Premium Extras

Our Premium Extras cover is our top extras cover and gives you benefits for a comprehensive range of therapies like dental, optical, physiotherapy and chiropractic. Premium Extras offers high benefits and generous annual limits per service (up to your limits) to keep your out-of-pocket expenses to a minimum.

All limits listed below are per person, per Membership year (excluding lifetime limit for orthodontics, which is the total amount claimable in your lifetime).

After five years of Membership, your overall benefit limits for both Dental and Therapies increases by $50 per year, up to $1,650 per person per Membership year.

What you're covered for

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General & major dental

$1,400 per person
Services covered Sub-limit per person per Membership year
Diagnostic dental
$600

2 month waiting period applies

Includes services like examinations, consultations and x-rays.

Example benefits paid
Periodic oral exam $50
X-rays $32
Preventive dental
$800

2 month waiting period applies

Includes cleaning and scaling, fluoride treatment and mouth guards.

Example benefits paid
Scale and clean $79
Fluoride treatment $22
Mouth guard $150
Fillings
$800

2 month waiting period applies

Restorative dental treatments including composite and amalgam fillings.

Example benefits paid
One surface composite filling $90

 

General services
$500

Includes services such as occlusal splints.

2 month waiting period applies

Example benefits paid
Occlusal splits $300
Extractions
$700

2 month waiting period applies

Simple extractions

Teeth removal services. Simple extractions include those completed in a standard dental appointment.

Example benefits paid
Simple tooth extraction $105

Surgical extractions

12 month waiting period applies

Surgical extractions include wisdom teeth extraction, removal of impacted teeth. Benefits paid on dental item numbers only unless hospital cover is held and all waits have been served for any in-patient services.

Example benefits paid
Surgical tooth extractions $180

A $700 combined sub-limit applies to surgical and simple extractions.

Crowns and bridges
$800

12 month waiting period applies

Example benefits paid
Full veneered crown $800

Sub-limit increases to $1,500 per year after 2 years of membership. Item benefits however remain the same.

Root canal treatment
$600

12 month waiting period appliesEndodontic services such as root canals and root fillings.

Example benefits paid
Root canal obturation $170
Dentures
$850

12 month waiting period applies

Prosthodontic services like plates and dentures.

Example benefits paid
Full upper and lower denture $850
Specialised gum treatments
$500

12 month waiting period applies

Periodontics, such as specialised gum treatments

Example benefits paid
Up to sub-limit (individual item benefits apply) $500
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Braces & orthodontics

$3,000 lifetime limit per person
Services covered Sub-limit per person per Membership year
Braces & orthodontic services
Lifetime limit $3,000

12 month waiting period applies

Braces and orthodontic services.

Example benefits paid
Orthodontic services 85% of cost up to benefit limit

Benefits are paid at 85% of cost up to eligible benefit limit based on years of Membership on Premium Extras cover.

Benefit limits start at $1,000 and increase to $2,000 after two years' Membership on Premium Extras cover, and to $3,000 after three years' Membership on Premium Extras cover, up to a lifetime limit of $3,000.

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Optical

$285 per person
Services covered Sub-limit per person per Membership year
Glasses and contact lenses
$285

2 month waiting period applies

Glasses including frames, single vision lenses and progressive lenses, contact lenses, prescription sunglasses etc.

Example benefits paid
Optical items or services Up to $285

Through our Premier Provider Network, you can take advantage of discounts at preferred providers across Australia.

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Therapies

$1,400 per person
Services covered Sub-limit per person per Membership year
Acupuncture

2 month waiting period applies

Example benefits paid
Initial and subsequent consultation $35

Benefits are payable for services rendered by Australian Regional Health Group Limited approved providers registered with Queensland Country Health Fund as well as Bowen therapists that are registered with the Bowen Association of Australia (BAA) or Bowen Therapists Federation of Australian (BTFA).

Audiology

2 month waiting period applies

Example benefits paid
Consultation $50
Report $60
Chiropractic
$700 (combined)^

2 month waiting period applies

Example benefits paid
Chiropractic initial visit $55
Chiropractic subsequent visit $35
X-rays (not for reading of X-rays) $60

A $700 combined limit applies to chiropractic, remedial massage/Bowen therapy/myotherapy and osteopathic services for Premium Extras.

Benefits are payable for services rendered by Australian Regional Health Group Limited approved providers registered with Queensland Country Health Fund as well as Bowen therapists that are registered with the Bowen Association of Australia (BAA) or Bowen Therapists Federation of Australian (BTFA).

Dietician

2 month waiting period applies

Example benefits paid
Initial consultation $75
Subsequent consultation $40
Exercise physiology
$700 (combined)*

2 month waiting period applies

Example benefits paid
Initial consultation $50
Subsequent consultation $35
Monthly program fee $35
Group therapy $10

A $150 combined sub-limit applies for group therapy services provided under physiotherapy and/or exercise physiology.

