Is Extras Health Insurance Worth It?

Discover the pros and cons of extras health insurance with Savvy to help you decide whether it’s worth it for you. 

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, updated on July 10th, 2023       

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Extras health insurance, also known as ancillary or general treatment insurance, provides coverage for services that aren’t covered by Medicare, such as dental, optical, physiotherapy and other allied health services. However, whether extras health insurance is worth it for you will depend on your individual needs, preferences and budget.  

Find out all the factors you need to consider when thinking about extras health insurance here with Savvy. Discover the pros and cons and the vital questions to ask yourself before making a final decision about whether extras cover is right for you.  

Is extras health insurance really worth it? What are the pros and cons?

There are many pros and cons to consider when looking at the costs and benefits of extras cover health insurance, including the following:  

The pros of extras cover: 

  1. Cover for services not covered by Medicare: extras cover can provide coverage for a variety of health services which aren’t covered by Medicare, including dental, optical, physiotherapy, chiropractic, podiatry, remedial massage, psychology, hearing aids, dietetics and more 
  2. Claim back between 50% and 80%: an extras policy may be able to refund you between 50% and 80% or more of the cost of receiving many of the healthcare services listed above, depending on the level of extras cover you choose to buy and your policy’s terms and conditions 
  3. Increased flexibility: with an extras policy, you may have more flexibility to afford the treatments and services you need, rather than being limited to what is covered by Medicare 
  4. Free preventive care: extras policies can offer free preventive health services such as dental and skin cancer check-ups which can help identify and treat health issues before they become more serious 
  5. Lifestyle and wellness benefits: some health funds offer lifestyle and wellness benefits with their extras policies, so you could have access to programs to help you quit smoking, lose weight, subsidised gym memberships and more 
  6. Subsidies for health aids and appliances: with some extras policies, you can claim benefits for CPAP machines, blood pressure monitors, glucose monitors and walking aids such as crutches 
  7. Tax benefits: if you have at least basic hospital cover, plus extras cover (or a combined hospital and extras policy), you may be eligible for the Private Health Insurance Rebate, which is a partial refund on the cost of your health insurance premiums  

The cons of extras cover:  

  1. Cost of premiums: the cost of this type of insurance should be carefully considered, as the more comprehensive policies can be expensive 
  2. Limited coverage: extras policies may not cover all health services and treatments you’d like to access, so it's important to check what’s included before purchasing a policy 
  3. Benefit limitations: most extras policies have benefit limits, which means there’s a maximum amount you can claim for each category of service or treatment either per year, or for the lifetime of the policy. This can be a disadvantage if you need a service which isn’t covered by your policy, or if you exceed your annual benefit limit for a particular type of treatment  
  4. Waiting periods: you may have to serve waiting periods before you can make a claim on your extras policy. These can range from a month up to several years depending on the level of policy you buy, the waiting periods you may have served in the past and the rules of each health fund 

How do I decide if extras insurance is worth it?

It's important to carefully review the coverage, limits, waiting periods, premiums, and potential out-of-pocket costs associated with extras health insurance. 

When deciding whether to buy extras cover, consider factors such as your anticipated healthcare needs, your potential frequency of use and your overall financial situation to help you determine if extras cover will provide value for money for your particular situation. 

Questions to ask yourself when deciding on extras cover 

Ask yourself the following questions to help make up your mind if you’re wondering if extras cover is really worth it: 

  • What specific health services or treatments may I need in the next year? 
  • How much am I willing to spend out-of-pocket for those services or treatments? 
  • Do I have any pre-existing conditions such as diabetes or sleep apnoea which require ongoing care or treatment? 
  • Will I be able to comfortably afford the premiums for a suitable extras policy?  
  • Do I participate in activities or sports which are more likely to result in injuries which may require extras coverage, such as football, netball or dancing? 
  • Does my job or lifestyle expose me to health risks that could benefit from extras coverage? 
  • Can I take advantage of any discounts or incentives offered by health insurance providers to reduce the cost of my extras coverage? 
  • Will I use any healthy lifestyle incentives such as a gym membership or subsidised weight loss programs?  

More questions about whether extras health insurance is worth it

Can I upgrade or downgrade my extras cover at any time?

This will depend on your specific insurer, but most health funds will allow you to change the level of your extras cover at any time you choose. However, there may be implications for your waiting periods if you do swap policies, as you may have to serve additional waiting periods for services you haven’t previously been covered for.  

What happens if I don't use all of my extras benefits within a year?

If you don’t use your benefit limits within a year, you’ll lose them in most cases. However, this depends on your insurer, as some may allow you to roll over unused benefits to the following year. Speak with your insurer if you’re unsure about whether you can make use of your unused benefits. 

Can I get free dental and optical treatment with extras cover?

Many health funds provide free basic optical and dental services, such as routine teeth cleaning and polishing, with some of their extras cover policies. However, you may have to get the treatment from one of your fund’s preferred providers, so it’s worth checking with your regular dentist which health funds they’re affiliated with. 

Is it worth having hospital cover since Medicare covers most costs if I have an accident?

Medicare covers basic hospital emergency treatment, but extras cover provides additional benefits for a wider range of non-hospital services. If you do have a motor vehicle accident, for example, Medicare will cover the cost of your emergency hospital treatment, but if you need rehabilitation services or remedial massage to help you recuperate, these costs may not be covered by Medicare. 

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