An exciting benefit exclusive to Police Health Members!

Most benefits for extra services, like your major dental, chiropractic and optical have Annual Maximums, which are renewed each calendar year. To provide extra protection to our members we have developed our Rollover Benefit to give you that little extra assurance if something were to happen.

The Police Heath Rollover Benefit allows members to carry over any unused Annual Maximum benefit that is not claimed during one calendar year into the following year. The Rollover Benefit covers most extras services, such as major dental and physiotherapy, and gives members more flexibility in using their limits.

Claims are always paid from the current year's Annual Maximum before your Rollover Benefit is accessed. New members are eligible for Rollover Benefit after just 12 months (2 years for major dental).

Here are some examples of how the Rollover Benefit works.

David has Platinum Health cover and can claim up to $850 of physiotherapy benefits each calendar year. In 2014, he had no claims for physiotherapy but in 2015 he injured his back and needed 25 visits to his physiotherapist, charged at $58.00 each visit (total cost = $1450).

Normally, David's benefits with Police Health – which pays $46.40 (80% of provider charge up to set sub-limit) for each physiotherapy visit, would have stopped at the $850 Annual Maximum, but because he had no claims in 2014, he can call on the unused Annual Maximum from 2014. That's an extra $850 Rollover Benefit available on top of the current years $850 Annual Maximum. So all of his physiotherapy visits in 2015 are claimable, providing David with $1160 in benefits. Please note that because David used his entire $850 Annual Maximum for 2015, there will be no unused Annual Maximum available to roll over to 2016, but David will have access to his normal $850 Annual Maximum for the 2016 calendar year.

Sarah, who has been a Police Health member for years, has not claimed any benefit for major dental services. However in 2015, she discovers that she needs two crowns, costing her $2,500 in total. With Police Health's 80% benefit, she can claim $2,000.

In addition to her major dental Annual Maximum of $1,300 for 2015, she can also use her unclaimed Annual Maximum from 2014, giving her access to another $1,300 of benefits. Even after the full $2,000 benefit for the crowns, Sarah still has $600 left for other major dental services that she may need in 2015.

However, like David, because Sarah has used all her Annual Maximum for 2015, there is no unused Annual Maximum available to roll over to 2016.

 

The table below helps further explain how the Rollover Benefit works using physiotherapy as an example.

(South Australia)

 

Year Annual Maximum Unused Annual Maximum Rollover Maximum
(after 12 months of membership)
Benefits paid
Unused maximum to be rolled forward (Rollover Benefit)
    (Rolled over from previous year) (Annual + unused annual maximums)   (Annual maximum - amount claimed)
2013 $850 N/A $850 $150 $700
2014 $850 $700 $1,550 $950 $0
2015 $850 $0 $850 $400 $450
2016 $850 $450 $1,300 $850 $0
2017 $850 $0      

If you have any questions regarding the Rollover Benefit please contact Police Health on Adelaide Local 8112 7000 Other Areas 1800 603 603 .