Extras cover is a common way to manage the cost of everyday healthcare, with 55% of Australians holding a policy according to APRA.
For many people, it’s a way to get some money back on regular health expenses that can otherwise add up quickly over the year. How much value you get will depend on the policy you choose, the services you use and how often you claim.
What is extras cover?
Extras cover is a type of private health insurance that lets you claim benefits for health services and treatments outside hospital that Medicare doesn't usually cover, such as dental, physiotherapy, podiatry and chiropractic care.
It's different to hospital cover, which helps pay for treatment you receive as an admitted hospital patient.
Most insurers group extras policies into three broad levels: low, medium and high. The higher the level of cover, the more services are generally included and the higher your annual benefit limits tend to be.
What does extras cover include?
Extras cover can include a wide range of out-of-hospital health services, but exactly what you can claim depends on your insurer and level of cover.
Extras policies aren’t standardised, so the services included and how insurers group them varies between providers. Lower-level extras policies generally offer fewer, more common services, while higher tiers build on this by adding a broader range of treatments and higher benefit limits.
What isn't covered by extras?
Extras cover is designed for out-of-hospital services, so it won't cover treatment you receive as an admitted hospital patient. That falls under hospital cover instead.
It also won't necessarily cover every service or the full cost of treatment. What you can claim depends on your policy, and exclusions, annual limits, waiting periods and benefit amounts can all affect how much your insurer pays.
Some services may not be covered at all by a particular extras policy, even if they're offered by another insurer or at a higher level of cover.
How does extras cover work?
Benefit payments
Extras cover works by paying a benefit towards eligible out-of-hospital health services when you make a claim. Depending on the policy, this may be a set dollar amount for a service or a percentage of the fee you're charged, which means you may still have an out-of-pocket cost.
For example, a fund might pay $50 towards a standard dental check-up regardless of what the dentist charges, or 60% of the cost of a physiotherapy session, leaving you to cover the remaining 40%.
Annual limits
Policies also come with annual benefit limits, which cap how much you can claim for certain services over a set period. These limits usually reset each calendar or financial year, depending on the insurer, and may apply to individual services or groups of services.
For example, a policy might set a $600 annual limit on general dental and a separate $400 limit on optical. Once you've reached that limit, you'll generally need to pay the full cost of any further treatment in that category until the limit resets.
Waiting periods
Waiting periods often apply before you're able to claim on your health insurance. Unlike hospital cover, extras waiting periods aren't regulated by the government, so they vary between insurers and services. However, insurers tend to use similar timeframes for many common treatments.
Typical waiting periods can include:
- General dental: around two months
- Major dental and orthodontics: around 12 months
- Optical: around two to six months
- Physiotherapy: around two to six months
- Psychology: around two months
- Hearing aids: around 12 to 36 months
However, some providers may choose to waive waiting periods for certain services.
If you switch insurers, you generally won't need to serve the same waiting period again for services you've already served it for, provided you're moving to an equivalent or lower level of cover. However, a new waiting period may apply if your new policy includes a higher level of cover or benefits you didn't previously have.
Preferred provider networks
Many health funds have agreements with preferred providers, such as certain dentists, physios and optometrists, which can give members access to higher benefits or lower out-of-pocket costs.
For example, your policy might pay a higher benefit for a dental check-up at a participating dentist than it would for the same treatment at a provider outside the fund's network.
If you regularly use a particular healthcare provider, it's worth checking whether they're part of the fund's network before choosing a policy, so you know what benefit you're likely to receive.
How much does extras cover cost?
The cost of extras cover depends on factors such as your age, insurer and the level of cover you choose.
As a general guide, extras cover can start from around:
| Level of cover | Fortnightly cost from | Approximate annual cost |
|---|---|---|
| Low | $6 | $156 |
| Medium | $15 | $390 |
| High | $29 | $754 |
| Source: Compare Club, September 2026 Figures are based on a 35-year-old adult living in Sydney and earning a base-tier income. Prices have been rounded to the nearest dollar. |
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However, price alone doesn’t tell you how much value you’ll get from a policy. Two extras plans at a similar price or level of cover can have very different annual limits, benefit percentages and included services.
For example, one mid-level policy might pay 60% back on physio with a $400 annual limit, while another could offer a lower percentage back but a higher yearly limit. It’s worth comparing the annual premium with the benefits you’re realistically likely to use, rather than choosing based only on cost.
How to get extras health insurance through Savvy
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Tell us what you're looking for
Fill out our online form with some information about yourself and the services you’d like covered.
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Compare your options
Review available extras policies and compare inclusions, benefit limits, waiting periods and price.
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Choose your extras policy
Once you find a plan that suits your needs, you can complete your application and get covered today.
Why compare health insurance policies through Savvy?
Pros and cons of extras cover
Pros
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Helps reduce everyday healthcare costs
Extras cover can pay benefits towards services Medicare generally doesn’t cover, which can reduce what you pay out of pocket.
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Encourages preventative care
Using your benefits regularly can help catch problems early, before they turn into more costly treatment down the track.
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Flexible tiers to suit your budget and needs
Low, medium and high-level policies let you match your cover, and your premium, to the services you're actually likely to use.
Cons
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Annual limits can restrict how much you can claim
Most extras policies cap the amount you can claim for individual services or groups of services each year, so cover doesn’t necessarily mean unlimited benefits.
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You can still have out-of-pocket costs
Extras usually pay only part of the bill, either as a set amount or percentage, leaving you to cover the remaining gap.
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Waiting periods can delay when you can claim
You may need to wait before claiming on certain services, particularly higher-cost treatments such as major dental, orthodontics or hearing aids.
Top tips for getting the best extras cover
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Only choose services you’ll actually use
Focus on the extras you’re most likely to claim, such as dental, optical or physio, rather than paying more for a broader policy packed with services you may never use.
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Compare limits as well as inclusions
Two policies can cover the same service but offer very different annual limits. Check how much you can actually claim each year, not just whether the service appears on the policy.
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Check how much you’re covered for
Look at whether benefits are paid as a set dollar amount or a percentage of the treatment cost. A policy with a higher benefit can leave you with a smaller out-of-pocket gap.
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Review your policy regularly
Extras policies and prices can change over time, and so can the services you use. Reviewing your cover at least once a year can help make sure you’re still paying for benefits that suit your needs.
