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Continue shoppingFor over 30 years, 1001 Optometry has offered Australians top-tier eye care and eyewear at affordable prices.
We’re committed to helping our customers maintain their eye health in an accessible way. That’s why we make it easy to claim eligible products with your health fund optical cover. This cover can also help you get the most out of your optical extras benefits.
The question everyone's asking is what can be claimed with optical health insurance extras. The comprehensive nature of insurance coverage can sometimes make it difficult to determine what options are available to you.
Fortunately, we help clarify exactly what can and can’t be claimed on your optical health insurance extras.
To claim your glasses on your health fund, you’ll first need a prescription from an optometrist. Then, you’ll need the optical extras included in your health fund policy.
If you’ve got these two things, you can claim a portion of your spend on prescription glasses (frames and lenses) and contact lenses* (including disposal and rigid contact lenses, as well as thin and light lenses.)
Be mindful that your level of coverage and which health fund you’re with will determine your health insurance benefits. Ultimately going on to determine how much you will be reimbursed.
*Note that different health funds will have different inclusions for prescription contact lenses, so it's important to review yours. Check if it includes elements like lens add ons, polaroid lenses, transition lenses and so on.
For many, prescription sunglasses are just as integral as regular glasses, especially in Australia’s bright climate. Fortunately, if you’ve got a valid prescription and optical extras benefits, you can claim your prescription sunglasses lenses with your health fund.
Important to note, that sunglasses frames and non-prescription sunglasses lenses are excluded from these benefits. This means you will have to pay out of pocket for either.
With a valid prescription and optical extras as part of your NIB optical health insurance, you may be eligible to claim back a portion of your prescription sunnies (excluding frames). Check with NIB to be sure.
If you have a valid prescription and optical extras as part of your Medibank health insurance, you may be eligible to claim back a portion of your prescription sunglass lenses. Note, that sunglasses frames are not included.
The inclusion of a valid prescription and optical extras in your Bupa optical health insurance may make you eligible for a sunglasses claim. This generally applies only to your prescription sunnies (excluding frames), and may only cover a portion of overall costs.
Your HCF insurance would require the inclusion of a valid prescription and optical extras to claim back a portion of your prescription sunglass lenses cost. However, this coverage excludes the sunglasses’ frames.
The optical benefits of your coverage will vary from health provider to health provider. They will also be affected according to the type and level of health insurance you take out.
We recommend getting familiar with the major funds (NIB, HCF, Bupa and Medibank) to understand how you can maximise your optical extras benefits with yours.
You can make your optical claim any time of the year, but remember that health funds typically don’t roll over any unused benefits. So, it’s important to submit your claims before your benefits expire!
Generally, your claim limits will reset at the end of the calendar or financial year–depending on your health fund. Some even reset based on the date joined. Make sure to check with your health provider and get your claims in before the close date.
Most health funds also allow you to claim your benefits within two years of your prescription glasses, sunglasses and contact lenses being purchased. At least, as long as the date on your itemised invoice falls within this period. This means you can tap into your optical cover for the previous year in the new year.
How much you can claim depends on:
Your health fund
Your level of cover
Your benefits annual limit
The portion of spending your health fund covers (this is often a flat amount or a percentage)
Waiting periods (generally, waiting periods for optical claims
Prior claims
If you’re unsure how much you can claim, speak to your health fund or visit us in-store. Just bring your health fund membership card into any of our stores and our friendly team of experts will be able to help you out!
Making your optical claim in-store is easy. Simply bring your private health fund membership card with you and we’ll process your claim at the point of sale, right there and then!
If you’ve purchased your prescription glasses, sunglasses or lenses online, our team at 1001 Optometry can help you make a claim. All you’ll need to do is email us at contactus@1001optical.com.au for an itemised receipt. After which, you can follow your health fund’s instructions for submitting a claim either online or via their app.
If you have a Medicare card and are under 65 years of age, your eye tests will be completely covered by Medicare once every three years.
However, if you’re over the age of 65 with a Medicare card, you’ll be eligible for one bulk-billed eye test every year.
While Medicare covers the cost of your eye tests, any prescription products purchased off the back of your assessment will not be covered. That’s where your private health insurance with optical benefits comes in!
At 1001 Optometry, we make it easy to claim your eligible optical products and services with your health fund so that you can get the prescription glasses you want! Shop our full range of prescription products today at your nearest store or online.
You can also easily book an eye test with us to update your prescription ahead of time. Get ahead of the crowd and enjoy the full range of your optical extras benefits with us!
Extras cover helps you reduce out-of-pocket expenses associated with managing your health. Depending on which extras cover you choose, you can claim a range of services. This includes dental, optical, physio and more.
Waiting periods will apply and vary depending on the type of service.
The extras gap you pay will depend on the level of coverage you’ve taken out and the annual limits established in those.
The difference between what your extras provider charges and the benefits you receive is your extras gap.
