CHOICE membership

Extras Health Insurance -Private Prescriptions

We recently moved from GMHBA to HBF for Extras Health Insurance having reviewed and thought that I’d found a better fit for the amount we pay and the amount we get back. We have one claim for a Private Prescription which is a 3 month supply consisting of 3 packs of 30 tablets, all on the one script with an invoice price of approx $130. GMHBA, for the 3 years we were with them, paid as I would expect removing the prescription co-payment of $41.30 from the $130 and then applying our % claim to the remainder. In our case that would mean about refund $53. HBF have divided the script value into 3 for a breakdown by pack and then applied $41.30 to each pack meaning our refund totals about $6. A big difference between the two funds approach and not obvious when comparing funds. HBF confirm this is there method. Which approach is the norm across funds?