Little girl and her mother at the doctors office

Comprehensive health insurance

Find out more about the top tier extras cover and choose the right policy for you and your family.

Extras insurance, also referred to as general or ancillary cover, is for all health services that are not covered by Medicare. This includes dental, optical, physiotherapy as well as other treatments and programs that concern physical and psychological wellbeing.

It's also the health insurance policy type that is exclusively for covering services at non-hospital medical facilities like GP offices and clinics. If you are looking for insurance for hospital related treatment you need to take out hospital insurance, or a combination hospital and extras policy.

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What are the different levels of extras insurance?

Extras insurance comes in three tiers of cover which are basic, medium and comprehensive.

  • Comprehensive cover. Comprehensive health insurance policies must include a wide range of services, with annual benefits that are equal to or above the industry average. Comprehensive policies offer cover for a wealth of services and treatments such as occupational therapy, remedial massage and blood glucose monitors.
  • Medium cover. Medium cover offers protection against the costs of major dental work and at least five options from a list that includes optical, chiropractic, physiotherapy and psychology.
  • Basic cover. These affordable policies provide cover for basic treatments and procedures.

What level of protection can I expect?

Comprehensive health insurance gives you the highest possible cover for a range of extras, including:

  • Dental. Accounting for more than half of all benefits paid out by insurers, comprehensive dental covers general and major operations, as well as orthodontic and endodontic work.
  • Optical. Most comprehensive health insurance policies provide cover for $250 worth of optical claims per year.
  • Therapies. Comprehensive extras insurance has various limits for physical and psychological therapies. Comprehensive health insurance often covers physiotherapy, podiatry and psychology along with treatments like acupuncture and naturopathy.
  • Other benefits. Many comprehensive extras policies provide some level of cover for expensive equipment such as hearing aids and treatments including laser eye surgery.

Any conditions I should be aware of?

While exclusions for what is and isn’t covered can vary from insurer to insurer, all policies will have limits and waiting periods you need to know about.

  • Benefit limits. Check what limits your policy has in regards to not only what you can claim but how much you can claim for a specific service. These limits can be yearly or lifetime, so don’t get caught out.
  • Waiting period. Another thing to be aware of is waiting periods. A waiting period is the time you have to wait before you can claim a benefit on a service. Depending on the benefit, waiting periods can be as short as one day or as long as a couple of years.

Who can benefit from comprehensive cover?

Whether or not you should invest in comprehensive extras insurance will largely depend on age and current health:

  • Families with children. A high level of cover could offer security for advanced dental work including braces and crowns. Families with a history of long or short-sightedness may feel that the likely costs of lenses make comprehensive health insurance a wise investment.
  • Singles or couples. A simple and well-rounded policy could help with a variety of out-of-hospital services, treatments and therapies.

Before you commit to a comprehensive extras insurance policy make sure to carefully compare all of your options. Some providers have loyalty bonuses and allow you to accumulate parts of your policy you don’t use. Others offer benefits such as discounted gym memberships and food payments which could add significant value to a sizeable investment.

Frequently asked questions

Even with fully comprehensive health cover this is rarely the case. Instead you will likely have to make gap-payments for any services, the gap being the difference between the insurer's contribution and the total cost.

This can be done in two ways and will depend on who your policy is with:

  • Fixed benefit. Your insurer will pay a specific amount for different services.
  • Percentage back. Your insurer will contribute a set percentage towards any treatment.
Most insurers implement waiting periods after you start a new policy meaning it will likely be a few months or even a year before they will contribute to any health care.
Ask your provider for an annual claims statement which will show how much you have paid and how much you have claimed.

Looking for comprehensive extras cover? Speak to an adviser and compare quotes

Picture: Shutterstock

Richard Laycock

Richard is the insurance editor at He is on a mission to make insurance easier to understand.

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