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Compare Hospital and Extras Cover
Compare Hospital and Extras Cover
Written by
Madeline Pettet
Edited by
Ellie Garran
Reviewed by
Dr Jill GambergCheck out our range of private health funds
iSelect does not compare all providers in the market or all policies offered by our partners in your area. Not all policies or special offers are available to all customers and some may only be available over the phone or on the website. Learn more.
How does combined hospital and extras cover work?
Imagine your health insurance is a combo meal – you order the burger (hospital cover) and the fries (extras cover). You don’t necessarily get a discount from ordering both together, but it definitely makes things a bit easier than going to two separate restaurants.
Do I need combined hospital and extras cover?
If you’re young and healthy, you might only want extras cover, which helps you with things like preventative care, such as seeing the dentist. But as you get older and even have kids of your own, you might want more out of your cover. Combined hospital and extras cover can be a convenient way to make this happen.
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Share some basic details about yourself or your household and the type of policy you’re looking for
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What’s the difference between hospital cover and extras cover?
Hospital cover
Where do I use it?
As the name suggests, hospital cover helps you out when you need to check into the hospital.
What does it cover?
That depends on your hospital cover tier. Gold covers all kinds of hospital procedures, like joint replacements, while basic and bronze cover fewer hospital treatments. Silver offers more treatments than basic or bronze, but fewer than gold.
How are costs covered?
You might need to pay an excess – think of it as the price of admission – and then Medicare and your health fund both chip in to help contribute to the total cost. It’s like splitting the bill, health insurance style. Depending on your provider and policy, you may still have out-of-pocket expenses.
Are there limits?
Nope, you can pop in for procedure after procedure, and your health insurance will still help cover the costs (assuming you need the treatment!).
Extras cover
Where do I use it?
If you’re not checking into hospital but you’re still seeing a medical professional, extras cover might be able to help.
What does it cover?
Extras cover can handle things that hospital cover misses out on. It’s your go-to for treatments like dental, optometry, and other services that Medicare doesn’t fully cover.
How are costs covered?
Depending on your cover, your extras might foot the entire bill for a treatment or help pay a portion of it.
Are there limits?
You’ll need to check your policy for specifics, but extras cover does have annual limits for how much you can claim back. These could vary depending on services and even be shared between people listed on the policy.
What are the pros and cons of combining hospital and extras cover?
There’s lots to love about combined hospital and extras cover, including:
Enjoying extra convenience: Pay just one premium, use the same membership card and app, and only need to remember the one fund name.
Being prepared while staying proactive about your health: Be ready if life throws more serious health issues at you, while also doing more in the here and now to keep your health in good shape.
Getting more cover in one go: Whether you’re a big believer in your own health or want to keep your family feeling their best, combined cover can mean you have more health needs covered.
Making the most of bundling perks: Sometimes health funds like to sweeten the deal for combined cover, offering special discounts on premiums or skipping waiting periods for some types of cover.
Everyone’s health needs are different. Some people might find combined hospital and extras cover means:
Risking overpaying: You might have fewer options to tailor your cover to suit your needs, so you could end up paying for cover you don’t intend to use.
Having less flexibility: Whether it’s missing out on cover you’d like or only having a few preferred providers in your area, locking things up with just one fund might leave you feeling a little restricted.
There’s lots to love about combined hospital and extras cover, including:
Enjoying extra convenience: Pay just one premium, use the same membership card and app, and only need to remember the one fund name.
Being prepared while staying proactive about your health: Be ready if life throws more serious health issues at you, while also doing more in the here and now to keep your health in good shape.
Getting more cover in one go: Whether you’re a big believer in your own health or want to keep your family feeling their best, combined cover can mean you have more health needs covered.
Making the most of bundling perks: Sometimes health funds like to sweeten the deal for combined cover, offering special discounts on premiums or skipping waiting periods for some types of cover.
Everyone’s health needs are different. Some people might find combined hospital and extras cover means:
Risking overpaying: You might have fewer options to tailor your cover to suit your needs, so you could end up paying for cover you don’t intend to use.
Having less flexibility: Whether it’s missing out on cover you’d like or only having a few preferred providers in your area, locking things up with just one fund might leave you feeling a little restricted.
What should I consider when comparing hospital and extras cover?
