person
$1,000 per family
Initial Consultation $29
Subsequent Consultation $27
CHIROPRACTIC/OSTEOPATHIC (2 month waiting period )
Limit per calendar year $540 per person
$1080 per family
CHIROPRATIC (Combined with Osteopathic yearly limit)
Initial Consultation $29
Subsequent Consultation $27
OSTEOPATHIC (Combined with Chiropractic yearly limit)
Initial Consultation $36
Subsequent Consultation $32
DISTRICT VISITING NURSE (Excluding Midwifery Services) (2 month waiting period )
Limit per calendar year $500 per person
$1000 per family
Per Visit $12
CLINICAL PSYCHOLOGY (2 month waiting period )
Limit per calendar year $540 per person
$1080 per family
Initial Consultation $45
Subsequent Consultation $40
Group Therapy $8
AMBULANCE (2 month waiting period )
Limit per calendar year Equal to benefit
Family Refund $80
Single Refund $40
GLASSES (12 month waiting period )
Limit per person per calendar year $220
Frames/Lenses/Contact Lenses $220
HEALTH AIDS/APPLIANCES
Limit per calendar year $1000 per person
$2000 per family
(36 month waiting period)
Limit per person every 36 months
Blood Glucose Monitor $200
Blood Pressure Monitor $150
TENS Machine $150
Nebuliser $150
Constant Air Pressure Monitor (CPAP) $400
Limit per person every 60 months
Hearing Aid $700
(12 month waiting period)
Braces/Splints 75% up to $500 every 36 months
CAM Boot 75% up to $500 every 36 months
Artificial Limbs & Prosthesis 75% up to $500 every 24 months
Wigs** 75% up to $250 every 24 months
Crutches/Walking Frame 75% up to $35 every 24 months
Compression Garments** 75% up to $250 every 24 months
**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.

 

A

Why Ancillary cover? With our Basic Ancillary cover you’ll get great benefits on a whole range of healthcare services and treatments not covered by your hospital cover or by Medicare. We provide benefits for prescription glasses and contact lenses as well as physiotherapy  to name a few. For a full list of services covered, and benefits paid, refer to the benefits table below.

 

Effective 1 April 2017

Our basic extras cover. Offers lower benefits and limits at a lower cost. Still covers a great range  of services that our members use. Can be combined with Dental or taken on its own.

SERVICE TYPE BENEFITS
PHYSIOTHERAPY/EXERCISE PHYSIOLOGY/OCCUPATIONAL THERAPY (2 month waiting period )
Limit per calendar year $390 per person
$780 per family
Initial Consultation $27
Subsequent Consultation $24
Group Therapy - sub limits apply $8
Group Therapy Sub Limit - Physiotherapy & Exercise Physiology $80
PODIATRY (2 month waiting period )
Limit per calendar year $390 per person
$780 per family
Initial Consultation $27
Subsequent Consultation $24
Foot Orthotics ( 12 month waiting period ) As per fund benefit schedule
DIETICIAN (2 month waiting period )
Limit per calendar year $390 per person
$780 per family
Initial Consultation $27
Subsequent Consultation $24
SPEECH THERAPY (2 month waiting period )
Limit per calendar year $390 per person
$780 per family
Initial Consultation $27
Subsequent Consultation $24
ORTHOPTIC (EYE THERAPY) (2 month waiting period )
Limit per calendar year $390 per person
$780 per family
Initial Consultation $27
Subsequent Consultation $24
CHIROPRACTIC/OSTEOPATHIC (2 month waiting period )
Limit per calendar year $390 per person
$780 per family
CHIROPRATIC (Combined with Osteopathic yearly limit)
Initial Consultation $22
Subsequent Consultation $21
OSTEOPATHIC (Combined with Chiropractic yearly limit)
Initial Consultation $27
Subsequent Consultation $24
DISTRICT VISITING NURSE (Excluding Midwifery Services) (2 month waiting period )
Limit per calendar year $350 per person
$700 per family
Per Visit $12
AMBULANCE (2 month waiting period )
Limit per calendar year Equal to benefit
Family Refund $70
Single Refund $35
GLASSES (12 month waiting period )
Limit per person per calendar year $165
Frames/Lenses/Contact Lenses $165
HEALTH AIDS/APPLIANCES
Limit per calendar year $600 per person
$1200 per family
(36 month waiting period)
Limit per person every 36 months
Blood Glucose Monitor $150
Blood Pressure Monitor $125
TENS Machine $125
Nebuliser $125
Constant Air Pressure Monitor (CPAP) $230
Limit per person every 60 months
Hearing Aid $450
(12 month waiting period)
Braces/Splints 65% up to $300 every 36 months
CAM Boot 65% up to $300 every 36 months
Artificial Limbs & Prosthesis 65% up to $300 every 24 months
Wigs** 65% up to $150 every 24 months
Crutches/Walking Frame 65% up to $25 every 24 months
Compression Garments** 65% up to $150 every 24 months
**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.

 

D

Why Dental Cover? We have agreements with most local dentists to limit your out-of-pocket expenses. Our Gap Free preventative Dental pays 100% of the fee when you see a Super Dental provider and up to the same maximum benefit amount for non agreement dentists.

 

Effective 1 April 2017

Our mid-range Dental cover. Can be taken on its own or in combination with the Basic Ancillary or Ancillary Plus. Includes Gap Free Preventative Dental.

Mildura Health Fund has set benefits for individual dental services. Some services have claiming limitations as per the Australian Dental Association schedule. These limitations can vary depending on service provided and can mean that in some cases benefits are not payable. If you are planning extensive treatment, ask your dentist for the item numbers and costs, and then contact us for a quote. The maximum benefit allowed for any service listed in the Mildura Health Fund Dental Benefit Schedule is the benefit prescribed. Benefits are only paid for services rendered by a registered dentist in private practice. Benefits are not payable in respect of any cosmetic dental treatment.
No Fund benefit will be payable for dental treatment that is subject to reimbursement by Medicare.


Benefit Examples
Items Waiting Periods Benefits Paid
General Dental Services
011 - Comprehensive oral examination 2 months $56.30
012 – Periodic oral examination $46.80
114 – Removal of calculus (first visit) $95.90
022 – Bitewing xray – first exposure $39.65
022 - Subsequent exposures (same day) $32.60
513 – Metallic restoration – three surfaces - direct $114.25
311 – Extraction – removal of tooth or part(s) thereof $97.80
323 – Surgical Extraction $182.20
Major Dental
821 – Active removable appliance – per arch 24 months 50% with max. benefit of $381.65
831 – Full banding – per arch 50% with max. benefit of $327.10
Inlay, Onlay, Crown & Bridge
556 – Veneer – indirect 2 months 75% with max. benefit of $600.00
615 – Full Crown – veneered - indirect 50% with max. benefit of $600.00
Dentures
719 – Complete set of dentures 12 months $1,000.00
GENERAL AND MAJOR DENTAL (2 month waiting period)
Maximum benefit payable per person in first membership year (once 2 months waiting period completed) $300
Maximum benefit payable per person per calendar year once first membership year completed $1,000
Percentage benefit of fees as per Fund Dental Schedule, unless otherwise stated 75%
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 $300
2nd calendar year of membership $400
3rd calendar year of membership $450
4th calendar year of membership $500
5th calendar year of membership $550
6th calendar year of membership $600
ORTHODONTICS (24 month waiting period)
Sublimit per person per calendar year $600
Lifetime limit per person $1,500
Inlay/onlay, crown and bridge and orthodontics are subject to the general and major dental calendar year limits.
Our orthodontics fact sheet can be downloaded here.

 

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