Man getting eyes calibrated by optometrist

Optical health insurance

Did you know health insurance can pay towards everyday optical products like contact lenses? Compare policies and get covered

We all know that sight is one of our most important senses, so it’s vital that we take good care of our vision. Unfortunately, prescription glasses and contact lenses aren’t covered by Medicare, which is why it’s important to take out extras cover from a private health fund.

Private health insurance provides cover for an extensive range of optical services and treatments, so read on to find out how you can find the right health insurance policy for your optical needs.

Compare policies that cover optical services

Are glasses and contact lenses covered by health insurance?

Australian private health funds provide cover for a wide range of optical services and treatments through their extras cover policies. some of these include:

  • Prescription glasses and contact lenses.
  • Rebates on prescription sunglasses and prescription swimming goggles.
  • Eye check-ups.

If you want cover for major optical procedures, for example cataract or eye lens surgery, you’ll need to take out hospital cover from a private health fund. These services are typically only included in high-level hospital cover policies, which attract higher premiums than basic policies.

However, it’s important to remember that levels of cover vary between funds and that some services, for example laser eye surgery, only receive restricted cover. It’s essential to read the fine print associated with your policy to work out exactly what is and isn’t covered.

Optical health insurance is a common feature of the vast majority of extras cover policies available from Australian health funds. However, as always, make sure you read any information from your health fund closely to find out whether optical services and treatments are covered and to what level.

How are optical products covered?

You can use this table to get an idea of how Australian health funds cover optical services.

Health fundPolicies and annual benefit limits*Waiting periods
hif
    • Premium Options. $280 per person
  • Super Options. $260 per person 
  • Special Options. $140 per person 
  • Saver Options. $110 per person 
  • 2 months
Peoplecare
  • Premium Extras cover. $300 per person
  • High Extras cover. $250 per person
  • Mid Extras. $200 per person
  • Basic Extras. $150 per person
  • 6 months
health.com.au
  • High Extras, Middle Extras and Basic Extras . $200 per person
  • Simple Extras . $250 per person
  • Extras 50. $200 per person
  • 2 months
CBHS health fund
  • Restricted health fund 
  • Top Extras. $375 per person 
  • Intermediate Extras. $250 per person 
  • Essential Extras. $200 per person 
  • 6 months
ahm
  • Super Extras. $250 per person
  • Family Extras. $220 per person
  • Lifestyle Extras and Black 60. $200 per person, $400 per family
  • 6 months for Black 60
  • None for the rest
Australian Unity
  • Gold Extras, Silver Extras and Bronze Extras. $200 per person
  • Basic Extras. $150 per person
  • 6 months
GMHBA
  • Gold Extras Set Benefits. $250 per person
  • Silver Extras Set Benefits. $200 per person
  • Bronze Extras Set Benefits. $150 per person
  • 6 months
HCF
  • Platinum Extras. $250 per person
  • Gold Extras. $200 per person
  • Silver Plus Extras. $180 per person
  • Bronze Plus Extras. $100 per person 
  • 2 months
nib
  • Top Extras. $350 per person
  • Core Extras . $250 per person
  • 6 months
Transport Health
  • Top Extras. $300 per person
  • Healthy Choice Extras. $225 per person
  • 6 months

*The policies listed in this table are extras only. However, most can be combined with hospital cover.

Can you bulk bill eye tests?

Bulk billing is when your optometrist or optical health professional accepts the Medicare benefit as full payment for the service they provide, meaning no out-of-pocket expense for you.

  • If you’re under the age of 65, you are eligible to undergo a bulk billable eye test once every three years.
  • People aged 65 years or over are eligible for a bulk billable eye test every year.

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

Australian private health funds will pay benefits for prescription glasses and/or contact lenses purchased from the vast majority of registered optical dispensers and eyewear stores across the country. If you’re ever in doubt about whether a particular purchase will be covered, check with your health fund for confirmation.

