Eligible Services
If you are not sure if your service is eligible for reimbursement contact 1300 561 454 for clarification.
The Program provides benefits toward eligible services detailed below:
General Practice Service (GP)
GP services are conducted by your general practitioner within their general practice setting. To be eligible for claiming, all services must have been allocated a Medicare Benefits Schedule item number at the time of payment.
All approved claims for a GP service will be deducted from your family’s unlimited allocations for these services.
Specialist Services
Specialist services are provided by Specialists or Consultant physicians within their consulting rooms or a hospital setting. Specialist services must have been allocated a Medicare Benefits Schedule item number at the time of payment.
All approved claims for a Specialist service must be accompanied by a Medicare Statement of Benefits before they are submitted to ADF Family Health for approval and the benefit will be deducted from your families allocations of funds i.e. $400 per Dependant.
Diagnostic and Radiology Services
All diagnostic and radiology services, where there is an MBS item number, are eligible. Service can include, X-rays, MRI, pathology and ultrasound.
All approved claims will be deducted from your families allocations of funds i.e. $400 per Dependant.
Allied Services
Allied Health Services provide a broad range of treatments to improve th ehealth and wellbeing of the patients they support. The ADF Family Health Program will pay the gap on the below Allied Health services when they are provided by a certified practitioner.
All approved claims for an allied service will be deducted from your families allocations of funds i.e. $400 per Dependant.
If you have private health insurance, click here to learn how to reduce your out of pocket expenses.
Allied Service | Description of Services |
Audiology | All services conducted by a certified practitioner |
Chiropractic | All services conducted by a certified practitioner |
Dental |
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Exercise Physiology | All services conducted by a certified practitioner |
Medically Prescribed Appliances (MPA) | Medically Prescribed Appliances (MPA) – MPA must not have a GST applied and claims must be accompanied by a written recommendation/prescription from a certified practitioner. |
Occupational Therapy | All services conducted by a certified practitioner |
Optical | All prescription-lenses, frames when accompanied with prescription lenses, contact lenses and lens coatings on prescription lenses. |
Osteopathy | All services conducted by a certified practitioner |
Physiotherapy | All services ; Ante/Post – Natal classes provided by a registered physiotherapist or midwife |
Podiatry and Chiropody | All services conducted by a certified practitioner |
Psychology |
All services conducted by a certified practitioner, including;
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Remedial Massage | All services conducted by a certified practitioner |
Other Services |
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