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Extras Cover in Private Health Insurance

Select who’s getting extras cover in private health insurance to compare and get a quote.
Extras cover helps cover the costs of non-hospital treatments (and not covered by
Medicare) like physio, dental, optical and more.
There are three levels of extras cover: Basic, Medium, and Comprehensive
Waiting periods apply (usually 6-12 months)
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Extras cover helps cover the costs of non-hospital treatments (and not covered by
Medicare) like physio, dental, optical and more.
There are three levels of extras cover: Basic, Medium, and Comprehensive
Waiting periods apply (usually 6-12 months)
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Want to Get More Out of Your Health Insurance? Private Health Extras Cover May Be the Perfect Solution.

Taking care of our overall well-being is a top priority for many Australians. It allows us to continue doing the things we love. However, life happens, and we may require some extra care and attention from healthcare professionals.

This is where health insurance extras-only policies come into play. They are designed to help take care of the costs of health services delivered outside of a hospital and those that aren’t covered by Medicare. This includes dental treatment physiotherapy, optical, and alternative or natural therapies such as naturopathy and remedial massage.

If you're unsure about the different types of policies available and how you can benefit from extras cover, read on. Understanding the ins and outs of extras cover will empower you to make informed decisions about your health insurance and ensure that you receive the care you need to maintain a healthy mind and body.

You can save on medical expenses

Taking out an extras policy in private health insurance is a great way to help you maintain a healthy lifestyle without exorbitant costs. A bit like travel insurance or ambulance cover, it also provides peace of mind if anything should happen.

For many people, extras cover enables them to take control of their health and actively work to prevent illness from occurring.

Think about it - you’re more likely to visit the dentist for regular dental check-ups to help prevent decay and more costly conditions from developing when you know you’re covered.

Or you may have a pre-existing condition so regular chiro or massage treatments could help get rid of persistent knots and aches. Or perhaps, you may enjoy savings on your glasses or medication that isn’t covered by the Pharmaceuticals Benefits Scheme (PBS).

Extras cover in private health insurance has you covered for the services important to you and your health.

Services of extras only health insurance you can benefit from

Depending on the policy type, extras cover offers a variety of services to choose from. You’re almost guaranteed to find at least one feature of an extras policy that you can take advantage of. Some of the most popular services for those with extras cover in private health insurance benefit from are:
  • Dental treatment including dental check-ups
  • Major dental and orthodontic treatment (with typical 12 month waiting period)
  • Chiropractic treatment
  • Physiotherapy
  • Podiatry
  • Occupational and speech therapy
  • Optical including eye check-ups, glasses, and contact lenses
  • Medical aids such as a glucose monitor and hearing aids
  • Prosthesis
  • Pharmaceuticals not covered by the PBS
  • Psychology
  • Alternative and natural therapies such as acupuncture, naturopathy, and remedial massage

What are the types of extras cover?

As with any health insurance, your cover is divided into 3 levels which will dictate the cost of your policy and what services are claimable.

  • 1. BASIC EXTRAS

    Basic cover pays benefits for a limited number of essential medical services such as general dental and physio. The benefits payable for these ancillary services are also much lower than those offered under a higher level of cover. An advantage of basic extras is that the premiums are low, making it one of the more affordable health insurance options. A disadvantage of basic extras is that many policies combine their benefit limits. This means you may use up your annual limits quickly in just a few visits to your chosen healthcare providers.

  • 2. MEDIUM EXTRAS

    Medium extras insurance provides excellent value for money and offers a wide range of valuable benefits. With this coverage, you gain access to essential services such as optical care, general dental treatments, major dental procedures, physiotherapy, chiropractic care, osteopathy, and much more. One of the most sought-after benefits is the soothing remedial massage that helps relax muscles. By opting for this cover, you can ensure comprehensive health care while making the most of your budget.

  • 3. COMPREHENSIVE EXTRAS

    If you’re looking for the top extras policy, comprehensive extras is the highest level of cover you can take out. It covers the most extensive range of medical treatments and returns the highest benefits when you claim. It’s also the most expensive option but you’re also paying for more peace of mind should you ever need any extras services.