However, if you prefer to do your shopping online, be warned that not all online optical retailers will be covered by your fund. With this in mind, check to see whether your health fund provides a list of online optical stores where you can buy the products you need and still access a full or partial refund.

Can I get cover for sunglasses?

If you need prescription sunglasses, these will be covered by your health fund in the vast majority of cases. Check with your health fund to confirm this before parting with any money.

However, non-prescription sunglasses are typically not included in your extras cover, but you may still be able to take advantage of discounted sunnies thanks to your health fund’s partnership with an eyewear retailer.

Can I get cover for laser eye surgery?

If you’re thinking of undergoing laser eye surgery so you can wave a permanent goodbye to prescription glasses and contact lenses, you should be aware that:

  • Procedures of this type are not covered by Medicare (unless it is required to treat certain eye diseases).
  • It’s also not covered by many private health funds, although some funds will offer a limited level of cover as part of their top hospital or comprehensive extras policies.

Even if your health fund says it covers laser eye surgery, check the fine print for more information on exactly how much of the total cost of the procedure will be covered. Also, keep in mind that:

    • Lifetime limits often apply to cover for laser eye surgery, as opposed to the annual limits quoted for many other extras services, so make sure you’re aware of the maximum level of cover available.
    • You will typically have to serve a waiting period before you can access any benefits for laser eye surgery. Waiting periods vary from one fund to the next, but expect to have to wait one or possibly two years before you can claim a benefit.

