Extras only health insurance policies: What’s covered?

If you are only interested in getting health insurance to cover ‘extras’ such as dental, optical, physiotherapy and chiropractic services, then you might be interested in an ‘extras only’ policy.

In this article:


What does an extras policy cover?

An extras policy can help pay for treatments such as dental, optical, physiotherapy and chiropractic therapy. These treatments are typically done out-of-hospital and are not usually covered by Medicare.

You will usually be able to claim money back after you have served any waiting periods that apply. Most policies will only allow you to claim back a certain percentage of costs for each service, and this will also be subject to annual cover limits.

Some other treatments that may be covered include: acupuncture, endodontic, glucose monitors, hearing aids, massage, non-PBS medicines, orthodontic, podiatry and psychology.

The table below displays some of our referral partners’ extras policies for a 30-year-old single female seeking cover in NSW without pregnancy cover. The table is sorted by Star Rating (highest to lowest) followed by provider name (alphabetical). Use Canstar’s health insurance comparison selector to view a wider range of products. Canstar may earn a fee for referrals.

How much does extras cover cost?

The cost of an extras policy will vary depending on what services you want to be covered for, the level of cover and the provider you choose. According to Canstar’s research, the average annual cost of extras cover is $685 for singles (as of April 2020) and $1,334 for couples (as of June 2020). The cost of family health insurance tends to be similar to the cost of couples health insurance. This is based on policies in Canstar’s database.

What are the waiting periods on extras cover?

Insurers typically have waiting periods that you have to serve before you can make a claim. For extras cover, waiting periods are set by the individual insurer. For example, according to Canstar’s database, the average waiting periods for some common services are:

  • Two months for general dental
  • Four months for optical
  • Two months for physiotherapy
  • Two months for chiropractic
  • Two months for massage
  • Two months for psychology

Once waiting periods are served and you maintain that cover in your policy you do not have to serve the waiting period again. Even when you switch providers, the Private Health Insurance Ombudsman says most insurers won’t require you to re-serve the waiting periods.

Is extras cover right for you?

If you’re weighing up whether to get extras cover, it’s a good idea to firstly consider what you want to be covered for. Many of the services covered by extras policies are generally not covered by Medicare (such as dental and optical). So, it could be worth getting cover if you think you are going to be using these services regularly in the future. For example, this could be the case if you wear glasses or contact lenses.

If you have kids you can also include them on your health insurance through a family health insurance policy. This could be handy if they need to get glasses or braces at some point.

How do you find the best extras cover?

If you are looking for a new extras policy, a good place to start could be Canstar’s Health Insurance Star Ratings and Awards. Canstar researches and rates health insurance policies as part of our annual Health Insurance Star Ratings. To recognise top performing health insurers, Canstar also presents national and state health insurance awards.

When assessing extras policies, Canstar considers both price and features. For the price score, Canstar looks at the monthly premium, out-of-pocket expenses and any Government Rebate that applies. For the features score, Canstar considers factors such as the treatments covered under the policy, benefit limits and annual limits. We also consider whether the insurance cover is for a single person, a single parent or a couple/family.

If you already have extras cover in place and want to work out whether your policy is giving you good value for money, you can request an annual claims statement from your provider. This will show the total benefits received in that financial year. According to the Australian Prudential Regulation Authority (APRA), insurers paid about $404 in extras benefits per person in the year to June 2020. Dental took up a large portion of this, accounting for about $212.17.

To check whether you are getting good value, look at your total benefits and your out-of-pocket costs against the cost of your premiums.

If you’re thinking about switching or want to take out a new extras policy, you might find it helpful to compare extras cover with Canstar. Canstar compares thousands of hospital, extras and combined hospital and extras policies each year.

This article was reviewed by our Sub Editor Jacqueline Belesky and Finance Editor Sean Callery before it was updated, as part of our fact-checking process.

Main image source: Anna Shvets (Pexels). 

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