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Welcome to the seventh installment of ‘Navigating the Funding Maze‘. Today I hope to give alittle more insight into Health Insurance and somethings you may be able to claim on your policies. I hope that this will be useful information.
From what I can see after doing a trawl through a number of health insurance websites is that while they all have their differences (or product differentiation to get all marketing speak … ) but the thing that have in common is that all of the applicable benefits that might be of some use fit under extras. So depending on the extras package you have (if you have any) will depend on what you can claim. For today’s exercise I will compare extras benefits from 4 of the major health funds for Psychology, Speech Therapy and Occupational Therapy.
Please note the information below is not intended to be taken as insurance or financial advise and is accurate only at the time of orginal posting. The purpose of this is for information purposes only. This summary provides only a small selection of the applicable health insurance products on the market. I strongly recommend that you do the required research, read all of the applicable product disclosure statements to ensure that you have the most appropriate insurance for your specific needs.
Policies can also be different based on states. For the purpose of this comparison I have looked at the information for people from NSW
HCF
HCF has 3 levels of Extras cover: Super Multicover, Multicover & General Extraz Plus
Super Multicover Extras
Psychology Services
- Waiting Period – 6 months
- Maximum Benefit (per person) – $600
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – $75
- Other Conditions – Can only be accessed once the year’s Medicare entitlement is exhausted.
Speech Therapy Services
- Waiting Period – 6 months
- Maximum Benefit (per person) – $500
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – First Visit $60. Subsequent visit $40
Occupational Therapy Services
- Waiting Period – 6 months
- Maximum Benefit (per person) – $600
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – First Visit $62. Subsequent visit $40
Multicover Extras
Psychology Services
- Waiting Period – 6 months
- Maximum Benefit (per person) – $300
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – $75
- Other Conditions – Can only be accessed once the year’s Medicare entitlement is exhausted.
Speech Therapy Services
- Waiting Period – 6 months
- Maximum Benefit (per person) – $500 (combined with Audioology. Maximum of $200 on Audiology)
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – First Visit $60. Subsequent visit $40
Occupational Therapy Services
- Waiting Period – 6 months
- Maximum Benefit (per person) – $500
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – First Visit $62. Subsequent visit $40
General Extras Plus Extras
Psychology Services
- Not covered
Speech Therapy Services
- Waiting Period – 6 months
- Maximum Benefit (per person) – $500 (max. $200 combined for speech pathology and occupational therapy, and $200 for exercise physiology)
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – First Visit $40. Subsequent visit $30
Occupational Therapy Services
- Waiting Period – 6 months
- Maximum Benefit (per person) – $500 (max. $200 combined for speech pathology and occupational therapy, and $200 for exercise physiology)
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – First Visit $40. Subsequent visit $30
For more information check out the
Check the HCF website for more details
Medibank Private
HCF has 3 levels of Extras cover: Ultra Health Cover, Top Extras & Basic Extras
Ultra Health Cover
Psychology Service
- Waiting Period – 2 months
- Maximum Benefit (per person) – $600
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – Not specified
Speech Therapy Services
- Waiting Period – 2 months
- Maximum Benefit (per person) – $600
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – Not specified
Occupational Therapy Services
- Waiting Period – 2 months
- Maximum Benefit (per person) – $600
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – Not specified
Top Extras
Psychology Service
- Waiting Period – 2 months
- Maximum Benefit (per person)
- Top Extras 85 – $500
- Top Extras 70 – $400
- Top Extras 55 – $200
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – Not specified
Speech Therapy Services
- Waiting Period – 2 months
- Maximum Benefit (per person)
- Top Extras 85 – $500
- Top Extras 70 – $400
- Top Extras 55 – $200
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – Not specified
Occupational Therapy Services
- Waiting Period – 2 months
- Maximum Benefit (per person)
- Top Extras 85 – $500
- Top Extras 70 – $400
- Top Extras 55 – $200
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – Not specified
Basic Extras
Psychology Services
- Not covered
Speech Therapy Services
- Not covered
Occupational Therapy Services
- Not covered
Check the Medibank Private website for more details
MBF
MBF has 6 levels of Extras cover. For the purposes of todays review I will cover the Platinum Extras, Gold Extras and Silver Extras.
