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What is extras cover and do I need it?

What exactly is Extras cover and do I even need it?

A female optometrist adjusts glasses on her male patient
A female optometrist adjusts glasses on her male patient

Advertisements for health insurance almost always mention "Extras cover". You might already have private health insurance and not be sure if Extras cover is included in your policy or you may be wondering, what exactly is Extras cover and do I even need it?

In Australia, there are two types of private health insurance cover available – Hospital cover and Extras cover. With nib, for example, you can get both Hospital and Extras cover, or you can choose to take out one or the other, depending on what services you want cover for.

What is Extras cover?

Extras cover (sometimes referred to as "ancillary cover") can help you cover the cost of the everyday services you and your family use to stay healthy, like going to the dentist for a check-up, a visit to the optometrist for new glasses or seeing the physio. Depending on the cover you choose, Extras can also include natural therapies like acupuncture and remedial massage, and a range of healthier lifestyle options (like some gym memberships or quit smoking programs).

How much can I claim?

Each Extras cover you look at will usually list a certain "percentage back" amount for services, up to an annual limit. For example, if the cover you're looking at gives you 60% back on physio, your $100 visit would only leave you $40 out of pocket, until you reach your limit for the year. Once you reach this limit, you won't be able to claim anything more for that particular service until your benefits are reset for the new calendar year.

It's worth noting that the covers offering the highest annual limits and the biggest percentage back on your claims are usually more expensive. Depending on your cover, other limits may also apply on particular services so it's important to understand your entitlements.

Tip: To avoid your annual limit creeping up on you unexpectedly, you can keep track of your usage throughout the year in Member Services.

Watch your waiting periods

If you're purchasing cover for the first time, or increasing your level of cover, you’ll probably need to wait a few months before you can claim on some, or all, of your inclusions. Make sure you read the details of your policy to ensure you’re fully aware of any waiting periods that may apply so you know when you can start making claims.

How do I claim on my Extras cover?

Claiming on your extras cover is quick and easy. Depending on the provider you’ve been to see, when you pay for your service, you may be able to swipe your nib card through what’s called a HICAPS machine. As long as you’re covered for that service and haven’t reached your annual limit, we’ll pay your claim on the spot and you’ll only need to sort out the gap.

If this isn’t an option for you, you can use either the nib app or member account from your phone, tablet or computer to submit your claim. It’s simply a matter of taking a photo of your receipts and pressing submit. Other claiming options are also available.

Choosing the right extras cover and finding great value is much easier than it first appears. It’s a case of looking at your lifestyle and health requirements and selecting the health services and features you want and may need. To check out the Extras options nib has available, visit our Compare Extras page or get a quote.

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