Astute Simplicity Health offers benefits towards the cost of an extensive range of other health care services not covered by our hospital cover or by Medicare. Examples of benefits are included in the extras benefit comparison and where applicable annual limits are per person covered per calendar year unless otherwise specified.

A calendar year runs from January to December.

Benefits are only payable when rendered by a practitioner in private practice who is recognised by the underwriter St.LukesHealth. Contact Astute Simplicity Health on 1300 090 960 to check whether your practitioner is registered.

Extras Protect is our top stand-alone extras cover and can be taken on its own if you only need extras cover, or you can tailor your own hospital and extras package by combining Extras Protect with a hospital cover from our stand-alone hospital range.

If you prefer a full range of benefits, then Extras Protect is your best choice.

To find out more about pricing, please click here

Extras Protect

Comprehensive option (to keep you and your family protected)
Extras Plan Level of Extras cover
Extras Protect Comprehensive

Extras benefits included in Extras Protect

Examples of benefits are included in the table below and where applicable annual limits are per person covered per calendar year unless otherwise specified. A calendar year runs from January to December. Benefits are only payable when rendered by a practitioner in private practice who is registered by the underwriter St.LukesHealth. You should contact the fund to ensure your provider is registered before undergoing treatment.

Gap Free Preventative Dental

The highly-regarded Gap Free Preventative Dental feature is available on Extra Protect. Under Gap Free Preventative Dental, we pay 100 per cent of your dentist’s regular fee* up to a maximum benefit for each eligible service. This means that for most dentists you will have no gap or out-of-pocket to pay for an examination, x-ray, scale and clean and fissure sealing. If your dentist charges above the maximum benefit a gap or out-of-pocket may apply.

The stand out feature of Gap Free Preventative Dental for Astute Simplicity Health members is that it applies to both adults and children at your choice of dentist.

We don’t tell you which dentist you need to go to in order to receive the higher benefit for preventative dental as it applies to all dentists^. A great way to help you keep your teeth and gums healthy.

An extra feature for children is gap free cover^ for fissure sealing. Placement of sealants in children assessed as having a high risk of tooth decay, is a safe and effective way in preventing dental decay in permanent teeth.

^ Includes examination, x-rays, scale and clean and fissure sealing. Benefits of 100 per cent of the dentist’s regular fee* apply up to a maximum benefit per service on Extras Protect. If your dentist charges above the maximum benefit, or in excess of the regular fee* he or she charges all patients, a gap or out of pocket may apply. Benefit applies to both adults and children who have served their two month waiting period. Other preventative services such as topical fluoride application and provision of mouth guard are not included. Annual limits apply.

* Regular fee refers to the average fee your dentist charges to all patients.

Benefits as of June 1, 2019.

