If you have private health insurance with extras cover, the short answer is yes, you should be able to claim back money on prescription glasses. But how much you get back, and which glasses qualify, depends on your fund and your level of cover. This guide breaks it all down simply.
In Australia, glasses are covered under extras cover (also called ancillary cover) not hospital cover. If you only have hospital cover, you won't be able to claim for optical.
Most extras policies include optical benefits, but the amount varies significantly between:
Tip: Check your fund's member portal or call them directly to find your exact optical annual limit and waiting period.
Optically is a registered optical provider with all major Australian health funds, including:
This means that when you purchase prescription glasses or sunglasses from Optically, you'll receive a fully itemised tax invoice with all the information your fund needs to process your claim.
Most funds will cover:
This varies by fund and policy, but as a general guide:
| Fund | Typical Optical Limit (per year) |
|---|---|
| Bupa | $150 – $300 |
| Medibank | $150 – $350 |
| HCF | $200 – $400 |
| NIB | $150 – $300 |
| HBF | $200 – $350 |
Limits vary by policy tier. Check with your fund for your specific entitlement.
Some funds reset your optical benefit every calendar year (January), while others reset on your policy anniversary date.
Most funds impose a waiting period before you can claim optical benefits. Typically:
If you've recently joined a fund, check your waiting period before purchasing - you can find this in your welcome letter or member portal.
The process is straightforward:
Many of our customers find they can claim their glasses purchase in full depending on their level of extras cover.
Generally no - your optical benefit is a once-per-year limit. However, some policies allow claims for both frames and lenses separately, which can mean a higher total claim. Check your policy's Schedule of Benefits for details.
Yes. Your health fund will require that your glasses are made to a valid prescription. At Optically, you can upload or email your prescription at checkout.
Yes - as long as you buy from a registered optical provider like Optically. You don't need to buy in-store to claim.
You pay the difference out of pocket. For example, if your limit is $200 and your glasses cost $250, you claim $200 and pay $50 yourself.
Yes! Prescription sunglasses are claimable under optical benefits, just like regular prescription glasses.
Standard Medicare does not cover prescription glasses for adults. The only exception is the Spectacles Subsidy Scheme available in some states (like NSW) for concession card holders.
If you have extras cover, buying prescription glasses from a registered provider like Optically means you can claim a significant portion, sometimes all of the cost back from your health fund. With frames and lenses starting from just $19, your out-of-pocket cost after claiming can be minimal.
Ready to use your optical benefit? Shop our full range of prescription glasses or visit us in Edgecliff, Sydney. Every purchase comes with a fully itemised invoice for easy claiming.