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.

How are optical products covered?

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

_{*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

_{*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.
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