Ready to find the perfect extras cover for your needs? Use our comparison tool to quickly discover the best policy options for you.

Our online comparison tool is one of the quickest and easiest ways to find the right cover for you.

Whether you’re in Victoria, NSW, Queensland, WA, South Australia or Tasmania, we can find the perfect cover options for you.

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For example, if dental cover is important to you, you’ll want to find the best cover for dental treatment rather than paying for services you won’t intend on using like medical aids or ambulance cover.

Which level of extras cover is right for you?

Finding out which level of cover which is right for you will depend on your health care needs and budget. After all, you don’t want to take out comprehensive insurance only to realise paying the premiums is a stretch and you’re not utilising all the benefits.

Typically, basic extras is ideal for young and healthy individuals that don’t have a complicated health history. These people use their cover to pay for dental treatments and the odd physiotherapy session. Growing families or those singles and couples entering their middle age with average health care needs may benefit more from medium extras cover. It’s more affordable than comprehensive and can help cover the costs of your children’s dental treatments. Or you may use the benefits of optical and physio to combat the effects of ageing.

Comprehensive extras insurance is ideal for those who want to pay for a greater level of security. Families with children who have a family history of poor dental or eye health may benefit from this higher level of coverage. Comprehensive extras will help cover the costs of braces and crowns or prescription glasses and contact lenses.

Comprehensive extras could also be a wise investment to singles or couples who regularly utilise a range of out-of-hospital health care services and therapies. With some policies, you can even benefit from discounted gym memberships which will help you remain fit and healthy. It may be the very thing you need to get you off the couch and into the gym!

Extras Cover Policy - Is It Worth the Cost?

When deciding whether to get extras cover in private health insurance, it's important to consider the costs versus paying for health services out of pocket. One key benefit of having extras coverage is that it encourages you to utilise health care services more frequently.

For example, regular dental cleanings can help prevent the need for expensive treatments like fillings or root canals. Additionally, with extras coverage, you're more likely to visit health care professionals like podiatrists or physiotherapists, as the majority of the cost will be reimbursed.

By taking advantage of these services, you not only save on costs but also improve your overall health and well-being.

To sum it up, extras cover in private health insurance will certainly save you money when compared to paying out of pocket, especially if you plan on using certain services more frequently.

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Who needs cover?

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Hospital Cover versus Extras Cover - What’s the Difference?

Hospital insurance will help pay for the treatment you receive in a hospital due to an illness or injury.

Extras cover, on the other hand, will help fund the cost of ancillary services (medical services or supplies that are not provided by acute care hospitals, doctors or health care professionals) that aren’t covered by Medicare (like dental treatment, physiotherapy , optical, and alternative or natural therapies such as naturopathy and remedial massage.

For some people, hospital cover will be more important to them than extras cover. Elderly people or those who are beginning to develop chronic health complaints may find hospital cover a higher priority.

A young, healthy individual may benefit more from a basic hospital cover and a medium extras policy to help them maintain their lifestyle and good health. However, avoiding Lifetime Health Cover Loading before you turn 31 is the main reason why people take out hospital cover.

Remember, you may not have to choose one over the other. Hospital and extras cover can easily be combined under the one policy or taken out as individual cover depending on your personal situation.

It’s important to remember, if you do take out extras only insurance and don’t have hospital cover you won’t be exempt from the Australian Government’s Medicare Levy Surcharge or Lifetime Health Cover Loading.

One of the main advantages of combining your hospital and extras policy with one fund is convenience. You’ll only have one premium to pay and one fund to contact when you need assistance. On top of that, you may be able to take advantage of the Australian Government rebate on private health insurance.

Our comparison tool is here to make things easier for you. Whether you're considering getting extras insurance as an individual policy or combining it with your existing cover, our tool allows you to compare the benefits of different options.

How your extras claims are paid with private health insurance

There are two methods health funds use to cover the costs of extra services, both of which come with advantages and disadvantages.

