Optical Benefits

Except where otherwise indicated, optical benefits are rebated at 90% of the fee charged for each service/item up to the maximum benefit shown.

All multiple year benefits (2 years and over) are calculated on a rolling year basis, from the date of service (instead of calendar year). Multiple year benefits (2 years and over) are divided over that period of time, with lifetime limits being paid over 5 years. For example: with a lifetime limit of $1,350, $270 is payable each year for 5 years. All rolling years incur a benefit limitation period.


Per-item limits and waiting periods, including those for pre-existing conditions, may apply. As at 1 April 2017.


Please keep in mind that each service has a limit and waiting periods may apply.

(A) When prescribed by a registered optometrist or opthalmologist. The cost of repairs may also be claimed under this item.

(B) This benefit is payable in respect of a particular illness or condition requiring treatment of the patient at home for which the services of a registered nurse, as directed by a medical practitioner, are necessary.

(C) Rebated at the maximum benefit level set by legislation.

(D) Where the practitioner is registered under a state law or is a member of an accredited professional association.

(E) Rebated at 90% of the fee charged for each service/item up to the maximum benefit payable.

(F) Rebated at 100% of the fee charged for each trip, including non-emergency travel, transfer between hospitals, travel in a private ambulance and air travel when authorised by a doctor.

(G) When accompanied by a doctor’s certificate stating that the machine is required for a specific ailment or condition.

(H) Items not included on Government’s Prostheses List - rebated as per Australian Health Services Alliance (AHSA) recommendations and/or individual Board approval.

(I) Members who incur health care costs that are not specifically covered under the standard RBHS extras benefit policy may be eligible for consideration by the Board for payment of benefits under the “special claims” category. The Board Policy for these claims is available on request.

(J) Rolling year limits are based on date of first service once benefit limitation periods have been served.