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.

Use your extras before you lose them

For most people with extras cover, there are 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.  

In this article: 

Extras health insurance 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 for non-PBS medication such as travel vaccinations, hearing aids or blood glucose monitors.

Usually you get a set benefit per visit or service, and an annual maximum benefit per type of service. Those annual maximum limits reset each year which, for most funds, happens on 1 January. Other funds base it on 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.

  • ACA 
  • APIA 
  • Australian Unity 
  • Bupa 
  • CBHS Corporate 
  • CBHS 
  • CUA 
  • Doctors’ Health 
  • Frank 
  • GMHBA 
  • HBF 
  • HCF 
  • HCI 
  • HIF 
  • Health Partners 
  • Latrobe 
  • Medibank 
  • Mildura Health 
  • MyOwn 
  • NIB 
  • Nurses & Midwives Health 
  • Phoenix Health 
  • Qantas Assure 
  • RACQ 
  • rthealth 
  • St.LukesHealth 
  • Teachers Health 
  • Transport Health 
  • TUH

Should you drop extras insurance? If you haven't used your extras cover much this year, it's worth considering.

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 this 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 annual limits for extras – use it before you lose it

$660 – General dental 

$250 – Optical (glasses and contact lenses) 

$450 – Physiotherapy 

$400 – Chiropractic 

$350 – Massage 

Median annual limits calculated using single policies from Victoria, and including combined service limits in some instances.

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 $35 examination
  • Optical $250 for single vision spectacles
  • Physiotherapy $42
  • Chiropractic $40
  • Massage $31

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 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 for prescription glasses or contact lenses a year, 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 if your health fund lets 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 includes Bupa optical stores, National Pharmacies Optical and The Optical Company's three chains: Kevin Paisley Optometry, Optical Warehouse and Stacey and Stacey Optometrists.


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