Considering Extras Cover?

Fortnightly trips to the physiotherapist; monthly check-ups at the optometrist. It all adds up. Luckily, when you don’t want to pay more than you have to, extras cover (also known as ancillary or general treatment services) gives you options.

Extras cover is for treatments not included in your hospital healthcare. Some policies offer flexible limits, so you can spend your limits on the services you use most often. Maybe you’re after the best extras cover for physiotherapy or looking for dental insurance only?

Most health cover providers offer packaged health insurance for both hospital and extras. You also have the choice to purchase them separately. In the end, it’s your personal choice to invest in extras cover.

Navigating the long list of extras health cover policies and special offers can be tricky, because the range of benefits offered and paid will typically vary widely between health funds.

Health funds may restrict the total amount you can claim by setting either a total claimable maximum per year, or applying individual service limits. It’s also important to be aware that funds may apply family or single limits restricting the number of times you can claim.

Extras cover

Extras health insurance can provide cover for ongoing costs such as dental, some pharmacy costs, physio, chiro or optical up to the benefit limit provided for under the policy.

Basic cover:

Great for younger members or infrequent users who are unlikely to require extensive coverage on extras services. Often includes general dental, physio, chiro and podiatry.

Medium cover:

If your needs are changing and you want extras health cover for more than just the basics. Often includes general dental, major dental, endodontic: orthodontic, optical, physiotherapy, chiropractic, podiatry, psychology and remedial massage.

Comprehensive cover:

Ideal if you want to be covered for an extensive range of services for you and your family members. Often includes general dental, major dental (benefit limits vary), endodontic, orthodontic (benefit limits vary), optical, physiotherapy, podiatry, orthotics psychology, remedial massage, natural therapies and medical aids and appliances such as hearing aids.

Extras cover means money in your pocket

Extras cover gives you money back for non-hospital services. The total amount you can claim depends on the level of cover you have. So the higher the level of health insurance cover, the higher your annual limit, and the higher the percentage you can claim back. That means more money in your pocket if you’re frequent user of the extras services.

The range of benefits offered and paid will typically vary widely between health funds. Some health funds may restrict the total amount you can claim by setting either a total claimable maximum per year, or applying individual service limits. It is also important to be aware that funds may apply family or single limits restricting the number of times you can claim.

The waiting period

As a first-time buyer, or someone updating their health insurance plan, you’ll likely have a waiting period. These range from two months for benefits on general dental and 12 months for major dental or pre-existing conditions before you can make your first claim. During this time, you won’t receive benefits for certain treatments or you’ll receive lower benefits. For those customers switching policies any waiting periods already served won’t need to be re-served, so you’ll be able to claim on those services immediately.

Extras cover benefits different people, differently

If you’re single or in a couple interested in health insurance for dental, optical, and physiotherapy, basic or medium cover shouldn’t break the bank. Generally, a couples policy is the same price as two single policies. This offers you and your partner the flexibility to choose the extras that meet your individual needs, rather than having to choose the same.

On the other hand, if your family is experiencing ongoing dental issues, maybe per person limits are important to you rather than a family limit? Are you updating your glasses annually? Wanting to invest in braces for the kids? In this instance, comprehensive cover may be more suitable.

The bottom line? Choose a fund that reflects your lifestyle. If you’re a family, then perhaps you need a fund that offers free dental checkups.
Everyone has different needs and desires so it’s helpful that most health insurance providers offer multiple levels of cover.

Is extras cover good value?

Extras health cover can be great value if you’re making the most of the services available.

Check for HICAPS availability. When booking treatment or care, this option allows you to make immediate claims on many services. If you miss making a claim on the spot, don’t worry, as most funds will refund claims up to two years after the date of service.

Look out for early payment discounts. Some funds offer up to 4% in discounts for payments made by direct debit, or by paying your annual premium upfront.

Review your health insurance payments. It can be better value to choose a fund that pays out a percentage of your bill for each treatment (e.g. 60%) rather than a fixed amount (e.g. $30).

Consider the switch

If you decide your policy is not meeting your needs, consider switching to a lower level of cover. See our guide to switching health insurance.

For friendly, expert advice on extras policies that suit your lifestyle, call iSelect on 13 19 20.

iSelect does not compare all products in the market. Not all products are available at all times.