  • 1. Percentage Benefits

    Percentage benefits calculates the benefits as a percentage. For example, you might receive 100% back from general dental care or 70% back from your physio treatment. So if a single physio session is charged at $100 you will get back $70 of the total cost.

    The advantage of percentage benefits is that you’ll know what percentage you’ll be reimbursed regardless of the bill from the health care service. A downside of this method is that you’re unable to prioritise particular services as the percentage benefit is applied to all services under your policy. However, you may be able to agree on a higher premium in exchange for a higher percentage rebate.

  • 2. Set Benefits

    Set benefits offer a fixed annual amount to each service utilised. For example, you may get $300 back for physio and $500 for general dental every year. Unlike percentage benefits, calculating your out-of-pocket expenses is more difficult, unless you know how much your dentist or physio charges for your treatment.

    However, set benefits do come with the advantage of being able to customise your cover by selecting a policy that offers higher benefits for the services you use the most. Some health funds may even increase the benefits annually in return for your loyalty.

How extras cover benefit limits work

Health insurance funds set limits on the amount you can claim for specific treatments each calendar year. This will depend on your level of cover and the individual fund.

Typically, limits are broken down into the following categories:

Combined Limits

Combined limits mean several services are under one limit. For example, an extras policy with an overall physical therapy scheme may incorporate dental treatment, optical , and alternative or natural therapies such as naturopathy and remedial massage under one benefit. In this case, once you’ve maxed out the limit of physio, you won’t be provided with any additional benefits for chiro and remedial massage.

Sub-limits

An extras policy with sub-limits means specific treatments under the one scheme will have individual benefit limitations. For example, a cover with an overall major dental benefit may have a limit of $600 for crowns and $400 for dentures.

Lifetime Limits

Lifetime limits are not very common and typically only apply to orthodontic treatments. An extras policy with lifetime limits means that your limit isn't renewed annually. The lifetime limit will remain even if you increase your level of extras cover or switch to a new health fund.

Reading the fine print about waiting periods

Depending on your fund, you may need to serve a waiting period before taking advantage of your extras benefits. It’s vital to read the fine print when comparing policies. The last thing you want is to take out an extras policy only to find out you have to wait an extended period before you can lodge a claim.

Here are some general waiting periods to keep in mind:

  • 2 months – most extras services including general dental, physiotherapy, and chiropractic treatment.
  • 6 months – optical services including glasses and contact lenses.
  • 12 months – major dental, orthotic appliances, and psychology consultations.
  • 12-36 months – orthodontics, assisted reproductive medications, and hearing aids.

Waiting periods are a part of both hospital cover and extras cover, but it's important to note that the waiting periods for hospital cover are regulated, whereas individual funds have the flexibility to set their own waiting periods for extras cover.

That's why it's crucial to compare different policies and carefully read the fine print. Additionally, keep an eye out for promotions that offer "extras no waiting period," as these can be a great opportunity to join a fund and have waiting periods waived.

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Extras Cover in Private Health Insurance FAQs

1. What does extras cover include?

Extras cover, also known as ancillary cover or general treatment, is a type of health insurance in Australia that provides coverage for out-of-hospital medical care. It offers a range of services that are not covered by Medicare. With extras cover, you can access benefits for treatments such as dental treatment, prescription glasses, osteopathy, physiotherapy, acupuncture, and more. It provides additional financial support for important healthcare services beyond what is covered by the public healthcare system.

2. How do out-of-pocket costs work with extras health insurance?

Out-of-pocket costs refer to the expenses you pay for healthcare services that are not covered by your health insurance. With extras health insurance, the amount you pay out-of-pocket can vary depending on the type of service and the terms of your policy. Some services may be fully covered, while others may have a gap between the cost and the benefit provided by the insurance. It's important to review your policy's benefit structure and understand the out-of-pocket costs associated with different services.

3. Are ambulance services covered by extras health insurance?

No, emergency ambulance services are generally not covered by extras health insurance. Ambulance coverage is typically included in hospital cover or can be purchased separately as ambulance-only cover. If you want coverage for ambulance services, it's important to consider adding ambulance cover to your health insurance policy or obtaining it through other means, such as a state ambulance subscription

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