Family Extras

Family Extras provides you with health insurance benefits for extra services not covered by Medicare and is open to singles, couples and families. Benefits include speech therapy, podiatry, and orthodontics, plus health improvement benefits. The table below shows the full range of benefits payable under Family Extras, effective 1 July 2009.

For more information, download the Family Extras policy. You can also call us on 134 246.

General Benefits

Therapies

Physiotherapy and osteopathy

 Initial consultation† $34
Subsequent consultation $26
Per class - Group hydrotherapy, pilates and antenatal exercises & rehabilitation* $13
Chiropractic Initial consultation† $34
Subsequent consultation $26
Financial year limits 0 – 9 years 10+ years
Per person per therapy $250 $300
Per family per therapy $625 $750
Combined $750 single
$1,875 family 		$900 single
$2,250 family
† 1 initial consultation per therapy per person per financial year
 * Benefits only paid where service is performed by an ahm registered physiotherapist 
Complementary and alternative therapies
Naturopathy, homeopathy, acupuncture, herbalism, remedial massage and exercise physiology $17
Financial year limits
Combined limit $300 per person $600 per family
Other therapies
Psychology and hypnotherapy
(provided by an ahm registered psychologist)		 Assessment or initial consultation† $70
Subsequent consultation $40
Group consultation $20
Speech therapy Initial consultation† $50
Subsequent consultation $26
Occupational therapy Initial consultation† $30
Subsequent consultation $26
Eye therapy (Orthoptics) Initial consultation† $25
Subsequent consultation $22
Podiatry Initial consultation† $25
Subsequent consultation $22
Casting $25
Podiatric surgery $150
Financial year limits 0 – 9 years 10+ years
Per person per therapy $250 $300
Per family per therapy $625 $750
Combined $750 single
$1,875 family 		$900 single
$2,250 family
† 1 initial consultation per person per therapy per financial year
Orthotics and orthopaedic shoes
Purchased from an ahm registered podiatrist or orthopaedic supplier only. Excludes benefits for sporthotics and formthotics. $150
Financial year limits
Combined limit $150 per person $300 per family
Optical
Frames, single lenses (pair), bi-focal (pair), multi-focal (pair), contact lenses
(payable for scripted sight correcting products only)		 $180
  $180
Repair to frames or lenses (payable for scripted sight correcting products only) $40
Financial year limits
Combined limit $180 per person $450 per family
Health improvement
Dietitian and nutritionist Initial consultation† $32
Subsequent consultation $25
Weight loss Per class (approved providers only) $8
Per course
(ahm approved providers only with medical evidence of a BMI of 26 or over for adult claims and an unhealthy BMI for children's claims)		 $80
Financial year limits - Dietitian, nutritionist and weight loss
Limit $250 per person
 $625 per family
† 1 initial consultation per therapy per person per financial year
More health improvement benefits

Quit smoking

Per course $80
Per course - Laser acupuncture therapy $80
Per item - Nicotine replacement therapy
(patches, gum, lozenges, inhalers) 		$40
Disease management association fees Per association - Asthma, diabetes, heart, arthritis, coeliac and Crohn's disease $40
Cancer Council UV products Per item - sunscreen, swimwear, hats and sunglasses
(does not include cosmetics, shade or accessory items. Your receipt must identify the item as Cancer Council approved)		 $40
Stress management Per course
(recognised psychologist or ahm approved provider)		 $80
Preventive tests Per test - Mammograms, skin cancer screenings, bowel cancer tests and scans and bone density tests
(where not claimable through Medicare)		 Up to $52
Health checks Per check# - Doctor health checks and Healthy Heart checks
(where not claimable through Medicare, an employer or another party)		 $40
Exercise classes Gym, yoga, pilates and exercise physiology Per class* $12
Per course* $120
Swimming lessons and training
(0-17 years of age by an Austswim® or Swim Australia accredited swim school with evidence of asthma, diabetes, an unhealthy BMI or a doctor's recommendation to undertake this activity due to their condition)		 Per lesson $8
Per course $80
Financial year limits
Limit $250 per person $625 per family
Combined limit for health improvement
  $500 per person $1,250 per family
# 1 per person per financial year
* When part of an ahm or a recognised health management program and by ahm approved provider. To be eligible for exercise program benefits, please have your GP or provider complete a health improvement approval form.
Disease prevention
ahm Health Risk Assessment
ahm Health Coaching Program		 100%
Financial year limits  Limit Combined 
ahm Health Risk Assessment 1 per 12 months No limit
ahm Health Coaching Program 1 per 6 months
Hearing aids
Per hearing aid $600
Repair $35
Cochlear speech processor replacement $600
Financial year limits
Combined limit $1,200 every 3 years per person No limit per family
Pharmacy
General items*, hormonal implants, contraceptives** (for medical reasons), preventive/travel vaccines Up to $50 each item above general patient PBS amount
Financial year limits 0 – 4 years 5 – 9 years 10+ years
Per person combined $350 $400 $450
Family limit $700 $800 $900
 * Excludes PBS scripts, over the counter or off the shelf medicines, vitamins and herbal medicines
** Sub limit of $150 per person and $300 per family
Maternity options
Per visit - Pre and post natal consultation and classes including lactation consultants $25
Per course - Birthing courses $120
Financial year limits

