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Extras Only Cover

Name: Extras Only Cover
Creator: Savvy
Published: 2021-04-23T14:44:10+09:30

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Written by , updated on July 6th, 2023

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Extras cover is an important type of private health insurance. It covers many preventative and non-hospital types of treatment which are provided to millions of Australians every year. Having the right extras cover could save you a significant amount of money, which is why it’s important to compare policies carefully to find a deal that offers the best value for your family’s unique needs.

Savvy can make your search for great extras cover simpler by allowing you to compare a variety of free, no-obligation quotes from leading insurance providers, helping you determine where the best value lies for you. Get started with a free online quote today.

What is extras cover?

Extras cover is a type of private health insurance which enables you to claim benefits for many out–of–hospital health carel services or treatments which aren’t covered under Medicare. An extras cover policy can include cover for common treatments or services like podiatry, dental, physiotherapy, chiropractic and more. Extras cover can prove immensely beneficial to your health and hip pocket if you take advantage of the benefits on offer. For example, regular teeth cleaning by a dentist can prevent plaque build-up, which can lead to the need for root canal work or even tooth extraction surgery.

Extras cover is different to hospital cover, which is more focused on the cost of treatments and other services within a hospital setting. If you’re looking for comprehensive cover for both in-hospital and out-of-hospital treatment, combined hospital and extras policies are available to purchase from a wide range of insurers.

What does extras cover include?

Extras cover can include some, or all, of the following:

Optical (contact lenses and glasses)
Physiotherapy
Chiropractic treatment
General dental (check-ups and more simple dental procedures)
Major dental (teeth removal, root canals, dentures and sometimes cosmetic procedures)
Orthodontics (braces and aligners)
Speech therapy
Remedial massage
Non-PBS medications (those not listed under the PBS)
Psychology and other mental health treatments
Hearing aids (supply and fitting)
Podiatry
Dietetics (nutrition assistance and diet or weight loss programs)
Gym memberships (may be offered by some insurers subject to specific conditions)
Travel vaccinations

How do I compare extras cover?

The priority in determining what extras cover is best for you is to identify which servicesyou need based on your health situation. For example, if you play sports, you may wish to prioritise physiotherapy in your extras cover. If you have back issues or are in a line of work that is high-intensity and strenuous, chiropractic cover may be a good option to consider.

While many extras options may be appealing, it’s important to not go over the top and instead restrict your cover to extras you’re more likely to need and use. For instance, if you’re in your 20s and have no hearing issues, you likely won’t need cover for hearing aids until you’re much older.

In addition, your income will play a role in determining what extras cover you can afford. It can prove costly if you choose an array of inclusions that are not relevant to your specific needs. More expensive extras policies may give you access to a greater number of benefits and higher claim limits but will set you back more overall than a cheaper policy, so it’s important to weigh up your priorities.

Make sure you explore all options thoroughly. You don’t have to have your hospital cover and extras cover with the same insurer, so you may choose to split them between two different health funds. Savvy can help you compare a range of free quotes for health insurance. By comparing policies carefully and reading the product information documents provided by different insurers, you can compare policies side-by-side with more confidence.

How much does extras cover cost?

The cost of your insurance will depend on several factors, including:

the level of cover you choose
any extras you opt to pay for
your life stage when you take out the policy

Taking out extras cover will generally cost you less than hospital cover. However, this doesn’t negate the need for hospital cover given its many benefits. Both options offer cover for a different type of health service and there isn’t any overlap between the two.

Ultimately, the cost of your extras cover will come down to the level of policy you opt for and its included services. An extras policy with top-level cover will cost more than one that offers cover for a more limited range of services. In addition, a singles policy will cost less than for a family.

Additionally, it’s worth considering the amount you’ll pay out of pocket for treatments and services. This will ultimately depend on what your healthcare provider charges and whether they have a specific agreement with your insurer, as well as what the level of extras cover you’ve chosen to take out is. Your policy may offer a fixed dollar amount for their cover or a set percentage of a fee you pay.

Types of health insurance

Hospital cover

This can help you pay for medical treatment if you need to be admitted to hospital. It can help cover the cost of your admission or accommodation and the fees charged by doctors, surgeons and anaesthetists. It can also cover other costs associated with a stay in a private hospital.

Extras cover

This helps cover the costs of health care treatments outside a hospital setting which aren’t covered by Medicare. This can include major and minor dental treatment, orthodontics, hearing aids, physiotherapy, glasses, contact lenses and podiatry (in most cases with annual limits).

Cover for singles

This is a standard health insurance policy designed for a single person, rather than being tailored to cater to the needs of a couple or family. It may include hospital cover plus extras, or either of these types of insurance on their own, depending on what you're after for your health cover.

Cover for families

A family health insurance policy is designed for a family unit including dependent children who may reach up to 31 years of age with some insurers. It offers private health insurance suitable for the whole family and may include shared limits for all members included in your policy.

Cover for seniors

A health insurance policy aimed at seniors is designed to appeal to people who are in the second half of their life. These are often specific Silver Plus policies that offer the same cover as other health insurance policies, with the exception that pregnancy and childbirth cover may not be included.

OVHC

Visitors who are in Australia on a temporary basis for travel, work or study may be able to take out Overseas Visitors Health Cover (OVHC). Many visas issued in Australia come with a requirement to take out this type of insurance, which covers visitors who may not be covered by Medicare.

Ambulance cover

Ambulance cover is generally available either packaged into your private health insurance or on its own as a separate policy or subscription. By having this protection, you could be covered for all eligible ambulance travel in Australia (subject to your insurer's terms and conditions).

