Best Extras Cover Comparison in Australia

Redaksi•Selasa, 30 Des 2025, 03.46

What Extras cover is (and what it isn’t)

Extras cover is a type of private health insurance designed to help pay for medical and health-related expenses that are not hospital care. It commonly applies to services such as dental check-ups, eye exams and prescription glasses, physiotherapy, chiropractic treatments, and other therapies that aren’t covered by Medicare. For many people, the practical value of Extras cover is that it can reduce out-of-pocket costs for everyday health services and make it easier to access a wider range of care.

Extras cover generally works by selecting a policy level that matches your needs and paying a monthly premium. When you use an included service, you can claim a portion of the cost back (and in some cases, the full cost), subject to the rules of your policy. In many cases, you can claim immediately at the time you pay for treatment, which can make budgeting simpler.

How Extras cover tiers typically work

One of the main attractions of Extras cover is that there are usually multiple levels you can choose from, allowing you to personalise what you’re covered for. While product names differ between insurers, Extras cover is often grouped into three broad tiers: basic, mid-level, and top.

Basic Extras: Generally includes a core set of services such as general dental, optical, physiotherapy, chiropractic, and emergency ambulance. Benefits are usually paid as a percentage (for example, 60%) or sometimes up to the full cost, with annual claim limits. As an illustration, general dental might be capped at $200 per year.
Mid-level Extras: Typically includes a broader range of services and higher benefits than basic. It may extend to major dental (such as root canals and crowns), podiatry, exercise physiology, acupuncture, and remedial massage. Annual limits are often higher than basic (for example, general dental may be up to $750 per year).
Top Extras: The most comprehensive tier, often building on mid-level cover and adding services such as antenatal and postnatal care, some non-PBS pharmaceuticals, home nursing, speech therapy, and hearing aids. This level can be significantly more expensive, so it may suit people who expect to use a wide range of services and want higher benefit limits.

Basic cover can suit people who are new to health insurance, expect to use only a handful of services, or are managing a tight budget (including single-parent households). It can also be a starting point, with the option to upgrade later. However, when you upgrade, you may need to serve waiting periods to access higher benefits.

Why comparing policies can be difficult

Extras products and tiers can vary considerably between insurers and may be marketed under different names. Some insurers offer a large number of standalone Extras products, which can make comparisons less straightforward. Because of this, it’s important to read the Product Disclosure Statement (PDS) for each policy you’re considering. The PDS is where you’ll find the details that matter in practice, including what is covered, what is excluded, waiting periods, and benefit limits.

Common services included in Extras cover

While inclusions vary by policy level and insurer, Extras cover often includes the following categories. The benefit you receive may be paid as a percentage of the provider’s charge, as a set amount, or through annual limits that apply per person or per policy.

General dental: Often includes check-ups, scale and cleans, x-rays, fillings and extractions (such as wisdom teeth removal, excluding hospital charges). Waiting periods are commonly around two months. Benefits may be paid as a percentage (for example, 50% to 80%) or as part of a combined annual limit (for example, $500 across multiple services).
Optical: May include eye exams and prescription optical items such as frames, lenses, contact lenses and certain lens coatings. Waiting periods are often two to six months. Benefits may be percentage-based or subject to a combined annual limit (for example, $200).
Major dental: Can include services like root canal, periodontics, crowns, dentures, bridges and veneers. This is typically found in mid or top levels, with waiting periods often around 12 months. This type of cover can be particularly relevant for seniors, including those aged 65 or above.
Orthodontics: Covers treatment to change the position of teeth and jaws using braces, retainers and other appliances. Often available in mid or top tiers, with waiting periods generally at least 12 months.
Physiotherapy: May include exercise programs and rehabilitation for injuries or movement disorders. Usually available across basic, mid and top policies, with benefits varying by level. Waiting periods commonly range from two to six months.
Chiropractic: Typically includes spinal adjustments and other hands-on therapies aimed at pain relief and mobility. Often included across most Extras plans, with benefits varying (for example, 50% back or a $600 annual limit). Waiting periods are commonly around two months.
Non-PBS pharmaceuticals: Some policies cover a range of prescription medications not listed on the Pharmaceutical Benefits Scheme (PBS), including certain specialty drugs and some over-the-counter options. This is more common in some mid or top policies, with benefits such as 50% reimbursement or an annual limit (for example, $400). Waiting periods often range from two to six months.
Podiatry: Covers assessment and management of conditions affecting feet and lower limbs, including orthotics and interventions. Typically included in mid and top policies, with benefits such as 70% reimbursement or an annual limit (for example, $500). Waiting periods are often two to six months.
Remedial massage: Often included in many Extras policies, with reimbursement rates ranging from 50% to 100%. Waiting periods commonly range from two to six months.
Exercise physiology: Involves assessment and prescription of tailored exercise programs to improve health and manage chronic conditions. Typically found in mid and top levels, with reimbursement rates often between 50% and 100%. Waiting periods are commonly two to six months.
Psychology and mental health services: May include counselling and therapy for issues such as anxiety, depression and stress management. Often available in mid or top levels, with varying annual limits and reimbursement rates. A two-month waiting period is common.
Hearing aids: Typically covered under top levels, with annual limits often ranging from $800 to $1,200. Waiting periods can range from 12 to 36 months.
Speech therapy: Covers diagnosis and treatment of communication disorders, including speech, language and swallowing difficulties. Often included in mid and top levels, with reimbursement rates commonly between 50% and 100% and annual limits often between $500 and $1,500. A two-month waiting period is common.
Ambulance: Emergency medical transportation is generally included in most Extras policies. In Queensland or Tasmania, ambulance services are provided by the state government. Waiting periods are often as short as one day, and policies may not apply annual limits or reimbursement percentages in the same way as other services.