Limit per person per rolling year*
* A rolling year begins on the date a service was first provided with the limit applying to that 12 month period

$250
Travel and accommodation
Travel over 200 kms return trip 15 cents per/km
Per night - Accommodation $30
(For specialist medical appointments and outpatient procedures only)
Financial year limits
Combined limit $200 per person $400 per family
Medical gases
Per unit (such as oxygen) $80
Financial year limits    
Combined limit $1,000 per person No limit per family
Joint fluid replacement injections
Per injection (eg. Synvisc, OsteoArtz, Hyalgan) $320 per injection
Financial year limits
Combined limit $640 per rolling year* per person No limit per family
* A rolling year begins on the date a service was first provided with the limit applying to that 12 month period
Ambulance
Emergency only 100%
Financial year limits No limit

Dental Benefits

These are examples of the most common dental services we pay benefits for. There are more services covered by this policy than we can include here so make sure you call us before you have any treatment to confirm the benefits you’ll receive.

Routine
Diagnostic
Comprehensive examination item 011 $28.20*
Periodic examination item 012 $25.50*
Emergency examination item 013 $23.80**
X-ray (one film) item 022 $20.00
Preventive
Clean and polish item 111 $27.50#
Scale and clean item 114 $50.00#
Topical fluoride application item 121 $18.10**
Mouthguard – custom made item 151 $73.60**
Extractions
Non-surgical extraction item 311 $53.65
Surgical extraction item 324 $150.05
Direct Restorations
Metallic restoration of 1 surface item 511 $45.65
Metallic restoration of 3 surfaces item 513 $66.25
Adhesive filling of 1 surface (front) item 521 $48.65
Adhesive filling of 3 surfaces (front) item 523 $68.45
Adhesive filling of 1 surface (back) item 531 $51.00
Adhesive filling of 3 surfaces (back) item 533 $78.60
Financial year limits 0 – 9 years 10+ years
Per person combined $500 $600
Family limit per therapy $1,250 $1,500
*Combined limit of two per year  
**Two per year
#Combined limit of three per year
Complex
Periodontics
Root planing (per tooth) item 222 $8.00
Endodontics(Root canal therapy)
Preparation of one root canal item 415 $110.15
Financial year limits 1 – 4 years 5 – 9 years 10+ years
Per person combined $600 $700 $800
Family limit $1,500 $1,750 $2,000
Major
Indirect restorations
Tooth coloured filling 1 surface item 551 $186.20
Crowns/bridges/implants
Fully veneered crown item 615 $394.05
Dentures (one complete set per person each 3 years)
Full upper or lower item 711/712 $308.20
Financial year limits 1 – 4 years 5 – 9 years 10+ years
Per person combined $750 $900 $1,100
Family limit $1,750 $2,250 $2,750
Orthodontics
100% up to your yearly limit for specialist services
70% up to your yearly limit for GP services
Financial year limits 1 – 2 years 3 – 4 years 5+ years
Per person $600 $750 $900
Lifetime limit $1,800

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Please note: For definitions on the terms used above, please see Important Information.
This is important information about your policy. Please read this in conjunction with your policy document which you can download and save for future reference.