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What does Optical Health Insurance cover?


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Optical health insurance to cover glasses, contact lenses and laser eye surgery is typically included in Extras cover and not in Hospital cover. This is because not everyone will use these products in their lifetime, while some will use them frequently.

What does Extras cover include?

Extras cover is an additional group of products offered by private health funds to cater for non-urgent health needs, personal wellbeing and other health issues. It can include cover for a variety of products and services including optical health insurance, dental care, orthodontics, health management programs, remedial massage, natural therapies, psychology and much more.

Extras cover is usually grouped together and not sold on an individual service basis, e.g. if you want health insurance that covers glasses you’ll probably also have to purchase cover for other services like dental, physiotherapy and natural therapies as part of the policy. Some funds do offer packages where you can select the Extras services you need but prices will vary.

Does every fund offer optical cover?

Optical health insurance, including cover for glasses and contact lenses is a common product for private health insurance companies and most will offer it as part of an Extras package. Some may also offer partial cover for laser eye surgery. It does vary from fund to fund so compare before making a choice.

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Can I buy glasses from anywhere and still get a refund?

Funds will pay benefits for prescription glasses and/or contact lenses provided by most registered optical dispensers and eyewear retailers. With the rise of online optical retailers, private health funds may also have a list of online retailers where members can buy optical products and still receive a full or partial refund as part of their optical health insurance covered under an Extras policy. This will vary from fund to fund so it’s best to compare and check the eyewear providers range to ensure you can find a suitable product as part of your contact lens or glasses health insurance.

My vision is 20-20, are sunglasses included in optical cover?

Prescription sunglasses will generally be covered for a partial or full rebate as part of your health insurance policy, however, non-prescription sunglasses won’t be covered. It’s best to compare funds before you make a choice.

Does the Medicare Levy Surcharge apply to optical cover?

The Medicare Levy Surcharge is only applied to taxpayers who do not have eligible private hospital insurance AND earn above $90,000 or $180,000 combined income for families and couples. It does not apply to Extras cover, including glasses health insurance.

Does Lifetime Health Cover apply to optical cover?

The government’s Lifetime Health Cover initiative only applies to Hospital cover and not to Extras cover. Furthermore, it only applies if you are over 31 years of age and have not maintained Hospital cover through a private health fund from 1 July following your 31st birthday.

Remember, it’s best to choose optical health insurance to suit your needs and your budget. Extras cover and rebates for glasses and contact lenses can vary significantly between funds and the details can be confusing.

Contact Choosewell on 1300 421 154 for more information about optical health insurance, glasses health insurance and laser eye surgery health insurance. We can help you find the best arrangement for you and your family’s needs.

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