Level of cover
For hospital cover, consider which tier suits your needs – basic, bronze, silver, or gold. While there aren’t standardised tiers for extras, you can still choose different levels of coverage. You’ll be able to select a policy that suits your lifestyle and health needs, like picking a streaming service that fits your ever-growing list of TV show recommendations.
Excess
Your excess is your entry fee to private hospital care – when you make a hospital cover claim, it’s what you pay before your admission. You’ll have a few excess amounts to choose from, and a higher excess often means lower premiums.
Waiting periods
When you sign up for a new policy or increase your level of cover, you’ll usually have to wait a little while before you can access your new coverage. While waiting periods are pretty standard across hospital policies, they can vary more for extras cover.
Cost
Your premium is your regular health insurance bill. As mentioned, a higher excess can mean lower premiums. You’ll also find a bit of variation in premiums between providers. It’s worth considering your premiums alongside your level of cover to make sure you’re achieving a good balance between what you’re paying and the value you’re getting.
Helpful tip
‘Gap cover’ is an arrangement that health funds sometimes offer to help reduce your out-of-pocket expenses. It’s worth exploring the type of gap cover in an insurer’s combined policies, especially whether they have agreements with a broad network of specialists. These agreements can significantly lower, or even eliminate, your out-of-pocket expenses for hospital procedures and dental check-ups.
Dr. Jill Gamberg
GP, Coach and Lifestyle Medicine Physician
Do I have to take out my hospital and extras cover with the same health fund?
Nope! You’re the boss of who wins your health insurance patronage. Having your hospital and extras policies under the same health fund is like wearing matching socks – nice, but not mandatory. Getting them separately is like building your own playlist – more tailored to you, but you have to do the tailoring yourself. It’s your health, and it’s your call.
Frequently Asked Questions
Do waiting periods apply before I can claim against my hospital or extras coverage?
They do. For hospital cover, the government has set the following waiting periods:
- 12 months for pre-existing conditions, pregnancy, and birth
- two months for psychiatric care, rehab, or palliative care, including for pre-existing conditions
- two months for everything else.
The exception to this is if you’re switching to a policy with the same or a lower level of coverage. If you’ve already served waiting periods on your previous policy, you don’t have to serve them again.
For extras cover, there are no government-mandated waiting periods, so you might find that they look different between funds. However, sometimes health funds do offer waivers on some extras waiting periods.
Do I have to have hospital and extras cover to avoid Lifetime Health Cover loading or the Medicare Levy Surcharge?
If you skip getting hospital cover by 1 July after hitting the big 3-1, once you do get health insurance, there’ll be a 2% extra charge on your premium for every year you went without coverage (maxing out at 70%). This little extra is called the Lifetime Health Cover (LHC) loading.
And that’s not the only additional charge you could be in for. The Medicare Levy Surcharge (MLS) is an extra tax you might need to pay if your income is over a certain threshold and you don’t have appropriate hospital cover. And that threshold? For 2025–26, it’s anything more than $101,000 for singles or $202,000 for families and couples.*
To dodge LHC loading, you’ve got to have your basics covered with hospital cover. Extras cover is like an optional side dish – nice to have, but it won’t help you avoid either the LHC loading or the MLS. So, remember, if it’s just extras in your health insurance basket, you might end up footing both.
*Single parents and couples (including de facto couples) are subject to family tiers. For families with children, the thresholds are increased by $1,500 for each child after the first.
Can I get hospital cover without extras cover?
If you want to keep your health insurance streamlined or just want to get on the good side of Lifetime Health Cover (LHC) loading and the Medicare Levy Surcharge (MLS), you’re allowed to pick up hospital-only cover. It’s up to you how you want to look after your health.
Right here and now, you might not be all that keen on extras or the extra premium cost. However, you can always change your mind later, too. You won’t be locked out of getting extras cover in the future.
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Health Insurance & Tax
Tax Implications on Health Insurance
How to save on Health Insurance
About the Medicare Levy Surcharge
About the Life Time Health Cover Loading
Government Rebate & Means Testing
iSelect does not compare all health insurance providers or policies in the market. The availability of policies will change from time to time. Not all policies available from its providers are compared by iSelect and due to commercial arrangements, your stated needs and circumstances, not all policies compared by iSelect are available to all customers. Some policies and special offers are available only from iSelect’s contact centre or website. Click here to view iSelect’s range of providers