Extras Cover: What It Is and What to Look For
What Is Extras Cover?
Extras cover (also called "general treatment" or "ancillary" cover) helps pay for everyday health services that Medicare doesn't cover — dental check-ups, glasses, physiotherapy, natural therapies, and more. Unlike hospital cover, extras are used outside of hospital and don't involve Medicare.
Common Extras Services
Dental
The most popular extras service. Covers check-ups, cleans, X-rays, fillings, and sometimes major dental work (crowns, bridges, root canals). Typical annual limits range from $500 to $1,500 per person. Some funds offer 100% back on two check-ups per year ("free dental").
Optical
Covers frames, lenses, and contact lenses. Typical annual limit: $150–$300 per person. Many funds also cover one eye exam per year. Some allow you to combine limits across family members.
Physiotherapy
Covers physio sessions for injuries, back pain, and rehabilitation. Typical limits: $200–$600 per year with per-session caps of $30–$60.
Chiropractic & Osteopathy
Often grouped together with physio. Limits are usually shared under a "remedial therapies" pool. Check whether your preferred practitioner is covered.
Other Common Extras
- Psychology — Mental health support sessions.
- Podiatry — Foot care.
- Speech therapy — For both children and adults.
- Dietetics — Consultations with dietitians and nutritionists.
- Natural therapies — Acupuncture, naturopathy, etc. (some funds have reduced or removed these).
How Extras Benefits Work
Every extras policy has:
- Annual limits — Maximum the fund pays per person per year for each service type.
- Per-service limits — Maximum benefit per visit (e.g. $50 for a dental check-up).
- Waiting periods — Typically 2 months for general dental, 6 months for major dental, 2 months for optical and physio.
You pay the provider's fee, then claim back from your fund — either on the spot (HICAPS) or via online claim.
Is Extras Cover Worth It?
If you regularly visit the dentist, wear glasses, or use physiotherapy, extras cover can easily save you hundreds per year. If you rarely use any of these services, paying out of pocket may be cheaper than premiums. Use our policy guide to compare.
Dental Only Cover
Some funds offer standalone dental-only cover for people who just want check-ups and basic dental. See our dental only cover guide for a detailed comparison.
Extras Pricing and the 2026 Rise
Extras-only policies are the cheapest way into private health insurance, typically $25–$50 a month for an individual and $60–$120 for a family, depending on limits. The 4.41% average premium increase on 1 April 2026 applied to extras and combined policies as well as hospital cover, so check your latest statement to see what you are actually paying now. Before renewing, ask whether your fund's April 2026 rise was matched by better benefits — some funds improved dental and optical limits while others simply raised prices.
How the Claims Process Actually Works
Extras claims follow a simple loop: you pay the provider, then the fund pays you back up to your limits. At most dentists and optometrists you will see HICAPS terminals — the practice submits the claim electronically and your benefit is deducted instantly, leaving you to pay only the gap. Otherwise you pay in full and submit the receipt through the fund's app or website, with money usually landing in your account within a few days. Two dates matter: your annual limits reset either on 1 January or on your policy anniversary, depending on the fund, and your waiting periods (typically 2 months for general dental, 6 months for major dental) run from when your cover starts. If you are close to the end of a limit year, book your check-up before it resets.
Is Your Extras Policy Paying for Itself? A 10-Minute Test
- List the extras services you used last year and what you actually received in benefits.
- Add up the premiums you paid.
- If benefits came to less than 80% of premiums, shop around — your needs may have changed.
- Before switching, check that waiting periods already served will carry over for equivalent cover.
- Consider a dental-only policy if dental is the only service you use.
Natural Therapies Are Shrinking — Check Your Policy
Over recent years many funds have reduced or removed natural therapy benefits such as acupuncture, naturopathy and remedial massage, or moved them behind higher per-session caps. If you use these services, confirm they are still included in your current policy before renewing — a policy that was right for you in 2024 may no longer cover what you claim. The 10-minute test above will tell you quickly whether your premiums are still justified.