Ultra Extras

Our newest top level of extras cover. Must be packaged with one of our Hospital Cover options.

Our newest top level of extras cover that gives you an extensive range of benefits for services like dental, optical, physiotherapy, chiropractic, health aids and appliances and many more. Ultra Extras gives you generous annual limits and high benefits per service (up to your limits) to keep your out-of-pocket expenses to a minimum.

Best suited for families, couples and singles wanting top cover.

Features:

  • Covers an extensive range of dental, optical and therapy services
  • Cover for orthodontics Generous per person limits
  • Cover for Health aids and appliances
  • Cover for Hearing aids
  • Our highest level of benefits
  • Keeps your out-of-pockets as low as possible
  • Increasing overall limits for membership loyalty

How benefits work

Overall limits apply to dental, orthodontics, optical, therapies, health aids and appliances plus other services. Sub-limits apply to certain services.

 

Rewarding limits

We also increase your overall benefit limits for dental (excluding orthodontics) and therapies by $50 after the first year of membership and then for each year after for the first five years of cover. We honour this loyalty limit for as long as you continuously hold the product.More information is  available here.

What you're covered for

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General and major dental

$1,400 per person
Services covered Sub-limit per person per Membership year
Crowns and bridges
$800

12 month waiting period applies

Example benefits paid
Full veneered crown $800

Sub-limit increases to $1,500 per year after 2 years of membership providing overall dental limit is not exceeded in claiming. Actual item benefits do not increase.

Dentures
$850

Prosthodontic services like plates and dentures.

Example benefits paid
Full upper and lower denture $850

12 month waiting period applies

Diagnostic dental
$600

Includes services like examinations, consultations and x-rays.

Example benefits paid
Periodic oral exam $54
X-rays $35

2 month waiting period applies

Extractions
$700

2 month waiting period applies

Simple extractions

Teeth removal services. Simple extractions include those completed in a standard dental appointment.

Example benefits paid
Simple tooth extraction $105

Surgical extractions

12 month waiting period applies

Surgical extractions include wisdom teeth extraction, removal of impacted teeth. Benefits paid on dental item numbers only unless hospital cover is held and all waits have been served for any in-patient services.

Example benefits paid
Surgical tooth extractions $180

A $700 combined sub-limit applies to surgical and simple extractions.

Fillings
$800

Restorative dental treatments including composite and amalgam fillings.

Example benefits paid
One surface composite filling $90

 2 month waiting period applies

General services
$500

Includes services such as occlusal splints.

2 month waiting period applies

Example benefits paid
Occlusal splits $300
Preventive dental
$800

Includes cleaning and scaling, fluoride treatment and mouth guards.

Example benefits paid
Scale and clean $89
Fluoride treatment $24
Mouth guard $150

2 month waiting period applies

Root canal treatment
$600

Endodontic services such as root canals and root fillings.

Example benefits paid
Root canal obturation $170

12 month waiting period applies

Specialised gum treatments
$500

Periodontics, such as specialised gum treatments

Example benefits paid
Up to sub-limit (individual item benefits apply) $500

12 month waiting period applies

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Braces and orthodontics

$3,000 lifetime limit per person
Services covered Sub-limit per person per Membership year
Braces and orthodontic services
Lifetime limit $3,000

12 month waiting period applies

Braces and orthodontic services.

Example benefits paid
Orthodontic services Up to eligible benefit limit

Benefits are paid up to eligible benefit limit based on years of Membership on Premium Extras Cover.

Benefit limits after initial waiting period (if applicable) start at $1,000 and increase to $2,000 after completion of two years' Membership on Premium Extras Cover, and to $3,000 after three years' Membership on Premium Extras Cover, up to a lifetime limit of $3,000. Lifetime limit will take into consideration all previous claims for orthodontic treatment, even under a previous funds’ cover.

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Optical

Up to $300 per person
Services covered Sub-limit per person per Membership year
Glasses and contact lenses
Up to $300

2 month waiting period applies

Glasses including frames, single vision lenses and progressive lenses, contact lenses, prescription sunglasses etc.

Example benefits paid
Optical items or services

Up to $300 

Through our Premier Provider Network, you can take advantage of discounts at preferred providers across Australia.

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Therapies

$1,400 per person
Services covered Sub-limit per person per Membership year
Acupuncture

2 month waiting period applies

Example benefits paid
Initial and subsequent consultation $35

Benefits are payable for services rendered by Australian Regional Health Group approved providers registered with Territory Health Fund.

Audiology

2 month waiting period applies

Example benefits paid

Consultation $35
Report $60
Chinese Medicine

2 month waiting period applies

Example benefits paid
Initial consultation $35
Subsequent consultation $35
Chiropractic
$400 (combined)^

2 month waiting period applies

Example benefits paid
Initial chiropractic consultation $55
Subsequent chiropractic consultation $35
X-rays (not for reading of X-rays) $60

A $400 combined limit applies to chiropractic and osteopathic services for Ultra Extras.

Dietitian

2 month waiting period applies

Example benefits paid
Initial consultation $75
Subsequent consultation $40
Exercise physiology
$700 (combined)*

2 month waiting period applies

Example benefits paid
Initial consultation $50
Subsequent consultation $35
Monthly program fee $35
Group therapy $10

* A $700 combined limit applies to physiotherapy and exercise physiology services under Premium Extras cover.

Foot orthoses and orthopaedic shoes
$150

2 month waiting period applies

Example benefits paid
Up to sub-limit for orthoses and custom made footwear  
Occupational therapy

2 month waiting period applies

Example benefits paid
Initial consultation $80
Subsequent consultation $40
Physiotherapy
$700 (combined)*

2 month waiting period applies

Example benefits paid
Inital consultation $55
Subsequent consultation $45
Group therapy $10

* Combined physiotherapy and exercise physiology services sub-limit of $700 applies.

