Extras

ServiceDescriptionBenefit ppAnnual limit pp

Ambulance

Pensioners must claim the pensioner discount first

Transport costs

(Please refer to page 30 of the Products and Benefits Guide for further clarification)

100%

Unlimited

Dental

This is not a comprehensive list of our dental benefits, please see the Dental Schedule insert inside.

Periodic examination

Plaque removal

Fluoride treatment

Tooth extraction Crowns & bridges

Fillings

Periodontics

Root canal treatment

Implants

Dentures

Orthodontics

80% up to $100

80% up to $100

80% up to $100

80% up to $120

Up to 80% of cost

Up to 80% of cost

Up to 80% of cost

Up to 80% of cost

Nil

Nil

Nil

$700

($400 sub limit for all

major dental)

$400 sub limit

$400 sub limit

$400 sub limit

$400 sub limit

Nil

Nil

Nil

Optical

Must be accompanied by a relevant sight correction prescription.

Single lens

Lenses

Frames

Repairs

Contact lenses

Contact lens solution

80% of total cost

$200

Pharmacy

Available only on prescription

Prescriptions related to a medical condition costing over the Pharmaceutical Benefits Scheme (PBS) limit ($38.80 as at 1/01/2017)

Up to $50 per script after deducting the PBS amount

$250

Physiotherapy/Hydrotherapy

Chiropractic/Osteopathy

Registered practitioner visit

Up to $25

$300 combined

Remedial Massage/Naturopathy/

Acupuncture

Registered practitioner visit

Up to $20

$100 combined

*In order for benefits to be paid on general treatments, the health practitioner must be appropriately qualified and registered with their relevant association. To confirm exactly what benefits are payable on any particular treatment, contact ACA Health with the specific item number or description of the service.

**Annual limits do not rollover to the next calendar year. Benefits are paid according to the limit of the year in which the services are provided/purchased.

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Waiting periods

  • Optical – 4 months
  • Dental – 9 months
  • All other services – 2 months

On joining general treatments cover for the first time, waiting periods must be served before benefits will be paid. If you have upgraded your general treatments cover, waiting periods will apply before the higher benefits will be paid.

What’s not covered?

  • Services not listed above (including orthodontic treatment)
  • Services while a membership is in arrears
  • Services incurred before waiting periods are served
  • Services where there is an entitlement under compensation insurance
  • Services claimed over 2 years after the service date
  • Products or services purchased in or from countries other than Australia
  • No special assistance
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