Extras cover in private health insurance

Although what you’re covered for differs depending on the level of your extras-only health insurance, extras cover generally can include the following healthcare treatments and services:

• General Dental: routine and preventative treatments such as scale and clean, polish, check-ups, examinations, x-rays and fillings.
• Major Dental: includes periodontal (gum treatment), endodontic (root canal), crowns and bridges.
• Orthodontic: includes treatments for teeth straightening, overbite, chewing and jaw alignment like braces and retainers.
• Optical: covers prescription glasses, frames and contact lenses.
• Non-PBS Pharmaceutical: covers pharmaceutical prescription items not listed on the general schedule of the Government Pharmaceutical Benefits Scheme (PBS).
• Physiotherapy: covers consultations and rehabilitation to treat physical issues caused by injury, surgical operation, illness and age-related changes.
• Chiropractic: covers consultations for health problems related to the musculoskeletal system and treatments such as spinal adjustments and joint pain relief.
• Exercise physiology: includes consults and physical rehabilitation by an exercise physiologist such as exercise counselling, physical assessments and prescription exercise programs.
• Occupational therapy: includes occupational therapy consultations to improve and enable people with physical, mental or developmental conditions to engage and participate in everyday ‘occupations’ such as daily living activities (for example showering, dressing, preparing food).
• Podiatry: includes treatments and services of the ankles and feet such as general toenail and skin care (for example ingrown toenails, corns, warts), musculoskeletal injuries and conditions (for example Achilles injuries, bursitis, plantar fasciitis), footwear padding and foot orthotics.
• Osteopathy: covers osteopathic consultations and treatments such as soft tissue and bone manipulations.
• Remedial massage: covers remedial massage consultations such as deep tissue massages.
• Natural therapies: includes cover for acupuncture, dry needling and chinese medicine.
• Psychology: covers consultation with a psychologist or clinical psychologist for mental or physical health issues such as anxiety, depression, pain management or eating disorders.
• Dietetics and nutrition: covers consultation with a dietitian or nutritionist for dietary, nutrition and eating advice.
• Speech therapy: includes speech therapy consultations to diagnose and treat swallowing disorders or verbal speech disabilities or impediments.
• Eye therapy: covers assessments and consultations with an orthoptist to treat eye conditions such as lazy eye and poor focus.
• Hearing aids: if included, covers the costs of hearing aids for people with hearing impairments.
• Appliances, protheses and aids: includes medically necessary appliances and prostheses that help manage, monitor or treat a health condition such as blood pressure monitor, blood glucose monitors, post-surgical bras and joint braces.
• Preventative tests, scans and screenings: these can be skin cancer screenings, bone mineral density tests, breast examinations and bowel cancer tests.

The cost of your extras-only health insurance will depend on your level of coverage, location and whether the policy is for a family, couple or single.

Canstar’s database shows monthly premiums of $12 a month all the way to $300 a month. You can use the comparison table at the top of the page to compare extras-only policies and find one that may potentially suit your needs.

Health insurance providers 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 providers. As an example, we’ve compiled a table of the minimum, median and maximum monthly waiting periods for some common services on Canstar’s database.

Monthly Waiting Periods for Extras Health Insurance Services

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source: www.canstar.com.au – 6/03/2023. Based on standalone extras only health insurance policies on Canstar’s Database. OSHC, visitor, and corporate policies, as well as policies from restricted funds, are excluded.

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 insurance providers won’t require you to re-serve many of the waiting periods. Check with the individual insurer before switching.

Explore more→ Can I waive my waiting period for health insurance?

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.

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 insurance providers, Canstar also presents national and state health insurance awards.

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. 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 using the table at the top of the page.