Hospital and extras cover

Compare hospital and extras cover. See your options for in and out of hospital services.

Private health insurance is divided into two main areas: hospital and extras cover. A combined hospital and extras policy can protect you against a range of health-related costs.

Keep reading to find out more about the benefits, costs covered and reasons why a combined hospital and extras policy might be right for you or use the free tool below to compare over 30 Australian health funds.

How much does hospital and extras health insurance cost?

Here you can find some options from Finder partners. These hospital and extras packages cover accidents, emergency ambulance, dental and more.

Fund Policy Summary of inclusions Price Apply
Essentials Flexi Basic Plus This is a Bronze level of hospital cover, so you'll get the 18 tier treatments plus dental surgery, back, neck and spine. You also get a $800 yearly to spend on extras including dental, physiotherapy and $200 for optical. $101.55 Go to Site
nib helath insurance logo Bronze Starter Hospital + Core Extras This Bronze level health insurance covers the 18 tier treatments plus sleep studies. You also get extras including unlimited preventative dental, $250 for optical and $350 for physiotherapy. $117.71

Go to Site

Hospital Silver + Mid Extras This is a silver level of hospital cover with 26 categories included. Extras include a $650 dental limit, $350 back on therapies,$150 back on chiropractic and $200 for optical. $139.85 Go to Site

Speak to a health insurance advisor

Need help now? Enter your details for a call back about your health insurance options. An expert can help you compare up-to-date policies from eight funds to see which one is best for you.

What you'll get:

  • 100% free expert advice
  • Pay the same as going direct
  • Instant advice if you call 1300 594 882

Choosewell Lender Logos

What is a combined hospital and extras policy?

A combined health insurance policy includes both of the main types of health insurance:

  • Hospital cover for in-hospital treatment
  • Extras cover for ancillaries such as optical, dental and physio

Many health funds offer combined packages and this often suits people who want all of their health insurance needs taken care of in one single policy. The main advantage of combined health cover is the convenience of only having to purchase, review, maintain and claim on one policy from one fund. There is also the incentive of possibly obtaining a discount for purchasing both types of cover through the one fund.

How are hospital and extras policies different?

Hospital and extras insurance are totally different forms of cover. Hospital cover is to help pay for treatment and accommodation in a hospital during an illness or injury, while extras is to help cover the costs of ancillary health services that we all may require, but which aren’t usually covered by Medicare. Personal circumstances will dictate whether one form of cover is more important to you than the other. If you are young and healthy, you may only require basic hospital cover and opt for more comprehensive extras such as dental and physio. If you are older and starting to develop chronic complaints that might require surgery, then hospital cover may be a higher priority for you than extras. Other important differences include the following:

  • Not having sufficient hospital cover when your income is above a specified level attracts a Medicare Levy Surcharge, while extras does not.
  • 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.

What benefits does hospital policy cover?

Hospital cover pays for your treatment and accommodation in a public or private hospital. If you are a Medicare card holder, 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 using Medicare.
  • Basic cover. 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. 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. This plan generally covers every service where Medicare pays a benefit.

Starting in April 2019, insurers will be required to slot each of their policies into one of four new tiers: Basic, Bronze, Silver and Gold. These will roughly correlate to the existing tiers, but the new system will make it easier for you to compare one policy to the next.

Top hospital cover 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
  • Colonoscopies
  • 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 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.

What can you claim on your extras policy?

While hospital cover is insurance you only claim on if you become ill or injured and need to go to hospital, extras 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
  • Physiotherapy
  • Osteopathy
  • Podiatry
  • Acupuncture
  • 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.

What waiting periods and limits apply to combined policies?

Both hospital and extras health insurance cover are subject to waiting periods and benefit limits. In the case of hospital cover, the Private Health Insurance Act stipulates that the waiting period for pre-existing medical conditions and obstetrics (pregnancy) must be no longer than 12 months and no longer than 2 months for other hospital benefits (apart from accidents, in which case the waiting period is waived).

What are waiting periods?

