What is Extras Cover?

Extras cover (also called ancillary cover or general cover) allows you to claim on benefits for out-of-hospital ancillary services that are not covered by Medicare.

How does extras cover work?

Extras cover provides health insurance benefits for additional services that we all use from time to time, but which aren't generally covered by Medicare. For the best value, you may want to consider an extras plan that provides health care benefits for the services you need and use the most. In some cases, your health fund will even allow you to choose the ancillary services you want cover for.

In addition to choosing the services that you are likely to claim benefits for, you may also be able to choose the level of cover you want for these services. For example, a higher level plan may pay unlimited costs for dental services, while a lower level plan may pay only up to a certain amount. The cost of extras cover generally increases with the level of cover it provides.

What does extras cover include?

Extras cover could pay benefits towards services including:

  • dental and optical
  • physiotherapy, chiropractic and podiatry
  • psychology 
  • natural therapies like acupuncture, naturopathy and remedial massage, and
  • non-PBS pharmaceuticals

It could also pay benefits for equipment including:

  • glucose monitors, and
  • hearing aids

Health insurance benefits for extras can be claimed in one of two ways:

  1. HICAPS: By far the easier way is to use HICAPS.  HICAPS is an electronic claiming service, simply swipe your health fund membership card through the HICAPS machine at your practitioner's office and they can claim the benefit directly from your health fund, so you only pay the difference.

  2. Full Payment Upfront: You can pay your practitioner the full amount and then submit a completed claim form and the receipt to your health fund, who will then refund your benefit portion either as a cheque or direct deposit into your bank account.

Is extras cover affordable?

Extras cover can be extremely affordable, particularly by choosing a plan that covers only those services you use regularly, so that you can keep your premium even lower.

For the fiscally minded, you can even forecast your savings by predicting the number of times you expect to visit various practitioners and calculate the amount of health care benefits you are likely to receive back from your health fund for those visits. 

In addition, for eligible customers, the Australian Government offers a rebate which can be applied to your premium, making extras cover even more affordable.

These articles are provided as reference material to allow more informed decision making, but are not intended as being a complete source of information on any topic. All readers should make their own independent analysis on the topic to make sure they have considered the aspects that are important to them.