Basic hospital cover

The cheapest and most barebones form of private hospital insurance, this can include cover for rehab, in-hospital psychiatric services and palliative care. Having this policy will enable you to avoid paying the Medicare Levy Surcharge (MLS) and Lifetime Health Cover (LHC) loading.

Bronze hospital cover

Bronze hospital cover is a step up from basic insurance, including 18 further clinical categories such as ear, nose and throat, bone, joint and muscle, digestive system, joint reconstructions, gynaecology and chemotherapy, radiotherapy and immunotherapy for cancer.

Silver hospital cover

Silver hospital cover is the second-most expensive type of policy and offers the second-most clinical categories. On top of what's offered by basic and bronze cover, it also includes heart and vascular system, lung and chest, blood, hearing device implantation and dental surgery.

Gold hospital cover

The highest level of private hospital insurance available in Australia, gold policies can offer cover for pregnancy and birth, weight loss surgery, assisted reproductive services and insulin pumps on top of all the categories provided by silver, bronze and basic hospital insurance.

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Pros and cons of extras cover

PROS

Reduce out-of-pocket expenses

Extras cover can reduce the amount you have to pay out-of-pocket for a range of services and treatments not covered by Medicare or hospital insurance.

Can offer cover for dental treatment

Extras cover can include free dental check-ups and cleaning, which is a common expense and may potentially prevent more serious dental issues from developing.

Assistance with the cost of pregnancy

Extras cover can provide relief from some of the costs of prenatal and obstetrics care, depending on the policy you choose and the coverage it offers.

Preventative health checks

Preventative health checks can be covered by an extras health insurance policy, which can assist with the early identification of developing health issues.

CONS

Can be under-utilised

Some customers don’t take full advantage of the extras cover available on their policy, potentially losing out on the benefits available and spending money where they don’t need to.

Complex products

Extras cover isn’t always simple, with many terms and conditions and exclusions to get your head around. Comparing through Savvy can help you understand what is and isn’t covered.

Can still incur out-of-pocket costs

There may still be additional ‘gap’ costs you may have to pay out-of-pocket even though you do have private health insurance. Such gap costs arise when your health care provider charges more for their services than your health insurer’s rebate.

Top tips for getting the best extras cover

Only choose necessary extras

When choosing your extras cover, prioritise protection for the services you’ll actually use and try to avoid paying for cover you don’t think you’ll need. This way, you can help streamline your policy and pay for what you need and not what you don’t.

Take full advantage of your extras cover

Once you have taken out your extras cover, enjoy and use the additional benefits you are now entitled. There may be waiting periods, but once these are over it could be time to get yourself that new pair of prescription sunglasses or give your teeth a check-up.

Keep an eye on your limits

It’s important to know what your policy’s annual limits are. This way, you can ensure you don’t reach it and end up having to pay more than you bargained for. Make sure you’re aware when your annual benefits renew into a new benefit year so that you can make the most of the cover you’re paying for.

Compare offers frequently

To make sure you are getting great value for your health insurance dollar, make sure to give your health insurance policy its own check-up at least once a year. Compare offers through Savvy regularly to help you keep up to date with the latest deals.

Frequently asked questions about extras cover

Should I get extras cover, hospital cover or a combined cover?

Each type of insurance is designed to offer cover for a range of defined health services. There is no overlap between hospital cover and extras cover, so which option is right for you or your family will depend on your personal circumstances, health status and budget.

If you’re concerned about requiring surgery in the future, hospital cover may provide you with cover for such treatment. Extras cover provides cover for out-of-hospital treatment.

What are the waiting periods for extras claims?

Unlike hospital insurance, extras cover doesn’t come with any Government-mandated limits relating to waiting periods. As a result, these will be set by individual insurers, which makes them especially important to compare before you buy your policy. This is also the case if you switch insurers, regardless of whether you opt for a more expensive policy or not, so you may be required to resit a waiting period in the event of a switch. However, some insurers will sometimes offer to shorten or waive waiting periods, so these are worth considering when shopping around.

How long do I have to make a claim on my extras cover?

In most instances, insurance providers will give you some leeway while you make a claim if you had cover at the time of the service or treatment. It may vary from fund to fund, but some may allow you to submit your claim up to two years after the date of treatment or service.

What’s an annual limit?

An annual limit is a cap which is placed on the amount you can claim for a certain type of service annually on your policy. Instead of annual limits, some extras services, like orthodontics, may have a lifetime limit. Read your insurer’s product information documents for more detailed information.

When does my extras cover’s annual limits restart?

This will vary between health funds, but your annual limits will usually restart either at the beginning of each financial year or each calendar year. Make sure to read your policy’s product information documents or contact them if you’re unsure.

I have a pre-existing condition. Am I still eligible for extras cover?

Yes – despite having a pre-existing condition, you will still be eligible for both hospital and extras cover. This is because private health insurance is community-rated in Australia, meaning you can’t be discriminated against (be denied a policy or pay more for it) based on factors such as pre-existing conditions or age. However, insurers will typically have their own waiting periods for treatments and services relating to pre-existing conditions, so it’s worth checking with your insurer as to what these may be.

Health insurance by age group

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Under 30s

Over 50s

Over 60s

Over 65s

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Helpful health insurance guides

Looking for health insurance to cover your condition or treatment?

Read one of our helpful guides on a range of different ailments and potential hospital or extras treatments to help you find out if they're covered.

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