Contact an adviser and compare health insurance for optical services

Full list of Australian health funds that offer optical health insurance

Health fundPolicies and annual benefit limits*Waiting periods
ahm
  • Super Extras. $250 per person
  • Family Extras. $220 per person
  • Lifestyle Extras and Black 60. $200 per person, $400 per family
  • 6 months for Black 60
  • None for the rest
Australian Unity
  • Gold Extras, Silver Extras and Bronze Extras. $200 per person
  • Basic Extras. $150 per person
  • 6 months
Budget Direct
  • Top Extras. $250 per person
  • Basic Extras. $$120 per person 
  • 6 months
Bupa
  • Platinum Extras. $380 per person 
  • Gold Extras. $340 per person 
  • Silver Extras. $290 per person 
  • Your Choice Extras. $260 per person 
  • Bronze Extras. $210 per person, $420 per membership 
  • 2 months
Cessnock District Health Fund
  • Gold Extras. $290 per person
  • Silver Extras. $240 per person
  • Bronze Extras $210 per person
  • 2 months
CUA Health
  • Gold Extras. $300 per person
  • Silver Extras. $230 per person
  • 6 months
Frank Health Insurance
  • Lots Extras. $250 per person, $500 per couple/family
  • Some Extras. $120 per person, $240 per couple/family
  • 6 months
GMF
  • Complete Extras and Mid Extras. $350 per person 
  • Lite Extras. $250 per person 
  • 2 months
GMHBA
  • Gold Extras Set Benefits. $250 per person
  • Silver Extras Set Benefits. $200 per person
  • Bronze Extras Set Benefits. $150 per person
  • 6 months
HBF
  • Flexi Extras Plus. $275 per person 
  • Flexi Extras Mid. $250 per person 
  • Flexi Extras. $200 per person 
  • Saver Flexi Extras Plus. $250 per person 
  • Saver Flexi Extras Mid. $200 per person 
  • Saver Flexi Extras. $150 per person 
  • 2 months
HCF
  • Platinum Extras. $250 per person
  • Gold Extras. $200 per person
  • Silver Plus Extras. $180 per person
  • Bronze Plus Extras. $100 per person 
  • 2 months
Health Care Insurance
  • Premier Extras. $250 per person 
  • Active Life Extras. $220 per person 
  • 6 months
health.com.au
  • High Extras, Middle Extras and Basic Extras . $200 per person
  • Simple Extras . $250 per person
  • Extras 50. $200 per person
  • 2 months
hif
    • Premium Options. $280 per person
  • Super Options. $260 per person 
  • Special Options. $140 per person 
  • Saver Options. $110 per person 
  • 2 months
Latrobe Health Services
  • Premier Gold. $250 per person
  • Family Care Gold. $250 per person
  • Premier Silver. $180 per person
  • Premier, Family Care. $125 per person
  • 2 months
Medibank
  • Top Extras and Basic Extras. $200 per person 
  • Growing Family Extras. $200 per person, $500 per policy
  • Health Start Extras. $150 per person 
  • 6 months
Mildura Health Fund
  • Five Star Extras. $250 per person 
  • Ancillary Plus. $220 per person 
  • Basic Ancillary. $165 per person 
  • 12 months
nib
  • Top Extras. $350 per person
  • Core Extras . $250 per person
  • 6 months
onemedifund
  • Extras Plus. $275 per person
  • Basic Extras. $180 per person
  • 6 months
Peoplecare
  • Premium Extras cover. $300 per person
  • High Extras cover. $250 per person
  • Mid Extras. $200 per person
  • Basic Extras. $150 per person
  • 6 months
Phoenix Health Fund
  • Top Extras. $310 per person 
  • Mid Extras. $200 per person 
  • Basic Extras. $150 per person 
  • 6 months
QCHF 
  • Premium Extras. $285 per person
  • Essential Extras. $200 per person
  • Young Extras. $210 per person, $420 per policy
  • 2 months
St. Lukes Health
  • Super Extras. $300 per person 
  • Budget Extras. $200 per person 
  • 6 months
Transport Health
  • Top Extras. $300 per person
  • Healthy Choice Extras. $225 per person
  • 6 months
Westfund
  • Platinum Extras. $350 per person 
  • Gold Extras. $250 per person 
  • 2 months
ACA Health
  • Restricted health fund 
  • Complete Ancillary. $400 per person 
  • Ancillary Lite. $200 per person
  • 4 months
CBHS health fund
  • Restricted health fund 
  • Top Extras. $375 per person 
  • Intermediate Extras. $250 per person 
  • Essential Extras. $200 per person 
  • 6 months
Defence Health
  • Restricted health fund
  • Premier Extras. $300 per person
  • Value Extras. $255 per person
  • Essential Extras. $170 per person
  • 2 months
Navy Health
  • Restricted health fund
  • Premium Extras. $350 per person
  • Healthy Living Extras. $250 per person
  • Saver Plus. $200 per person
  • Basic Extras. $150 per person
  • 6 months
Police Health
  • Restricted health fund
  • SureCover Extras. $330 per person, $600 rollover per person 
  • 2 months
Reserve Bank Health Society
  • Restricted health fund
  • Extras Cover. $460 per person 
  • 12 months
rt health fund
  • Restricted health fund 
  • Premium Extras. $300 per person
  • Smart Extras. $250 per person
  • Value Extras. $200 per person
  • 3 months
Teachers Health Fund
  • Restricted health fund 
  • Top Extras. $260 per person 
  • Essential Extras. $165 per person 
  • 6 months
TUH Health Fund
  • Restricted health fund 
  • Comprehensive Extras. $250 per person 
  • Healthy Options (60%) Extras. $250 per person
  • Mid Range Extras. $200 per person 
  • Basic Extras. $160 per person 
  • 2 months for Comprehensive and Basic Extras
  • 6 months for Healthy Options and Mid Range Extras

*The policies listed in this table are extras only. However, most can be combined with hospital cover.

Contact an adviser and compare health insurance for optical services

* The offers compared on this page are chosen from a range of products finder.com.au has access to track details from and is not representative of all the products available in the market. Products are displayed in no particular order or ranking. The use of terms 'Best' and 'Top' are not product ratings and are subject to our disclaimer. You should consider seeking independent financial advice and consider your personal financial circumstances when comparing products.
Picture: Shutterstock

Richard Laycock

Richard is the insurance editor at finder.com.au. He is on a mission to make insurance easier to understand.

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