In Australia, there are three main types of insurance: hospital cover, extras cover or combined hospital and extras cover.

While combined hospital insurance and extras health insurance is one of the most popular types of health cover, some people prefer just to take out extras only services with their health fund.

Extras cover, also known as ancillary cover, handles the health services not usually covered by Medicare, such as physiotherapy, chiro, dental treatments, or optical care.

Extras cover is different from hospital cover. While hospital cover helps you manage the costs of in-hospital treatments, extras cover is your ally for services outside of the hospital setting.

But like all things, it has its pros and cons.

Let’s unpack it all so you can find the right health insurance policy for your needs.

The Pros and Cons of Extras Cover

Pros Cons
  • Diverse Coverage: Extras benefits covers a range of services not typically covered by Medicare, including dental care, physiotherapy, chiropractic services, osteopathy, and even equipment like orthotics, glasses and hearing aids.
  • Preventative Care: With extras cover, you can focus on maintaining your health over time. It supports preventative services, such as regular dental check-ups, mental health cover and even gym memberships to keep you moving.
  • Choice of Provider: You can often choose your healthcare provider with extras cover. It allows you to seek treatment from your preferred dentist, physiotherapist, or other healthcare professionals.
  • Waiting Periods: Most extras policies come with waiting periods. This means there’s a set time you need to wait before you can claim benefits after starting your policy.
  • Annual Limits: There’s a cap to how much fun you can have. Extras cover often includes annual limits (and sometimes lifetime limit) which limit how much you can claim for certain services in a financial year.
  • Limited Coverage: Extras cover focuses on specific ancillary services and treatments that are not typically covered by Medicare. While this can be good for those who frequently use these services, it may not provide comprehensive coverage for all healthcare needs, like treatment in a private hospital.

More About Extras Cover

Extras cover can vary greatly depending on the provider and level of cover you choose.

You can opt for a basic extras policy which covers a limited range of services like physio and chiro,or a more comprehensive one that includes a broader range of services like orthodontics, podiatry, speech therapy, and more.

Some policies even offer benefits for natural therapies such as acupuncture or remedial massage.

Waiting Periods

If you’re considering extras cover, remember that policies often come with waiting periods. These waiting periods are different depending on the service and the provider.

For instance, waiting periods for services such as major dental work (like root canals or fillings) or orthodontics can be longer than those for general dental check-ups or consultations.

Government Health Insurance Rebate & Medicare Levy Surcharge

When you have extras cover only, you’re not eligible for the government health insurance rebate. The government rebate is a financial incentive provided by the Australian government to encourage individuals to have at a minimum hospital private health insurance.

On the other hand, if you choose to have hospital cover, you may be eligible for the government health insurance rebate. This means you can receive a financial benefit in the form of reduced premiums for your hospital cover policy.

Not to mention having hospital cover can help you avoid the Medicare Levy Surcharge (MLS). The MLS is an additional tax imposed on Australian taxpayers who do not have adequate private patient hospital cover and earn above a certain income threshold. By maintaining hospital cover, you can potentially avoid paying this surcharge.

It’s important to note that the eligibility criteria and the exact amount of the rebate depend on factors such as your income, age, and family status.

It’s a good idea to speak with your private health insurance provider or refer to the Australian government’s guidelines to determine your specific eligibility and the rebate amount you may receive.

A Note on the Lifetime Health Cover Loading

The Lifetime Health Cover (LHC) loading is an important factor to consider when it comes to private health insurance, specifically hospital cover. The LHC loading is a government initiative that encourages individuals to take out hospital cover earlier in life and maintain it continuously. It aims to reduce the strain on the public healthcare system.

The LHC loading applies a 2% loading on top of your hospital premium for every year you are aged 31 or older and do not have hospital cover. This loading is cumulative and is added to your premium each year, up to a maximum loading of 70%. Once you have held hospital cover continuously for 10 years, the loading is removed.

It’s crucial to note that the LHC loading only applies to hospital cover, not extras cover. Therefore, if you only have extras cover and do not have hospital cover, you may still be subject to the LHC loading.

By taking out hospital cover before the age of 31 and maintaining it continuously, you can avoid the LHC loading and ensure that you have affordable access to hospital services when you need them. If you have any questions or concerns about the LHC loading and how it may affect your health insurance, it is recommended to consult with your private health insurance provider or seek advice from the Australian government’s official sources.


What does extras cover get me?

Extras cover can be beneficial for managing out-of-pocket costs for a range of healthcare services. It offers benefits for prescription glasses, contact lenses, dentures, and even services like glucose monitors for diabetes management.

What are benefit limits?

Extras policies also come with benefit limits, which cap how much you can claim for specific services. There are also sub-limits for particular categories within the overall service group. For example, your policy might have a total limit for dental services and then individual sub-limits for general dental, major dental, and orthodontics.

Do I have to pay out of pocket expenses with extras cover?

Out-of-pocket expenses may still apply with extras cover. Factors such as annual limits, benefit percentages, gap payments, and waiting periods can affect the extent of these expenses. Review your policy for specific details and contact your health insurance provider for clarification.

Let CHI Help You Find the Right Extras Policy

Navigating the world of extras cover and private health insurance in Australia can be complex, but with the right information, you can make an informed decision that best suits your healthcare needs.

Let Compare Health Insurance find you the right extras cover and extras services for your needs with our easy online comparison tool. Compare policies and get quotes from Australia’s leading health fund providers in just minutes.