No-gap optical is an attractive benefit offered by some extras health insurance policies. It means you don't have to pay anything towards your new glasses, as long as they don't cost more than your annual limit.
If you have a $200 annual limit, and your new specs also happen to cost $200, you can walk away with a fresh prescription - for free!
Not all health insurers offer no-gap optical, but we've rounded up a few with limits ranging from $100-$250 so that you can compare policies at a glance.
Below are a few Finder partners that cover Optical in their extras policies. We've displayed the yearly limit, and they will have either a 2 or 6 month waiting period. They also include other benefits such as dental or physiotherapy. All prices are based on a single individual with less than $97,000 income and living in Sydney.
Each month we analyse over 10,000 extras insurance products and rate each one on price and features. What we end up with is a nice round number out of 10 that helps you compare extras cover a bit faster.
We want to compare apples to apples, not apples to apple pie. It doesn't make sense to compare a top extras policy with coverage for hearing aids and braces against a policy designed only for dental. So we've separated all the extras policies on the market into pools and categories. Once in their pools and categories, each product gets a price score and a features score, which are then combined to give the Final Score.
Read the full Finder Score methodology
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Extras cover is available in several levels (basic, medium and comprehensive) and generally covers ancillary services such as optical, dental and physio up to set annual benefit limits.
If a doctor charges a higher fee than the Medicare Benefit Schedule (MBS) fee for a service, the medical gap is the difference between the MBS fee and the doctor’s fee. This amount will have to be paid either by your health fund or by you.
In the case of optical services that are not listed on the MBS, the medical gap is the gap between what an optometrist charges for lenses and frames and what your private health extras cover will pay towards them.
To avoid having to pay any medical gap, you need to be with a health fund that has a no-gap scheme. A no-gap optical scheme is one where a health fund agrees to cover the medical gap if members go to a preferred optometrist or an optical dispenser with which the health fund has an arrangement. These practices charge capped prices that have been agreed upon with the health fund for a select range of lenses and frames.
Here are Finder's partner health funds that offer a no-gap optical option:
| Fund | What's covered? | More info |
|---|---|---|
 | ahm offers 100% back up to your annual limit on the cost of prescription glasses, frames, lenses, repairs, and contact lenses. | Get quote |
 | For prescription glasses, contact lenses or repairs supplied by an optometrist in private practice. Excludes non-prescription sunglasses and contact lenses, and optical consultations. | More info |
 | 100% Optical benefits on prescription lenses and contact lenses. | More info |
 | Includes prescription glasses, prescription sunglasses and prescription contact lenses. Doesn't include non-prescription sunglasses, repairs or frames purchased without prescription lenses or ophthalmology appointments. | Get quote |
 | 100% Optical benefits on frames, single vision lenses. Frames, bi-focal or multi-focal lenses and contact lenses. | Get quote |
 | HCF offers a range of fully covered services through HCF Eyecare Centres, Dresden, or Specsavers on a range of standardd prescription glasses and one free digital retinal imaging with your eye test per calendar year. | Get quote |
 | You can claim 100% of your annual limit on prescription glasses, contact lenses or sunglasses from any optical provider in Australia with HIF. | More info |
 | 100% back on eligible items up to annual limits at all recognised providers. Includes prescription glasses and contact lenses. | Get quote |
 | Through its nib Eye Care Centres, nib offers members 100% back on three ranges of complete single vision prescription glasses and selected contact lenses (depending on your level of cover) with free delivery anywhere in Australia. | More info |
 | Optical benefits (glasses & contacts) are paid when glasses or contacts are prescribed by a registered optometrist. They have to be for sight correction and we don't pay on non-prescription sunglasses. | More info |
 | Transport Health offers members 100% back on a selection of single vision, bifocal and multifocal glasses from several ranges at Specsavers (depending on your level of cover). |
Table last updated April 2021
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