Medibank - If you are a recognised provider, and payment for an optical appliance is made in full on the date of order and processed, the rebate may be claimed electronically by the provider on the date of order. The practice must have a documented refund policy which includes a full refund of the benefit Medibank has paid. For non-collection the refund must be processed within six weeks of the order date and in the case of order cancellation the refund must be processed immediately.
NIB - If payment for an optical appliance is made in full on the date of order, the rebate may be claimed on the date of order.
Bupa - Bupa does not support the use of health fund benefits at the time of ordering, even if paid in full. However, the date of ordering can be entered into HICAPS/Health Point for claiming purposes on the day of appliance collection.
HCF - HCF’s fund rules exclude benefits for goods and services that have not been received at the time of claiming.
Doctor's Health Fund - If payment for an optical appliance is made in full on the date of order, the rebate may be claimed on the date of order.
Australian Unity - We cannot prevent optical providers from completing a claim through HICAPS on the date of order.
HBF - HBF does process optical claims using the date of order as the service date. Electronic claims are eligible to be made on the date of order.
GMHBA - If payment for an optical appliance is made in full on the date of order, the rebate may be manually claimed on the date of order directly through the health fund. NOTE: HICAPS cannot be processed on date of order.
Medibank - Patients may not use their rebate over two claiming periods for the same product. For example, they cannot use their December frame rebate towards an optical frame and their January rebate on the same frame.
NIB - Splitting of optical appliance claims over two claiming periods is permissible where the date of frame purchase can be input on HICAPS/Health Point using a particular year’s benefits (e.g. December) and the lenses in the following year (e.g. January).
Bupa - No. Splitting of optical appliance claims over two claiming periods is not permissible unless the patient is purchasing the frame and lenses from different providers.
HCF - A rebate will not be provided unless a complete product is delivered to the patient. Splitting of optical appliance claims is not permissible.
Doctor's Health Fund - Patients may not use their rebate over two claiming periods for the same product.
Australian Unity - A product can be purchased over two claiming periods so long as the item is paid for and collected in the year it is being claimed on.
HBF - Patients are not eligible to claim over 2 years for the same service at the same provider. If the patient purchases frames and lenses from different providers they may be eligible to claim a benefit over 2 years.
GMHBA - Patients are not eligible to claim over 2 years for the same service at the same provider. If the patient purchases frames and lenses from different providers they may be eligible to claim a benefit over 2 years.
Medibank - Patients are able to purchase an optical frame and receive a benefit under item 110 only and subsequently order their lenses from another provider. They must however have a valid prescription and a copy of the valid prescription must be on file at the practice.
NIB - Patients are able to purchase their frame and receive a benefit under item 110 only and subsequently order their lenses from another provider.
Bupa - Patients are able to purchase their frame and receive a benefit under item 110 only and subsequently order their lenses from another provider.
HCF - A frame only is not considered a complete optical or medical appliance and the patient must pay in full with no rebate claimed in store / no code 110 listed on receipt. Once the patient has lenses glazed in the frame and has a receipt indicating that, the patient may receive a rebate in full from the HCF office.
Doctor's Health Fund - Patients are able to purchase an optical frame and receive a benefit under item 110 only and subsequently order their lenses from another provider. They must however have a valid prescription and a copy of the valid prescription must be on file at the practice.
Australian Unity - Patients are able to purchase an optical frame and receive a benefit under item 110 only and subsequently order their lenses from another provider.
HBF - Patients are able to purchase an optical frame and receive a benefit under item 110 only and subsequently order their lenses from another provider.
GMHBA - A frame only is not considered a complete optical or medical appliance and the patient must pay in full with no rebate claimed in store / no code 110 listed on receipt. Once the patient has lenses glazed in the frame and has a receipt indicating that, the patient may receive a rebate in full from the GMHBA office.
Medibank - If a patient orders prescription sunglasses, plano lenses removed from the frame must be retained for a minimum of six months, labelled with the customer name and available for auditing purposes.
NIB - Plano sunglass lenses DO NOT need to be retained by the provider if a patient orders a complete pair of prescription sunglasses.
Bupa - Bupa recommends that the practice retains plano sunglass lenses. Benefits are only payable for prescription spectacles or contact lenses (optical appliance) that are designed and manufactured with the sole purpose of correcting a refractive error or ameliorate a refractive abnormality or defect of sight.
HCF - Plano sunglass lenses DO NOT need to be retained by the provider if a patient orders a complete pair of prescription sunglasses.
Doctor's Health Fund - Plano Lenses do not need to be retained by the provider if the patient orders a complete pair of prescription sunglasses.
Australian Unity - Plano Lenses do not need to be retained by the provider if the patient orders a complete pair of prescription sunglasses.
HBF - Plano Lenses do not need to be retained by the provider if the patient orders a complete pair of prescription sunglasses.
GMHBA - Plano Lenses do not need to be retained by the provider if the patient orders a complete pair of prescription sunglasses.
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