Platinum Extras
Psychology Service
- Waiting Period – 2 months (however if it was a preexisting condition it may be 12 months. I would recommend to have this confirmed)
- Maximum Benefit (per person) – $500
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – First Visit $44. Subsequent visit $44. Group Sessions $25
Speech Therapy Services
- Waiting Period – 2 months (however if it was a preexisting condition it may be 12 months. I would recommend to have this confirmed)
- Maximum Benefit (per person) – $500
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – First Visit $56. Subsequent visit $29. Group Sessions $11
Occupational Therapy Services
- Waiting Period – 2 months (however if it was a preexisting condition it may be 12 months. I would recommend to have this confirmed)
- Maximum Benefit (per person) – $500
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – First Visit $35. Subsequent visit $25. Group Sessions $12
Gold Extras
Psychology Service
- Waiting Period – 2 months (however if it was a preexisting condition it may be 12 months. I would recommend to have this confirmed)
- Maximum Benefit (per person) – $500
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – First Visit $37. Subsequent visit $37. Group Sessions $20
Speech Therapy Services
- Waiting Period – 2 months (however if it was a preexisting condition it may be 12 months. I would recommend to have this confirmed)
- Maximum Benefit (per person) – $500
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – First Visit $47. Subsequent visit $24. Group Sessions $10
Occupational Therapy Services
- Waiting Period – 2 months (however if it was a preexisting condition it may be 12 months. I would recommend to have this confirmed)
- Maximum Benefit (per person) – $500
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – First Visit $28. Subsequent visit $21. Group Sessions $10
Silver Extras
Psychology Service
- Waiting Period – 2 months (however if it was a preexisting condition it may be 12 months. I would recommend to have this confirmed)
- Maximum Benefit (per person) – $400
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – First Visit $27. Subsequent visit $27. Group Sessions $15
Speech Therapy Services
- Waiting Period – 2 months (however if it was a preexisting condition it may be 12 months. I would recommend to have this confirmed)
- Maximum Benefit (per person) – $400
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – First Visit $25. Subsequent visit $17. Group Sessions $9
Occupational Therapy Services
- Waiting Period – 2 months (however if it was a preexisting condition it may be 12 months. I would recommend to have this confirmed)
- Maximum Benefit (per person) – $400
- Maximum Benefit (per family) – No Additional family Limit
- Benefit per visit – First Visit $25. Subsequent visit $17. Group Sessions $9
Check the MBF website for more details
NIB
NIB has 9 levels of Extras cover. For the purposes of todays review I will cover the Top Cover and Family Plus. Many of NIB’s options do not include Psychology, Speech Therapy and Occupational Therapy. I would pay close attend to all of the options you consider with them to ensure you get what you need
Top Cover
Psychology Service
- Waiting Period – 2 months
- Maximum Benefit (per person) – $300
- Maximum Benefit (per family) – There are annual limits for total extras cover. Check the product disclosure statements to identify that limit appropriate for you.
- Benefit per visit – 75% of the cost back
- Other conditions – No benefits for tests, assessments or couple/group sessions or if a benefit has alredy been claimed through medicare.
Speech Therapy Services
- Waiting Period – 2 months
- Maximum Benefit (per person) – $400 (limited combined with together with podiatry, orthoptics (eye therapy), dietetics, home nursing, occupational therapy)
- Maximum Benefit (per family) – There are annual limits for total extras cover. Check the product disclosure statements to identify that limit appropriate for you.
- Benefit per visit – 75% of the cost back
Occupational Therapy Services
- Waiting Period – 2 months
- Maximum Benefit (per person) – $400 (limited combined with together with speech therapy podiatry, orthoptics (eye therapy), dietetics, home nursing)
- Maximum Benefit (per family) – There are annual limits for total extras cover. Check the product disclosure statements to identify that limit appropriate for you.
- Benefit per visit – 75% of the cost back
Family Plus
Psychology Service
- Waiting Period – 2 months
- Maximum Benefit (per person) – $200
- Maximum Benefit (per family) – There are annual limits for total extras cover. Check the product disclosure statements to identify that limit appropriate for you.
- Benefit per visit – 65% of the cost back
- Other conditions – No benefits for tests, assessments or couple/group sessions or if a benefit has alredy been claimed through medicare.
Speech Therapy Services
- Waiting Period – 2 months
- Maximum Benefit (per person) – $400 (limited combined with together with Natural therapies, Podiatry, Orthotics)
- Maximum Benefit (per family) – There are annual limits for total extras cover. Check the product disclosure statements to identify that limit appropriate for you.
- Benefit per visit – 75% of the cost back
Occupational Therapy Services
- Not covered
Check the NIB website for more detailsWhat have your experience been with claiming benefits for Autism therapies with your Health Insurance Fund? Do you have any lessons/scars?
Please feel free to add links to more relevant information you have found useful in the comments below.
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