Changes that may impact you

From 1 May 2026, claims for Australian Register of Therapeutic Goods (ARTG) approved weight management medication (including GLP‑1 medicines) will continue to be covered, but we are introducing a new sub-limit of $150 per person, per year to 16 impacted nib Extras products:

1. Top Extras

2. Advantage Extras

3. Core & Young at Heart Extras

4. Core Boost & Young at Heart Extras

5. Core, Wellbeing & Young at Heart Extras

6. Core Boost, Wellbeing and Young at Heart Extras

7. Core, Family and Young at Heart Extras

8. Core Boost, Family and Young at Heart Extras

9. Gold Advanced Cover

10. Essentials Plus Pregnancy – Basic Plus

11. Top Cover – Gold

12. Premier 85% – Gold

13. Young At Heart Top – Silver Plus

14. Mid Plus – Silver Plus

15. Premium Extras

16. Executive R – Gold.

How is the sub-limit applied?

If you’re claiming for a weight management medication, a sublimit of $150 will apply per person, per year for the above nib Extras products.

There is an exception. If you’re claiming for a weight management medication that is not being used for weight management purposes, you’ll need to provide us with a doctor’s letter confirming it’s not being used for weight management purposes along with an official pharmacy receipt (not cash receipt). Without it, your claim will be assessed under the $150 weight‑management sub‑limit. You can contact us if you need support.

To see if your medication is affected by this change, check the list of impacted weight management medication.

Why is this change being introduced?

This change takes into account rising pharmacy costs while ensuring ongoing access to these medicines for members. Benefits for other eligible pharmaceutical items under your Extras cover remain unchanged.

From 2 June 2025, service limits will apply to Extras products that include preventative dental. This update aligns with industry best practice and helps ensure the long-term affordability of dental benefits for our members.

While your annual limits will not be changing, we’re introducing service limits (how many times you can claim within a calendar year) for some preventative dental services. We’ve also reclassified some general dental services to preventative dental.

What is a service limit? 

A service limit means there’s a cap on how often you can claim for certain treatments. You’re still covered, but only up to a set usage limit.

What does this mean for you?

• You can still visit the dentist, but some treatments will have service limits. For example, you can usually claim two scale and cleans every calendar year. 

• If you need a course of dental treatment, different parts of your treatment may have different limits on how much you can claim. The benefit limits depend on your nib policy. Contact us before your treatment so we can help you understand what’s covered and how much you’ll get back.

• Some dentists are aware of service limits and may inform you, but it’s important to check yourself. Please find the impacted service limits in the table below.

Can I change dental practitioners and still be covered for No Gap dental?

Yes, if you need to change dental practitioners, you can still be covered for eligible No Gap preventative dental services such as check-ups and cleans, subject to your annual limits/Service limits. Coverage applies per provider /per calendar year, so switching between dental practitioners within the same clinic does not allow for additional services beyond what’s included in your cover.

Preventive dental service limit item listing table

How do I check my annual limits?  

Log in to your member account or the nib App to review your Extras cover and check your annual limits.

Unsure if you need additional treatment? Contact us before you book your next dental appointment, we’re happy to help.