With Extras cover, we put a limit on how much we’ll pay over a year. Most limits are for the calendar year, so at the beginning of each year your benefit limits are renewed, allowing you to claim benefits again.
Other limits
nib benefits are limited to one benefit per patient, per provider, per day. For example, if a provider performs both remedial massage and acupuncture for you in one appointment, you’ll be able to make a claim for the service that has the higher benefit, and you’ll need to pay full-price for the other service.
Similarly, where multiple services are performed on the same day at different times by the same provider (e.g. a morning visit followed by an afternoon visit) then only one visit or service is payable.
Frequently asked questions
Q: How do I check my annual limits?
A: You can check your annual limits and how much you have left to claim by going to the “My Usage” tab in your member account or in the nib App, or you can contact us.
Q: When do my limits reset?
A: For most of our members, limits reset at the start of each calendar year. Log in to check how much you have left or contact us if you have any questions.
Q: What is a lifetime limit?
A: A lifetime limit is the maximum amount you can claim on a specific service in your lifetime, even if you change health insurers. Once you reach this limit you won’t be able to claim on that service again.
Q: What happens to my annual limits if I transfer from another health fund to nib?
A: Any benefits you have already claimed with your previous health fund this calendar year will be deducted from your new cover with nib. For example, if you have an annual limit of $1,000 for major dental treatment and you’ve already claimed $400 this calendar year, you’ll still have $600 remaining.
If you’ve recently made the switch, your private health insurance annual limits will reset on 1 January.
