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Hospital and extras cover
Health insurance is split into 2 parts: Hospital and Extras. Hospitals and extras cover, also called combined cover, offers the best of both worlds from around $94 a month.
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Compare hospital and extras cover
The table below lists some combined health insurance policies from Finder partners, covering accidents, emergency ambulance, dental and more.
We update our data regularly, but information can change between updates. Confirm details with the provider you're interested in before making a decision.
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Use our free tool to see quotes for combined cover from 30+ health funds. Simply select 'Hospital + Extras' on your type of cover.
What are hospital, extras and combined cover?
Hospital onlyHospital cover pays for hospital treatment during illness or injury, including accommodation, surgery and other costs.
Extras onlyExtras helps pays for non-hospital treatments that are not covered by Medicare, including optical, dental, physio and more.
CombinedHospital and extras covers both types of treatment, giving you comprehensive coverage for a huge range of medical costs.
Do I need both hospital and extras cover?
Not everyone needs a combined policy, and you may not even need health insurance at all. However, there are some life stages where people generally start to think about whether they need life insurance.
If you're young and healthy, you may only need basic hospital cover, but may still want comprehensive extras, like dental and physio. If you're older, then hospital cover may be a higher priority for you. Other important differences include the following:
- Earn over $90k? Not having sufficient hospital cover when your income is above a specified level attracts a Medicare Levy Surcharge, while extras does not.
- Turning 31? You are charged a Lifetime Health Cover (LHC) loading of 2% for every year you don’t take out hospital cover after you turn 31 years of age. Extras policies don't have this penalty applied.
Hospital cover and accommodation in a public or private hospital. If you are a Medicare cardholder, you are entitled to hospital treatment under Medicare but many people take out private hospital cover because it offers several advantages over the public healthcare system. Private hospital cover offers the following benefits:
- Treatment as a private patient in a public or private hospital
- Treatment by your own doctor
- Little or no waiting lists
Most health funds offer different levels of hospital cover:
- Public hospital. This covers you for most treatments, but only as a private patient in a public hospital. You get to choose your own doctor, but you have to wait in the public queue for your treatment and you'll most likely have higher out-of-pocket expenses than you would if you were a public patient on Medicare.
- Basic cover (also known as Basic or Bronze). This plan covers treatment in a private or public hospital, but often excludes cover for cardiac-related services, non-cosmetic plastic surgery, rehab, psychiatric services, palliative care and others.
- Medium cover (also known as Silver). This plan often covers much of what basic cover doesn’t, but frequently excludes pregnancy and birth-related services, IVF, cataract procedures, joint replacements and dialysis.
- Top cover (also known as Gold). This plan generally covers every service where Medicare pays a benefit.
Gold health insurance will usually include the following:
- Treatment as a private patient in a private hospital
- Emergency ambulance treatment and transport
- Surgical procedures such as joint reconstructions and removal of appendix, tonsils, adenoids and wisdom teeth
- Palliative care
- Psychiatric treatment
- Approved rehabilitation programs
- Major heart surgery
- Childbirth and inpatient pregnancy services
- Fertility treatments such as IVF
- Plastic and reconstructive surgery to repair an injury or congenital defects
- Major eye surgery
- Renal dialysis treatment.
Whether services and procedures such as IVF, heart surgery and psychiatric services are covered will depend on the fund, but typically most will not cover cosmetic surgery, alternative medicines and any surgery or hospital treatments for which Medicare does not offer a benefit.
While hospital cover is insurance you only claim on if you become ill or injured and need to go to hospital, extras cover can reimburse you for general services that aren’t covered by Medicare. These can include:
- General dental care (eg, cleaning, fillings and extractions)
- Major dental care (eg, orthodontics, wisdom teeth, crowns, bridges, root canal work and dentures)
- Optical care (eg, prescription glasses and contact lenses)
- Chiropractic care
- Hearing aids
Starting in April 2019, insurers will no longer offer cover for certain natural therapies that the government has found to be ineffective. These include naturopathy, herbalism, Buteyko, Yoga and Tai Chi. Acupuncture, physio and chiropractic will not be affected.
Like hospital cover, extras are usually available in three levels of protection:
- Basic. This plan covers the main services, including dental (general only), optical, physio, chiro, osteo and often emergency ambulance transport.
- Medium. This plan generally covers everything the basic policy covers, but with more generous benefit levels, plus some major dental, podiatry, occupational therapy and, in some cases, travel vaccines and immunisations.
- Comprehensive. This plan usually covers everything the medium policy does and typically applies larger benefit levels. It also includes orthodontics, psychology, speech pathology and some prescription medicines not covered by the PBS.
Because people have different needs when it comes to ancillary services, many funds will allow you to mix and match your extras to suit your requirements (eg, optical and dental only if that is all you need), although benefit levels are usually restricted to an amount per person per year and waiting periods apply to most services.
Typical combined packages
When funds create their own packaged cover, it's common for them to pair a hospital policy with an extras policy on a similar rung. For example, if you're getting basic hospital, a health fund will typically package that with its lowest extras option.
Funds will also package policies that they think are suited to someone's life stage. In many cases, these will be placed in categories such as young and singles, family cover, couples cover and seniors cover. While these policies won't have been designed specifically for people that fit into these groups, the fund is making a suggestion about the type of cover you need if you identify with one of these demographics.
While this is not always the case, your best bet to find the option that's right for you is to choose your own levels of hospital and extras benefits rather than going with a preselected option.
How to mix and match
Mixing and matching your hospital and extras options is the best way to get the most out of your benefits. Say for example you're young and healthy and don't need a high level of hospital cover but still want peace of mind knowing that you have hospital cover. Add to this that you like to get a remedial massage, need glasses and are fastidious about your teeth and see the dentist a couple of times a year. In this hypothetical situation, you can choose a basic tier hospital policy with comprehensive extras.
To go a step further, when you're comparison shopping, make sure you're looking beyond just one provider for both options. You might find a better deal by taking out your hospital with one fund and your extras with another.
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