How a year's worth of extras cover can pay for itself in a week


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Believe it or not, it's easy to claim more money back in a week than you'll pay in health cover premiums all year.

Extras health insurance is the little brother to hospital cover. Significantly cheaper, it helps towards the cost of non-hospital healthcare, like dentistry, optical and physiotherapy.

So is it really worth it? Well, yes, as long as you use it.

health insurance extras

In fact, extras is actually one of the few types of insurance where you can easily claim back the price of your premium, without anything going too awry. Plus, you can do it in just a few days.

Yes, you might need to stomach a trip to the dentist or commit to an exercise course, but it's pretty easy to guarantee value from your extras policy every year. Here's how it's possible:

Compare policies

The most important thing to do is compare your extras policies carefully to find cover that suits your needs. You might decide you want to spend more money for higher annual limits or just need the basics to help with regular healthcare.

Pay attention to what benefits are included, as well as waiting periods, annual limits and - of course - the price. Mid-range extras policies usually cost around $10-$15 a week.

This article isn't sponsored but, for the sake of an example, I've used ahm's lifestyle extras policy which costs $11.70 a week or $608.40 a year. I'll be using these figures throughout, so you can see how easy it is to make an extras policy work for you.

Monday: Dental check-up

Here's a genuine breakdown of my recent trip to the dentist. It wasn't anything too out of the ordinary, so if you make annual visits to the dentist, you can expect to lodge a similar claim every year.

While my extras insurance didn't cover the full cost, it did cover $187.65. That's almost half of the total bill and the equivalent of 16 weeks' worth of premiums.

Item Cost Insurance payment
011 - Comprehensive oral exam $68 $36.70
022 - Single x-ray (x2) $92 $51
114 - Removal of calculus $172 $74.45
121 - Tropical application of remineralising or cariostatic agents $45 $25.50
  $377 $187.65

Tuesday: Exercise course

Now that gyms are beginning to reopen, it's actually worthwhile to enrol in an exercise course, particularly if lockdown has taken its toll on your fitness. Extras insurance can be a huge help when it comes to the cost.

You'll probably have to get approval from your insurer, which may involve a letter from your doctor or physio confirming you have a genuine need to visit the gym. This could mean anything from managing an injury or health condition, to improving mental wellness or even your BMI.

For a $250 exercise course, I can claim back the full $250. That's 21 weeks' worth of premiums. It's flexible too, so you can claim for things like personal training sessions and kids' swimming lessons.

Wednesday: New glasses

Often, mid-range extras policies have a $200 limit for optical and no waiting period. That means you can buy a policy today and get cashback if you bought new glasses tomorrow.

Major retail opticians are doing their best to make it easy for health fund members too. Many offer new glasses bundles for a similar price as what's covered by popular policies. For example, Specsavers offer two pairs from $149 and Oscar Wylee offers two pairs from $199.

I bought two pairs of new glasses recently, with lens upgrades, for a total cost of $239.00. Immediately, I claimed $200 back from my extras policy. That's 17 weeks' worth of premiums.

Thursday: Therapy or counselling

Lockdown has been tough on lots of us. Whether you're feeling more anxious, want to get a better grip on your anger or your relationship has suffered through isolation, therapy and counselling can help.

With ahm, I can claim $71 off the price of an initial consultation, either in-person or via telehealth. That's the equivalent of six weeks' worth of premiums.

Friday: Contraceptives

If you have a prescription for a contraceptive, you may be able to claim some of the cost back on your extras. For ahm, that's $50 per prescription, up to an annual limit of $350, but the contraceptive must be prescription only and on a private script.

The average cost of the contraceptive pill in Australia is around $80 for a 3-month supply. I can claim $50 back for that one prescription. That's four weeks' worth of premiums. Repeat the prescription and you can claim again.

Even more value to be had

Using the examples above, that's a total of $758.65 claimed back in just five days. Meanwhile, the annual policy price of ahm's lifestyle extras is just $608.40. Already, you've saved $150.25.

Remember, you haven't even touched half of your benefits or come close to many of the limits, so you still have a further 360 days to get even more value out of your extras policy.

Don't forget, many health funds also offer free coverage for a few weeks if you bundle hospital cover with extras. So it's even easier to get value from your policy.

For any Aussies who turned 31 in the last 12 months, that's a deal definitely worth considering as it means you'll avoid the Lifetime Health Cover Loading penalty that's applied from July 1.

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Nicola Middlemiss is a senior insurance writer at Finder.
Nicki Folland-Smith
June 24, 2020 6.51pm

Any advice for those of us in our 40s that don't currently have extras or hospital insurance? We are fairly healthy but wear glasses. Two kids u18. Our local hospital is new & has everything, I can't see the advantage of having hospital cover. What am I missing?

Martin Dantas
June 26, 2020 12.35pm

Hospital cover will definitely come in handy if ever your kids need elective surgery for example. I had my wisdom teeth taken out in a private hospital... well worth it.

Renee Cummings
July 28, 2020 2.49pm

I am struggling to make relation to being financially better off by having extras cover using the examples you have described above.

The dental quote includes X-ray which not frequently done under a general preventive dental. Depending on the condition of your teeth may have an X-ray once every 3 years. This is not an ongoing "saving" like you are trying to describe.

I cannot see what your defining as an exercise course given you show general examples like swimming or PT session. In your quote what are you referring to? The average person will likely not access $255 worth of an "exercise course." You further reference potentially needing doctors certificate to access these features, the cost of this consult is not considered in your "savings." You later reference your cost is based off ahm lifestyle extras. I can see under their lifestyle extras cover they reference exercises classes, not course being covered, with the caveat of potentially needing medical screening prior to accessing this feature.

Regards to getting 100% back on optical. The reality is most people will not access this feature. Especially annually, if they are it's likely they only access the feature to make paying their "extras" cover worth it.

You state a 3 month supply of contraception is $80. I have used multiple contraception medications (brands and strengths) none have cost me $80. I have checked ahm lifestyle extras disclosure on contraceptive medications where they state: Benefits are not payable for oral contraceptives (unless they're prescribed for purposes other than contraception). Other purposes being later defined at PCOS, Acne, period pain, endometriosis.

I guess before you recommend extras cover in a financial magazine ensure you have solid research. A good take away for others reading this is to do your research on the extras. Think long and hard about if you will be using the features in the extras You are paying for.

Bini Abraham
September 6, 2020 7.16pm

I think this article is a gross misrepresentation of value offered. Here is why, as per her example, She got less than 50% back on the dental visit, cost of therapist visit has not been stated but the rebate has been which i have dismissed here. Given the figures quoted in this example adding the gap back to cost of extras cover. I am already out of pocket by $108.

Besides @renee cummings, states the obvious fact on oral contraceptive.

The best I can describe this article is misinformed and misleading.

@ Nikki - yes there is an alternative it is called Xtras Health Plan Savings scheme. It is not insurance, the best way i can describe it is super for health. Small amount aggregating and over time I have created an account where I dont have gaps on health visits. It is an Australian Company and is new, the only negative i see is that they are slowly growing the practitioner base but are wanting to grow the member base first so that they can negotiate better rates with health providers


Steven W
June 29, 2021 8.29pm

"For any Aussies who turned 31 in the last 12 months, that's a deal definitely worth considering as it means you'll avoid the Lifetime Health Cover Loading penalty that's applied from July 1."

Lifetime health cover loading penalty only applies if you don't have private HOSPITAL cover, not private EXTRAS cover.