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Make the most of your extras cover

Need a new set of spectacles, dental check-up or a massage? Now might be the time to get it.

optical glasses
Last updated: 08 November 2019

If you have extras health insurance, there may be only a few weeks left to use your benefits before you lose them. Most health insurance funds reset their extras benefits on 1 January, and anything you haven't used before then is lost.

Extras cover pays benefits for health costs including spectacles and contact lenses, a dental check-up, a set of braces or dentures, physiotherapy, podiatry, chiropractic, massage and counselling. It even helps with the cost of non-PBS medication and medical devices such as hearing aids or blood glucose monitors.

Usually you get a set benefit per visit or service, capped at an annual maximum benefit per type of service. 

The annual maximum limits reset each year – on 1 January for most funds. Other funds reset at the end of the financial year, and a few on the date you joined. 

Only very few funds – such as Police Health and Emergency Services Health – let you claim unused benefits for some services during the next year.

Is your health insurer on this list? Act now

If you have health insurance with one of the below funds, your extras benefits will reset on 1 January and what you haven't used will be gone.

How much money could you be leaving on the table?

Extras health insurance usually only pays a portion of your costs, so we're not recommending you go out and get treatments for things you don't need, because it will still cost you. 

But if, for example, you've put off going to the physiotherapist to get treatment for your back pain, or you haven't been to the dentist all year, now is a good time to go – especially if you might need longer term or expensive treatment, as your benefits will stretch further.

Typical health insurance benefits per service

How much you get back for each treatment depends on your policy, but these are median figures:

  • General dental $33 examination
  • Optical $200 for single vision spectacles
  • Physiotherapy $40
  • Chiropractic $39
  • Massage $30

Note: These are the median benefits per person (single policy in Victoria) for the first service in a year – usually the benefits are smaller for subsequent services. Only policies with $ benefits for services were used for this calculation – a number of policies pay a percentage of your cost, usually between 50 and 100%.

How to get expensive glasses for free

On average you'll get about $250 a year for prescription glasses or contact lenses, with benefit limits ranging from $100 up to $600 on some premium policies. That often fully covers the cost for single vision specs, but if you need multifocals (which correct both near and far vision problems) you can be out of pocket by hundreds of dollars.

To double your benefit and reduce your out-of-pocket costs, check whether your health fund will let you claim for lenses in the old year and frames in the new year.

  • Medibank allows two bills for frames and lenses, one in December, one in January.
  • Bupa allows separate lenses and frames claims at their Member's First providers, which include Bupa optical stores, National Pharmacies Optical and The Optical Company's three chains: Kevin Paisley Optometry, Optical Warehouse and Stacey and Stacey Optometrists.

We care about accuracy. See something that's not quite right in this article? Email us at factcheck@choice.com.au or read more about fact checking at CHOICE.

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