Waiting periods for extras vary with funds but most apply a 2-month waiting period for services such as optical, general dental, physio, osteo and chiro and up to 12 months for major dental or 36 months for hearing aids. The reason waiting periods exist is to prevent people with pre-existing medical conditions from taking out private health insurance, obtaining the benefit and then cancelling their policy. This not only costs the fund, but affects every other health fund member because premiums would rise rapidly if this practice was allowed to occur.

What are claims limits?

Benefit limitation periods are another form of waiting period. These vary between funds, with some applying restrictions to certain hospital products, where only a minimum benefit is payable for up to three years. They can also apply to extras, where only minimum coverage for dental may be available in the first year, increasing after three years. Like waiting periods, benefit limitation periods are used to keep private health costs down, to prevent people from jumping the queue and to ensure that loyal members get the services they need in the long term.

Do you need to have hospital and extras with the same fund?

The main advantage of choosing a combined hospital and extras policy through one fund is convenience. You only have one premium to pay and one fund to deal with. The downside of this is you may not be getting the most value for money on one type of coverage or the other. So it really comes down to knowing what you need and doing the research via a comparison website to see whether you would get more benefits from a combined policy or by purchasing your hospital and extras insurance separately to take advantage of deals from two different funds. There is also the question of discounts and bonuses. If your current fund offers great hospital cover but less attractive extras, this may be offset by the fact that they also provide loyalty bonuses for years of membership and for taking out combined hospital and extras insurance cover.

Health insurance sign up deals for May 2019

ahm Deals ahm Deals

Skip the waits on 2 & 6 months extras. PLUS 1 month free.

When joining hosptial + extras. One month free after your first 60 days.

Last verified

Coupon code ends

Medibank Health Insurance Deals Medibank Health Insurance Deals

Get up to one month free + 2 and 6 month waits waived

Offer applies when joining Medibank Gold or Silver hospital & extras cover.

Last verified

Coupon code ends

nib Health Insurance Deal nib Health Insurance Deal

Skip the waits on 2 & 6 month extras. Plus get a $200 gift card.

Offer applies when joining hospital + extras.

Last verified

Get deal

Deal ends

Latest headlines

Picture: Unsplash

Was this content helpful to you? No  Yes

Related Posts

You might like these...

Ask an Expert

You are about to post a question on

  • Do not enter personal information (eg. surname, phone number, bank details) as your question will be made public
  • is a financial comparison and information service, not a bank or product provider
  • We cannot provide you with personal advice or recommendations
  • Your answer might already be waiting – check previous questions below to see if yours has already been asked

Finder only provides general advice and factual information, so consider your own circumstances, or seek advice before you decide to act on our content. By submitting a question, you're accepting our Terms of Use, Disclaimer & Privacy Policy and Privacy & Cookies Policy.

18 Responses

  1. Default Gravatar
    JohnOctober 19, 2018

    Member 707447
    Can I claim for hearing aids, please ?
    If so, how much can be claimed. The answer to this has a bearing on what level of hearing aid I can afford.

    • Avatarfinder Customer Care
      JohnOctober 19, 2018Staff

      Hi John,

      Thank you for reaching out to finder.

      We are a comparison website that assists users on our website. If you wish to inquire if your current insurance company covers hearing aids, you may check on your insurance contract with them for their contact details and call them directly. Hope this helps!


  2. Default Gravatar
    DaphneMarch 20, 2018

    I am already insured with A.H.M.
    I am interested in going with Qantas Assure option but am scared about moving from what seems to be ok. I do find claiming difficult though. Thankyou

    • Default Gravatar
      March 28, 2018

      Hi Daphne,

      Thank you for reaching out to us.

      Qantas Assure offers you Hospital and Extras Cover so you have the policy that will suit you even though you do not get sick most of the time. You may check this page for more information regarding each of their coverage, waiting periods and exclusions.

      With regards to their claiming process, you may simply lodge the claim in their Member Portal at the Qantas Assure webpage. Though it will be best to reach out to them first through their contact number above to make sure that the procedure or treatment that you will be receiving is covered by your policy.

      I hope this helps.

      Please do not hesitate to reach out to us again if you have additional questions.


