When Does Private Health Insurance Reset?
Find out when private health insurance companies reset their extras benefits right here with Savvy.
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Private health insurance provides coverage for a wide range of healthcare services, spanning hospital admissions to dental and optical services. However, most extras policies have annual benefit limits, which can impact how much you can claim for specific services each year.
To squeeze the most value out of your policy, it's important to understand how these limits work and when they reset to help you get the maximum value from your policy. Find out all about health insurance reset dates here with Savvy to help maximise your benefits and get the most value from your health insurance.
When do private health insurance benefits reset?
Most health funds in Australia reset their extras benefit limits either at the start of the calendar year (on January 1) or the start of the financial year (July 1). However, some funds use the date you first took out your extras cover as the annual reset date. Knowing which date your fund uses will help you understand how to get the maximum benefit from the health cover you’ve purchased.
What are benefit limit reset dates?
All extras health insurance policies sold in Australia have benefit limits. These can either be annual limits or policy lifetime limits, and they determine how much you can claim on your policy for specific services over a set period. For example, a $500 annual limit on minor dental means that you can claim up to $500 in one year for minor dental treatments.
A lifetime limit on your policy doesn’t reset and is the maximum amount that you can ever claim on that policy. Once you’ve reached a policy lifetime limit, you won’t be able to claim for that particular service again unless you switch to a new health insurance policy which enables you to do so.
What happens if I reach my annual benefit limit?
If you reach your annual benefit limits for a specific service, you'll need to pay for any additional costs out of pocket. This means you won't be able to claim any more benefits for that service until your limits reset.
For example, with the $500 minor dental limit mentioned above, once you’ve claimed up to the $500 limit, you’ll have to pay out-of-pocket for any further minor dental costs you have until your reset date arrives. Once that date is reached, you’ll again have up to $500 to claim on minor dental services in the next 12 months.
Do benefit limits stay the same for the life of the policy?
Most benefit limits remain the same for the life of the health insurance policy that you buy. However, some health funds may have ‘loyalty’ increases as part of the terms and conditions of their policies. This means that benefit limits can increase for each year you hold the same policy up to a pre-defined maximum amount. These loyalty increases are aimed at encouraging people to remain with the same health fund for a longer period.
For this reason, it’s important to review the terms of your health insurance policy often to make sure you understand exactly what the policy entitles you to claim. By comparing health insurance policies frequently you’ll gain a deep understanding of the health insurance benefits on offer, which will help you make the best decision about the most appropriate level of cover for you and your family.
Frequently asked questions about health insurance reset dates
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