What Can You Claim?
The ADF Family Health Program will pay an amount towards your treatment of many services to assist you to lessen the out-of-pocket expenses you may experience.
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 |
Ambulance Subscription | The cost of the subscription to any state or territory-based ambulance service. Please be aware that ambulance services, trips or call-out fees cannot be claimed. To be eligible, the receipt must show the name of a person listed on the ADF Family Health policy. |
Audiology | All services conducted by a certified practitioner |
Chiropractic | All services conducted by a certified practitioner |
Dietician | All services conducted by a certified provider |
Dental |
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Exercise Physiology | All services conducted by a certified practitioner |
Immunisations | You may claim for reimbursement of vaccinations not covered under the National Immunisation Program, or vaccinations by a non-GP provider. Please note that vaccinations reimbursable under the Pharmaceutical Benefit Scheme are not covered under this modality. Your claim must include an official doctor’s or pharmacy receipt showing:
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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 prescriptions lenses, frames when accompanied with prescription lenses, contact lenses and lens coatings on prescription lenses. |
Osteopathy | All services conducted by a certified practitioner |
Pharmacy | You may claim reimbursement of costs above the Pharmaceutical Benefits Scheme (PBS) co-payment threshold amount for pharmaceuticals that meet the following criteria:
Your claim must be accompanied with an official pharmacy receipt listing the following details:
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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 service conducted by a certified practitioner |
Speech Therapy | All services conducted by a certified provider |
Tobacco and Nicotine Addiction | Quit Smoking Courses
The cost of an online or in-person course is claimable with a course completion certificate and payment receipt from one of the above foundations. Nicotine Replacement
Your claim must be accompanied with a recognised pharmacy receipt clearly showing:
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Other Services |
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