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When do health insurance benefits reset?

Extras benefits reset each year, and they don't roll over! Make sure you maximise your claims before your fund's cut off date.

What you need to know

  • Extras health insurance gives you a yearly benefit for treatments like optical and dental.
  • These benefits reset each year, generally either 1st of January or 1st of July.
  • Extras benefits do not typically roll over, so you should try and use them before they reset.

When do health funds reset extras benefits?

Extras benefits reset on 3 different dates: January 1st, July 1st, or the anniversary of your policy start date. This table lists the dates that each fund uses, as of April 2024.

FundWhen Extras ResetFind out more
AHM logoahm health insurance1 July.

Note: ahm has announced it will let customers keep any unused benefits from 1 July 2023 until 30 June 2024.

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HCF logoHCF1 January Get quote
Medibank logoMedibank Private1 January More info
NIB logo
NIB
1 January Get quote
Qantas Insurance logoQantas Health Insurance1 January Get quote
Suncorp1 January More info
ACA Health Benefits Fund logoACA1 January More info
Apia LogoAPIA1 January More info
Australian Unity LogoAustralian Unity1 January More info
Bupa logoBupa1 January Get quote
CBHS Corporate Health logoCBHS Corporate1 January More info
CBHS health insurance logoCBHS Health Fund1 January More info
Hunter Health logoHunter HealthPolicies reset every 12 months from the date you become a member. More info
Defence_Health_Logo_100Defence Health1 July More info
Doctors Health Fund logoDoctors' Health Fund1 January More info
Emergency Services Health logoEmergency Services Health1 January More info
Frank health insurance logoFrank1 January Get quote
GMHBA health fund logoGMHBA1 January Get quote
GU Health logoGrand United Corporate HealthPolicies reset every 12 months from the date you become a member. More info
HBF logoHBF1 January Get quote
Health Care Insurance logoHealth Care Insurance1 January More info
HIF health insurance logo

HIF

1 January Get quote
Health Partners logoHealth Partners1 January Get quote
Latrobe logoLatrobe Health ServicesNot stated More info
Mildura LogoMildura Health Fund1 January More info
MyOwn logoMyOwn Health1 January Get quote
Onemedifund logo

onemedifund

1 July More info
Navy Health Logo

Navy Health

1 July More info
Nurses-and-midwives logoNurses & Midwives Health1 January More info
peoplecarePeoplecare Health Insurance1 July Get quote
Phoenix health fund logoPhoenix Health Fund1 January More info
Police health logoPolice Health1 January More info
Queensland Country Health Fund logoQueensland Country Health FundMembership year based on when you joined More info
RT health fund logoRT Health Fund1 January More info
Rbhs logoRBHS1 January More info
St.lukes health logoSt.Lukes Health1 January More info
Teachers health logoTeachers Health1 January More info
Transport health logoTransport Health1 January More info
TUH LogoTUH1 January More info
UniHealth logoUniHealth1 January More info
Westfund health insurance logo

Westfund

1 January More info

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What other limits can apply?

There are a few other extras cover limits you should be aware of.

  • Waiting periods: All extras policies have a waiting period before you will be able to claim (with a few exceptions). This period is typically 2, 6 or 12 months, but can be as long as a few years for things like hearing aids or braces.
  • Claim time limit: You need to make a claim within a certain time after you get a service. This time limit is typically 2 years.
  • Service limit: There may be a limit on the number of times you can claim a benefit for the same service in a year. For example, you may be allowed to only claim 2 dentists appointments per year.
  • Daily claim limit: Some health funds limit you to claiming one extras benefit per day. So if you receive multiple services within one consultation, you may only be able to claim the service which attracts the higher benefit.

Finder survey: Do Australians understand how their health insurance extras limits work?

Response
Yes55.79%
Somewhat38.22%
No5.98%
Source: Finder survey by Pure Profile of 1006 Australians, December 2023

What are the types of services that have annual limits?

Annual limits usually apply to a wide range of general treatments included in extras cover, such as:

However, there are certain parts of extras cover to which annual limits don’t usually apply, for example ambulance cover.

What is the difference between a combined limit and a sublimit?

When comparing extras cover, it’s important to be aware that sub-limits and combined annual limits may also apply. While your policy may have an annual limit of $1,000 for general dental services, there may also be a sub-limit that sets the maximum amount you can claim for a specific dental treatment, for example a routine checkup or a basic extraction. This sub-limit is subtracted from the larger annual limit.

However, combined annual limits may also apply. For example, your policy may provide up to $300 cover for each of the following services: physiotherapy, chiropractic treatment and osteopathy. However, those services may also be grouped together into one category with a combined annual benefit limit of $750 – so the maximum yearly amount you can claim for all the physio, chiro and osteo services you receive is $750.

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