Some insurers also offer a top-up rebate for prescriptions not covered by the PBS, and some medically recommended treatments for conditions like weight loss, acne and contraception may be eligible for rebates. It’s important to check with both your GP and insurer before purchase.

Costs and affordability considerations

Premiums vary widely depending on the level of cover, the insurer, and the services included. Based on analysis referenced in the extracted content, basic Extras cover premiums typically range from $20 to $60 per month, mid-level cover from $60 to $150 per month, and top-level cover from $150 to $280 per month.

Lower-cost plans can be easier on the budget, but they may come with more limited benefits or higher out-of-pocket expenses. Higher-cost plans usually provide more extensive coverage, but can be expensive. A survey referenced in the extracted content found that cost was the primary reason many Australians don’t have private health insurance (79.8%).

Industry reporting cited in the extracted content also noted that the average annual cost of Extras-only policies fell by 5.9% in 2024–25 to $1,068, and that Extras policies were up 30.2% compared with the previous year.

Provider networks and why they matter

Some insurers have agreements with specific healthcare providers. If you use a provider outside an insurer’s network, you may not receive the full benefit available under your policy. Checking which providers are partnered with an insurer before booking an appointment can help you understand what you’re likely to get back and avoid unexpected gaps.

How to choose the right Extras cover for your situation

Choosing the best Extras cover depends on your healthcare needs and your budget. Singles may focus on services that match lifestyle needs, such as dental and optical. Couples may look for cost-effective options that cover both partners. Families often need a broader mix of services, while single-parent families may prioritise children’s health needs while keeping premiums manageable.

It can also help to consider how often you expect to claim. Survey results in the extracted content indicated that 13% of Australians have only Extras cover, while 68% have both Hospital and Extras. In terms of usage, 33% use their Extras cover 1–2 times a year, 29% use it 3–5 times, 20% use it 6–10 times, and 11% use it more than 10 times a year.

Key checkpoints when comparing Extras policies

Reimbursement percentage: Understand what percentage of treatment costs the policy covers (often 50% to 100%), noting that different services can have different rates.
Annual limits: Check limits per person or per policy for each service category (for example, general dental may have a $500 limit, while optical may have a lower cap).
Waiting periods: Be aware of waiting periods, which can range from around two months to one year (and longer for some services such as hearing aids).
Exclusions: Review what is not covered, which can include certain cosmetic procedures or specific therapies.
Co-payments and gaps: Understand whether you’ll need to pay a co-payment and how the gap between provider fees and insurer benefits could affect your out-of-pocket costs.
Provider requirements: Check whether you need to use certain providers to receive full benefits, and whether the available network suits you.
Claims process: Confirm how to claim, what documentation is required, and how quickly reimbursements are processed.
Upgrade options: If you may change cover levels later, check how upgrades work and whether waiting periods apply to higher benefits.

A practical way to think about value

Extras cover is often most valuable when the services you use regularly align with what your policy covers well. Dental and optical are commonly prioritised. Preventive dental care is frequently highlighted as a reason people choose Extras cover, and some insurers may offer at least one free scale and clean each year with preferred providers (and sometimes multiple visits). Regardless of the policy you choose, checking the PDS and comparing benefits, limits, and waiting periods side by side can help you identify which level of cover is most likely to match your needs and reduce your out-of-pocket costs over time.