  3. Default Gravatar
    darcyMarch 6, 2018

    We are a young family of 5 & have been with pupa for a good few years now. It just seems every year the prices go up but we’re not getting any extra out of them. Is there another mob that can do the same but for not so much coin?

    • Avatarfinder Customer Care
      MayMarch 9, 2018Staff

      Hi Darcy,

      Thanks for getting in touch.

      There are affordable health insurance in the market, all you need is to compare the benefits and check the level of cover you can get. If you fill out the panel found on this page and click on the orange “Search Policies” button, you’d be able to compare less expensive health insurance in the market. If you are getting an insurance for your whole family, you can select “family” to answer the question: “Who needs cover?”.

      Hope this helps.


  4. Default Gravatar
    BabiMarch 5, 2018

    I have held private health policies for more than 50yrs and am an aged pensioner under 70 and am looking for a combined hospital & extras cover that includes private hospital, heart surgery, hip & knee replacement, cataract surgery & optical, dental general & major, physiotherapy, podiatry – is there such a policy under $90 a fortnight?

    • Avatarfinder Customer Care
      MayMarch 6, 2018Staff

      Hi Babi,

      Thanks for your question. Please note that you’ve reached finder, a comparison website and we don’t offer insurance ourselves.

      The cost of a combined hospital and extras policy would actually differ between brands. To determine the premium cost, insurers would also factor in the level of cover you’ll choose and even your personal circumstance and health conditions. You can enter your details into the panel above to be able to search policies from different brands. I also suggest that you get in touch with the insurance company directly to discuss your options.


  5. Default Gravatar
    dallasSeptember 28, 2017

    Im a 70 female. Im with NIB at the moment. What hospital and extra cover is right for me?

    • Avatarfinder Customer Care
      MaySeptember 29, 2017Staff

      Hi Dallas,

      Thank you for your inquiry.

      If you like to get the combined hospital and extras cover from nib, you can fill out the form from this page to compare health insurance from nib and request a quote from a consultant.

      You can also compare your options for hospital and extras cover offered by other insurers if you will fill out the form above and click on the orange “Search Policies” button.

      Hope this helps.


  6. Default Gravatar
    LESLEYJuly 6, 2017

    I am looking for Seniors Health but noticed you are asking if I am having a baby. I want a fund that is for seniors only.

    • Avatarfinder Customer Care
      RenchJuly 6, 2017Staff

      Hi Lesley,

      Thanks for reaching out to us.

      You can check this page for helpful information and you may make use of the search filter from there and compare your options.

      Hope this helps.


  7. Default Gravatar
    rayFebruary 27, 2017

    have been a member of MEDIBANK for 36 years now
    cost to wife and myself are 70 years old.
    look for new private hospital and extras policy.

    • Avatarfinder Customer Care
      ZubairFebruary 28, 2017Staff

      Hi Ray,

      Sorry to hear you’re having issues with the price rise. If you would like to compare your options in hopes of finding a more affordable option, you can do so by entering your details into the quote comparison tool at the top of the page.

      Once you have done so you will be able to review quotes from every fund in Australia and sort these quotes by price or by the value of the policy. While we are able to provide quotes for every fund in Australia, you will only be able to apply for cover with the funds in our panel.

      All the best,

  8. Default Gravatar
    ReneeFebruary 9, 2017

    my husband and I are both over 60.
    currently members of hcf -hospital advanced savings and multicover.

    important to us :Dental, optical and ambulance.
    is there a better option cost wise, other than HCF for us as we have only a moderate income.


    • Avatarfinder Customer Care
      RichardFebruary 9, 2017Staff

      Hi Renee,

      Thanks for getting in touch. To review your options, please enter your details into the comparison tool above. Once you’ve done so you will be able to review policies from 30+ funds based on the value of the policy or simply on price.

      All the best,

  9. Default Gravatar
    July 21, 2016

    where do I get health cover to satisfy 410 visa please?

    • Avatarfinder Customer Care
      RichardJuly 28, 2016Staff

      Hi Derick,

      Thanks for your question. Unfortunately, none of the funds in our panel cover retirement visas. Bupa sill have it listed on its OVHC page as an option why selecting cover.

      I hope this was helpful,

Ask a question
Go to site