Service Category Benefits Annual Limit
Per person, per calendar year
General Dental – 2 month waiting period
Annual Limit – $1000
preventative dental (examinations, x-rays and scale and clean) *Regular fee refers to the average fee your dentist charges to all patients of his or her practice for each eligible service. 100% of dentist’s regular fee up to maximum benefit per service* limit of two general dental consultations per person, per calendar year
comprehensive oral examination see above limit of two general dental consultationsper person, per calendar year
scaling and clean see above
simple extraction $101
mouthguard $95 limit of one per person, per calendar year
posterior tooth filling – 1 surface $91
Major Dental – 12 month waiting period
Annual Limit – $1500
Periodontics Sub-limit – $1000
course of non-surgical treatment 70%
fixed rebates apply to some periodontic treatment
Endodontics Sub-limit – $1000
preparation of root canal – 1 canal $165
root canal obturation – 1 canal $172
Crowns & Bridges Sub-limit – $1000
full crown veneered – indirect $810
Procedures for Dental Implants Sub-limit – $1000
full crown attached to implant – veneered – indirect $630
Dentures Sub-limit – $800
complete upper denture $505
complete upper and lower denture $800 limit of one upper and one lower denture per person payable every 2 calendar years
Orthodontics Sub-limit $1000
course of treatment 100%
fixed rebates apply to some orthodontic services
lifetime limit $2800
Pharmacy – 2 month waiting period
Annual Limit – $600
per non PBS prescription $70
for prescriptions not covered by the PBS, excluding contraceptives, anabolic steroids, 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 non-concessional PBS co-payment amount.
Optical – 6 month waiting period
Annual Limit – $300
frames 100% of fee up to annual limit
single vision lenses* 100% of fee up to annual limit
bi-focal lenses* 100% of fee up to annual limit
multi-focal lenses* 100% of fee up to annual limit
soft contacts $300
hard contacts $300
disposable contacts (12 months supply) $300
repair to frames $25
*includes benefit towards hardening of lenses
Physiotherapy – 2 month waiting period
Annual Limit – $850
physiotherapy – initial $55
physiotherapy – subsequent $42
exercise physiology Sub-limit – $200
– initial $45
– subsequent $35
other approved group session (including hydrotherapy) $15 Sub-limit -$300
ante natal/post natal $25 Sub-limit -$400
lymphedema $40 included in physiotherapy limit
Other Therapies – 2 month waiting period
Annual Limit – $1000
Podiatry Sub-limit -$400
– initial $40
– subsequent $32
Occupational Therapy Sub-limit -$400
– initial $70
– subsequent $49
Eye Therapy Sub-limit -$400
– initial $65
– subsequent $38
Speech Therapy Sub-limit -$400
– initial $80
– subsequent $52
Dietetics Sub-limit -$200
– initial $75
– subsequent $45
Alternative Therapies – 2 month waiting period
Annual Limit – $500
Chiropractic Sub-limit -$400
– initial $40
– subsequent $28
Chiropractic X-rays $60 included in chiropractic limit
Osteopathic included in chiropractic limit
– initial $50
– subsequent $40
Acupuncture Sub-limit -$400
– initial $35
– subsequent $30
Natural Therapies Sub-limit -$400
– initial $32
– subsequent $28
includes Chinese & Myotherapy
Remedial Massage included in natural therapies limit
– initial $35
– subsequent $30
Clinical Psychology – 12 month waiting period
Annual Limit – $400
– initial $85
– subsequent $80
Home Nursing – 2 month waiting period
Annual Limit – $500
per service $50
for services rendered by a registered nurse in private practice
Health Appliances and Aids – 12 month waiting period
Annual Limit – $1000
foot orthotics (custom-made) 85% Sub-limit -$200
repair to custom made foot orthotics $30 limit of one repair per person, per calendar year
other specified orthotics*
eg. custom made spinal & knee braces
90% limits apply to individual items
specified prosthetic appliances*
eg. breast prosthesis after mastectomy
90% limits apply to individual items
other specified health aids*
eg. blood glucose monitor, nebuliser
90% limits apply to individual items
*a full list is available by contacting the Astute Simplicity Health Team.
Audiology – 2 month waiting period
2 per year
per consultation $40
only payable when service rendered by an Audiologist in private practice and approved by this fund. Benefit will not be payable if the service is claimable from any other source.
Diabetes Education – 2 month waiting period
– initial $55 included in dietetics limit
– subsequent $45 included in dietetics limit
Health Management Programs – 3 month waiting period
singles policy 70% $125
family/couples policy 70% $250
Benefits are payable for approved health management programs. Limits apply to the policy, not to each person covered by the policy. Contact the Astute Simplicity Health Team for more information on health management programs.
Member Rewards – 5 year qualifying period
5% increase in dental benefits (excluding preventative services paid under Gap Free Preventative Dental)
5% increase in annual dental limits
Member reward benefits are payable after 5 years continuous membership on an eligible Astute Simplicity Health product. Qualifying conditions apply.

The overall limit for each service category is highlighted. Some categories have sub-limits which are included within the overall limit for that service category.

Want to find out more?

Call today on 1300 090 960