* A $700 combined limit applies to physiotherapy and exercise physiology services under Premium Extras cover.

There are specific requirements to claim for exercise physiology. Please contact the health fund for details.

Foot orthoses and orthopaedic shoes
$150

2 month waiting period applies

Example benefits paid
85% of cost up to sub-limit for orthoses and custom made footwear  
Naturopathy/homeopathy

2 month waiting period applies

Example benefits paid
Initial and subsequent consultation $35

Benefits are payable for services rendered by Australian Regional Health Group approved providers registered with Queensland Country Health Fund.

Occupational therapy

2 month waiting period applies

Example benefits paid
Initial consultation $80
Subsequent consultation $40
Orthoptic therapy

2 month waiting period applies

Example benefits paid
Initial and subsequent consultation $60
Osteopathy
$700 (combined)^

2 month waiting period applies

Example benefits paid
Initial consultation $35
Subsequent consultation $35

^ A $700 combined limit applies to chiropractic, remedial massage, Bowen therapy, myotherapy and osteopathic services for Premium Extras.

Physiotherapy
$700 (combined)*

2 month waiting period applies

Example benefits paid
Inital consultation $55
Subsequent consultation $40
Group therapy $10

A $150 combined sub-limit for group therapy services provided under physiotherapy and/or exercise physiology.

* A $700 combined limit applies to physiotherapy and exercise physiology services under Premium Extras cover.

Podiatry
$600

2 month waiting period applies

Example benefits paid
Initial and subsequent consultation $40
Approved appliances (orthotics) 85% of cost up to sub-limit
Minor procedures 75% of cost up to sub-limit
Psychology

2 month waiting period applies

Example benefits paid
Initial and subsequent consultation $80
Report $80
Group therapy $80
Remedial massage, Bowen therapy, myotherapy
$700 (combined)^

2 month waiting period applies

Example benefits paid
Initial and subsequent consultation $35

For services rendered by Australian Regional Health Group approved providers registered with Queensland Country Health Fund as well as Bowen Therapists that are registered with the Bowen Association of Australia (BAA) or Bowen Therapists Federation of Australia.

^ A $700 combined limit applies to chiropractic, remedial massage, Bowen therapy, myotherapy and osteopathic services for Premium Extras.

Speech therapy

2 month waiting period applies

Example benefits paid
Initial consultation $70
Subsequent consultation $35
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Other services
Services covered Sub-limit per person per Membership year
Childbirth education
$60

12 month waiting period applies

Example benefits paid
Education session $60
Healthy living
$150 per person

2 month waiting period applies

As well as helping you to get well, we want to help you stay well. Our Healthy Living benefit helps you living a healthy lifestyle through:

  • Participate in your choice of weight management programs
  • Participate in quit smoking programs
  • Participate in other approved health management programs* including gym memberships, personal training programs and yoga
  • Have your skin checked for skin cancers through mole mapping Consultation fees for diabetes education
  • Consultation fees for metabolic dieticians and nutritionists when providing assistance with weight management
  • Bowel screening tests and bone density tests (no doctor’s referral required
  • PSA test (one per year) – we cover a second yearly test not covered by Medicare.
Example benefits paid
Healthy living benefits Up to $150

*To comply with private health insurance legislation, you must have been referred by your health care professional to participate in a health management program to address or improve a specific medical condition. A Health Management Program Benefit Approval Form (available on our website) must accompany a claim for these benefits.

Pharmaceutical
$500

2 month waiting period applies

The Pharmaceutical Benefits Scheme (PBS) is a national pharmaceutical scheme funded by the Federal Government where patients contribute to the cost of prescribed drugs.

We’ll pay benefits as outlined in the extras table below, up to the individual script benefit limit for your cover. The benefit amount per script is calculated by deducting the PBS General Patient Contribution amount from the purchase price. This is conditional on the pharmaceutical prescription being listed in the MIMs Schedule as S4 or S8 and being dispensed in quantities in accordance with this schedule.

We also pay for compound pharmacy scripts, as long as one of the ingredients meets these criteria. The PBS General Patient Contribution amount is updated by the Government and changes every year on 1 January.

Queensland Country doesn’t cover pharmaceutical prescriptions covered by the PBS or for contraceptives and items normally available without prescriptions.

As at 1 January 2017, the PBS contribution is set at $38.80.

It’s important to note that a doctor’s letter may be required for some pharmacy items.

Example benefits paid
Pharmaceuticals Up to $70
School accidents
$750

2 month waiting period applies

Example benefits paid
100% of cost up to sub-limit