Orthoptic therapy

2 month waiting period applies

Example benefits paid
Initial and subsequent consultation $60
Osteopathy
$400 (combined)^

2 month waiting period applies

Example benefits paid
Initial consultation $55
Subsequent consultation $35

^ A $400 combined limit applies to chiropractic and osteopathic services for Ultra Extras.

Podiatry
$600

2 month waiting period applies

Example benefits paid
Initial and subsequent consultation $40
Approved appliances (orthotics) Up to sub-limit
Minor procedures Up to sub-limit
Psychology

2 month waiting period applies

Example benefits paid
Initial and subsequent consultation $80
Report $80
Group therapy $80
Remedial massage or myotherapy
$400 (combined)^

2 month waiting period applies

Example benefits paid
Initial and subsequent consultation $40

Benefits are payable for services rendered by Australian Regional Health Group Limited approved providers registered with Territory Health Fund. 

^ A $400 combined limit applies to remedial massage and myotherapy for Ultra Extras.

Speech therapy

2 month waiting period applies

Example benefits paid
Initial consultation $80
Subsequent consultation $40
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Health appliances and services

Services covered Sub-limit per person per Membership year
Mechanical aids & appliances

12 month waiting period applies

Example benefits paid
Benefit up to 100% of the cost or hire of Mechanical Aids and Appliances approved by the Fund Up to $2000

Sub-limits and replacement periods apply to some items. Please contact the Fund for benefit eligibility before hiring or purchasing the health aid or appliance.

Mammograms and bone densitometry

12 month waiting period applies

Example benefits paid

Benefit up to $75 limited to two services for each of these tests, only if performed in a radiology practice and not claimable from another source.

Nursing services

12 month waiting period applies

 

Example benefits paid

A benefit up to $50 per visit or $150 per day is payable:

  • Bush nursing services provided by a registered nurse employed at a public hospital or bush nursing centre where there is no
    resident medical practitioner
  • Home nursing services provided by a registered nurse in private practice
up to $1000

A benefit up to $150 per day is payable:

  • for clinically relevant special nursing provided by a registered nurse in private practice.

 

up to $750

 

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Hearing aids

Services covered Sub-limit per person per Membership year
Hearing aids

12 month waiting period applies

Example benefits paid
The benefit limit applies based on your length of membership

From $1000

  • Up to 10 years $1,000
  • 10-15 years $1,500
  • 15 years+ $2,000

A benefit amount is provided to use over three Membership Years based on the date of which the purchase of a hearing aid/s is made.

The purchase of a hearing aid/s means either a once-only payment or a regular subscription i.e. monthly.

Hearing aid maintenance, batteries & chargers

12 month waiting period applies

Example benefits paid

For the cost of maintenance fees, repairs, batteries or purchase and/or repairs of a charging dock for hearing aids.

Up to $100

Australia hearing services

12 month waiting period applies

Example benefits paid

Benefit for the cost of a Hearing Services Card.

 

Up to $25

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Other services

Services covered Sub-limit per person per Membership year
Childbirth education
$60
Example benefits paid
Education session $60

12 month waiting period applies

Healthy living
$150 per person

2 month waiting period applies

As well as helping you to get well, we want to help you stay well. Our Healthy Living benefit helps you living a healthy lifestyle through:

  • Participation in a choice of approved weight management programs^^ 
  • Quit smoking programs
  • Approved health management programs* including gym memberships, personal training programs, Aquatic exercise/rehabilitation* including pool entry and exercise classes (excludes swim classes/lessons)
  • Have your skin checked for skin cancers through a mole mapping service^
  • Consultation fees for diabetes education
  • Consultation fees for metabolic dietitians and nutritionists when providing assistance with weight management
  • Bowel screening tests and bone density tests
  • Prostate-Specific Antigen  test (one per year) – we cover a second yearly text not covered by Medicare
  • Supermarket tours conducted by a dietitian or other allied health professional qualified to provide nutrition advice.

*To comply with private health insurance legislation, you must have been referred by your health care professional to participate in a health management program to address or improve a specific medical condition. A Health Management Program Benefit Approval Form must accompany a claim for these benefits.

^^Before enrolling in a weight management program please contact the Fund to clarify the eligibility to benefits.

^ No benefit is payable where Medicare have paid a benefit towards this service.

Example benefits paid
Healthy living benefits Up to $150
Pharmaceutical
$500

2 month waiting period applies

The Pharmaceutical Benefits Scheme (PBS) is a national pharmaceutical scheme funded by the Federal Government where patients contribute to the cost of prescribed drugs.

Territory Health doesn't cover pharmaceutical prescriptions covered by the Pharmaceutical Benefits Scheme or for contraceptives and items normally available without prescriptions. Prescriptions not covered by the Pharmaceutical Benefits Scheme (PBS), excluding contraceptives and items normally available without prescription and drugs not approved for sale in Australia. A co-payment applies to each prescription item equal to the current PBS.

We’ll pay benefits as outlined in the Extras table up to the claim limit for this category, with consideration to the maximum individual script benefit limit. The benefit amount per script is calculated by deducting the PBS general patient contribution amount from the purchase price (up to script benefit limit). This is conditional on the pharmaceutical prescription being listed in the MIMs Schedule as S4 or S8 and being dispensed in quantities in accordance with this schedule. We also pay for compound pharmacy scripts, as long as one of the ingredients meet this criteria.

A doctor's letter may be required for some pharmacy items.

The PBS contribution amount is reviewed annually by the Government and changes every year on 1 January. 

Example benefits paid
Pharmaceuticals Up to $70
School accidents
$750
Example benefits paid
100% of cost up to sub-limit  

2 month waiting period applies