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No-gap optical

Here's how to get no-gap optical.

Richard Laycock
Richard Laycock

Updated

Fact checked

Other than eye exams and checkups with an optometrist, which can often be bulk-billed, optical services are not covered by Medicare.

Compare optical extras with no gap

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 physio.

FundPolicyIncluded treatmentsLimitPriceApply
HCF Health Insurance logoStarter Extras
  • Spectacle frames
  • Spectacle lenses
  • Contact lenses
$100.00$16.25Go to Site
AAMI Health Insurance logoStarter Extras
  • Prescription lenses
  • Contact lenses
$150.0021.04Go to Site
Suncorp Health Insurance logoStarter Extras
  • Prescription lenses
  • Contact lenses
$150.0021.04Go to Site
NIB Health Insurance logoCore extras
  • Prescription glasses
  • Contact lenses
$250.00$31.19Go to Site
Qantas health insurance logoBasic Extras
  • Prescription glasses
  • Contact lenses
$250.00$31.27Go to Site
AHM Health Insurance logoblack 60
  • With this cover you get 100% back on optical up to annual limits to spend on included services, such as the cost of glasses, frames, lenses, repairs, and contact lenses.
$200.00$34.50Go to Site
Medibank health insurance logoEssential Extras 75
  • Prescription glasses
  • Contact lenses
$200.00$39.00Go to Site
CUA health insurance logo60% Extras
  • Prescription lenses (includes frames when invoiced together)
  • Contact lenses
$200.00$42.15
Health.com.au health insurance logoExtras 50
  • Prescription lenses
  • Contact lenses
$200.00$50.68Go to Site

*Quotes are based on single individual with less than $90,000 income and living in Sydney.

Compare policies that offer optical

If you're only looking for optical cover, search for extras then on your results page select 'refine search' and tick optical.

Optical services and health insurance

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.

What is the medical gap and how do I avoid it?

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.

Which health funds have a no-gap optical scheme?

Here are Finder's partner health funds that offer a no-gap optical option:

FundWhat’s covered?More info
AHM health insuranceahm offers 100% back up to your annual limit on the cost of prescription glasses, frames, lenses, repairs, and contact lenses.More info
HCF health insuranceHCF 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.More info
HIF health insuranceYou can claim 100% of your annual limit on prescription glasses, contact lenses or sunglasses from any optical provider in Australia with HIF.More info
nib health insuranceThrough 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
Transport Health insuranceTransport 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).More info

Picture: Shutterstock

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