Pay only 50 per cent of the provider's fee for a wide range of treatments and services
Extras private health insurance is designed to help you meet the cost of a wide range of general treatments not covered by Medicare, ensuring that you can get the health care you need whenever you need it. health.com.au offers several extras cover policies to provide cover for different ancillary treatments, including optical, dental, physio and much more. Most of these cover options are only available when paired with a health.com.au Hospital Cover product. However, health.com.au Extras 50 Health Insurance is available as standalone extras cover.
What does Health.com.au Extras 50 cover?
Extras 50 Health Insurance from health.com.au provides cover for 50 per cent of your provider’s fee for a wide range of general treatments and services. This entry-level extras policy gives you the freedom to choose the health care provider you want and includes cover for 50 per cent of the cost of the following treatments:
- General dental: This includes preventative dental procedures such as fillings, scaling and cleaning.
- Major dental: Extras 50 Health Insurance provides cover for endodontics, periodontics, crowns, dentures, bridges and root canals.
- Orthodontic: Braces and retainers are also covered by the policy.
- Optical: Glasses, lenses, contact lenses and vision testing are all covered.
- Physiotherapy, chiropractic and osteopathy.
- Massage and natural therapies: This includes cover for remedial massage, acupuncture and naturopathy.
- Non-PBS prescriptions: Cover is provided for 50 per cent of your bill after you have made a $37.70 co-payment.
- Health maintenance: This provides cover for expenses such as gym memberships and quit smoking courses.
- Dietitian: Your policy will help cover the cost if you need to see a dietitian.
- Psychology: Extras 50 also helps cover the cost of your outpatient psychology needs.
- Emergency ambulance: The policy provides cover for the cost of emergency ambulance transport nationwide.
What is not covered by Health.com.au Extras 50?
Your health.com.au Extras 50 claim will not be paid if:
- You have already exceeded the annual cap on a particular benefit
- It is for a pre-existing condition during the first 12 months of your policy
- It is for any other benefit while you are still serving a waiting period
- It is for hospital and/or medical treatment received in a private hospital
- It is for an extras service not covered by this policy, such as occupational therapy, speech therapy or health appliances
- It is for treatment received from an unqualified provider who is not recognised by health.com.au
- It is for treatment or a service received more than two years ago
What excess options are available?
There is no excess to pay when you make a claim on your Extras 50 health cover. However, it’s worth remembering that the policy only provides cover for 50 per cent of the fee charged by your healthcare provider, so you will need to foot the other half of the bill.
What are the waiting periods applied?
Keep in mind that the following waiting periods apply to your Extras 50 policy:
- 2 months for all treatments and services, except those listed below
- 12 months for pre-existing conditions, major dental and orthodontics
Who is eligible?
You will need to meet the following requirements in order to take out an Extras 50 policy with health.com.au. You must:
- Be at least 16 years of age (if you are under this age you can be covered as a dependant under a family or single parent policy)
- Not have a similar policy with health.com.au and another private health fund at the same time
- Have a policy that reflects your state of residence
- Satisfy the Medicare residency and eligibility requirements
Making a claim
There are two choices available when you need to make a claim on your Extras 50 policy:
- At the health care provider: You can swipe your health.com.au Claims Card at the more than 45,000 providers across Australia who offer the HICAPS electronic claiming system.
- Online: You can also visit the health.com.au website to provide the full details of your claim.
Benefits are then paid electronically by direct credit into your nominated bank account.
What else you need to know
Q. Does health.com.au offer any other extras-only policies?
- A. No. All of the other extras covers available from health.com.au must be purchased with hospital cover.
Q. Do I need to keep my receipt after making a claim?
- A. Yes. For audit purposes, health.com.au requests that you keep all invoices and receipts for at least two years after making a claim.
Q. How long do I have to lodge a claim?
- A. You must lodge your extras claim within two years of the date of service.
Q. Is there a premium discount available?
- A. Yes. You can save 4 per cent off the cost of premiums by paying for your cover via direct debit from a cheque or savings account with a bank, building society or credit union. The discount is also available when you pay your premiums with a Visa or MasterCard.
Q. How much general dental cover is available?
- A. Extras 50 covers 50 per cent of the provider’s fee for general dental services up to an annual cap of $500 per person, or $1,000 on a couples or family policy.
Q. Can I take out cover for more than one person?
- A. Yes. Extras 50 can be taken out as a singles policy, couples policy, single parent policy or family policy.