Your vision and being able to see is one of the five important senses. Which is why optometrists do a really good job in making sure regular Aussies can see! In Australia, your health insurance is meant to work with your Medicare optical benefits for eye care. It can help pay for things like prescription glasses and contact lenses.
Here we will detail a little bit more about optical extra health insurance comparison, why it’s important and also the difference between Medicare and private health insurance and how they both deal with optical. Then of course, you can do a private health insurance comparison to get the best optical extras cover for your needs (and the best news is, you can easily compare health insurance Australia through Billy Explores!
Medicare vs Private Health Insurance + Optical
Both Medicare and private health insurance cover optical. However, the level of care you receive is very different with Medicare vs private health insurance. Medicare you can have various items bulk-billed by an optometrist, and also have any eye surgery covered under the public hospital system (and normal wait times). Optical health insurance will allow you to have private hospital surgery and also additional services not covered by Medicare. Also, you can normally compare health care providers as well with optical extras private health insurance, and you normally won’t have this choice under Medicare.
What’s Covered Under Optical Private Health Insurance?
Hospital and extras policies can cover a wide range of eye treatments, both in and out of the hospital.
As a private patient, hospital cover can help pay for your eye care in the hospital, such as:
- Retinal detachment
- Eye sickness
- Conditions of the tear duct
- Eye injuries that are treated by doctors
- Cataract removal
- Macular degeneration
Extras coverage can help pay for eyewear like prescription glasses, contact lenses, and even prescription sunglasses. Extras benefits can also help pay for eye therapy to treat things like blurry vision, crossed eyes, lazy eyes, and double vision.
You can get back up to a certain amount per year for eye care. You could get new glasses every year if you wanted to, depending on how much you could spend. Also, your health fund may offer special deals like discounts and extra benefits to members through their own eye care centres or a partner eyewear store (e.g. OPSM, Specsavers and Laubman & Pank).
Does Optical Cover Change Based On How Many Extras You Have?
Yes, some extras policies don’t cover optical at all, while others do cover optical but may have limits, which again depend on your level of cover. Higher-end extras policies usually have more benefits, higher rebates, and higher limits on how much you can claim for optical services. On the other hand, if you have less coverage, you may have to pay more out of pocket.
Are There Any Waiting Periods With Optical Extras Health Insurance?
Your waiting period will depend on your health fund, what you’re claiming, and what kind of health insurance policy you have.
If you need hospital treatment or surgery for your eyes, you’ll usually have to wait two months or 12 months before you can use your hospital insurance.
If you want to use your extras policy’s optical benefits, you might have to wait anywhere from two to six months1 before you can get eye therapy or a new pair of glasses or contact lenses. As was already said, laser eye surgery has a longer waiting period, which varies by fund and policy.
Can You Get Optical Extras Health Cover Without Any Waiting Periods?
During a promotion, insurers may drop their two- and six-month waiting periods for extras coverage. This means that you usually won’t have to wait to use your optical benefits. You can take advantage of these deals, but don’t forget to read the policy brochure so you know what the policy covers.
Of course, the best way to identify if there’s any opportunity to find optical extras cover without waiting periods is to do a private health insurance comparison.
How Much Can I Get Back For My Glasses From My Extras Cover?
Depending on your policy, you may be able to get back some of the money you spent on glasses or contacts through your extras cover.
Some insurance companies will cover prescription lenses and frames up to a certain dollar amount (for example, $250) or will reimburse you for a certain percentage of the costs (for example, 60%, you’ll pay the other 40% out of pocket).
Is Eye Therapy Covered Under Extras Health Insurance?
Some extra health insurance policies can help pay for eye therapy done by a doctor who is known and trusted. Adding eye or vision therapy to your policy, however, may cost extra and be subject to waiting periods and limits.
Usually, you have to wait two months before you can use your extras cover to pay for eye therapy. However, this can vary by policy and health fund.
Also, you can usually only get reimbursed for eye therapy up to:
- A certain amount per visit, like $50 per visit.
- A limit per policy per year, such as $350 per year.
- A group limit (e.g. if eye, speech and occupational therapies are grouped together)
- A service limit (e.g. only covers one initial consultation per year)
Optical Extras Insurance Comparison
Now you know a little bit more about optical extras cover, and the difference between Medicare and private health insurance and how they treat optical. So, now the only thing left to do is compare health insurance, Australia! You can quickly and easily do a health insurance in Australia comparison through Billy Explores (including an extras health insurance comparison). So let’s start comparing health insurance, Australia! To get started, just click here.