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How will we pay optical claims from 13 January 2027?

From 13 January 2027, the amount you get back for optical items will vary depending on the provider you visit

From 13 January 2027, we'll use two different ways to work out what you get back for covered optical items. The optical items you're covered for (referred to as "Optical Appliance" in your policy booklet) and your annual limit will stay the same.

You can still visit any recognised optical provider. At a First Choice optical provider, you’ll continue to get a percentage of the provider’s fee back, based on your level of cover. At a non-First Choice network provider, you’ll receive a set benefit amount towards each eligible optical item.

At First Choice optical providers, members can access exclusive offers, including No Gap ranges on selected products. First Choice providers may also offer discounts on products outside these ranges, helping you reduce your out-of-pocket costs. Non-First Choice providers set their own fees so your out-of-pocket cost may vary depending on the provider’s fee, the item you purchase and your level of cover. Before purchasing an optical item, check whether your optical provider is in the First Choice network and ask for quote. This can help you understand what you may get back and what out-of-pockets you may have.

Check your optical provider or find a First Choice optical provider

Before your next purchase or appointment, use the Find a Provider tool to check whether your optical provider is in the First Choice network. If they are, you’ll continue to get a percentage of their fee back, based on your level of cover. If they are not, you can still visit them and receive a set benefit amount towards each optical item from 13 January 2027. Your annual limit will stay the same.

If you have any questions or would like to discuss your options, we're here to help. Members can contact us or check what you're covered for in your member account.

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