Family Extras Cover

The exact benefits you can get on an extras policy can vary depending on your health fund and level of cover. However, there are a few common inclusions you can expect to see. Typically, a higher level of cover includes more services and has higher limits.

Health funds can set their levels of cover and categorise their services as they see fit. However, here are a few common extras benefits and the levels of cover you may see them on. Keep in mind that higher level policies will usually also include the services from the lower levels.

Basic extras cover

• Physiotherapy
• General dental check-ups (e.g. fillings and x-rays)
• Optical (e.g. prescription glasses and contact lenses)

Medium extras cover

• Chiropractic
• Major dental (e.g. wisdom tooth extractions and dentures)
• Exercise physiology and osteopathy
• Podiatry and orthotics
• Vaccinations
• Acupuncture
• Remedial massage and myotherapy

Top extras cover

• Non-PBS pharmaceuticals
• Antenatal services
• Orthodontics (e.g. braces and mouthguards)
• Eye therapy
• Speech therapy
• Hearing aids
• Periodontics (i.e. root canals)

A family extras policy can include yourself, your partner and any of your dependent children. This can include stepchildren, adopted children and foster children. If you’re a single parent, you can take out single-parent cover, which will only cover you and your dependents.

The age you can keep your kids on your policy until will vary between health funds and may depend on a variety of factors such as if they’re studying or if they’re married/in a de-facto relationship. Some health funds will cover your dependent children up to the age of 31 years old.

All extras policies will come with limits on the amount you can claim, but when you have multiple people under one policy, some limits might work slightly differently. Here are a few limit types to look out for:

• Family/policy limit. Like an annual limit, a family or policy limit is the total amount you can claim for a particular service across everyone included on the policy within a year. For example, if you have a $400 family limit on physio and your partner makes a claim for $200, you’ll have $200 left for the rest of the family that year.
• Per-person limit. Some family policies will also put a limit on the amount you can claim per person in addition to your family limit. This means once you’ve hit your per-person limit, you won’t be able to claim again, even if you haven’t hit your family limit until the limit resets.
• Lifetime limit. Some extras services and products come with lifetime limits that carry over from other funds and don’t reset annually. When you move onto a family policy, your lifetime limits will also carry over, although these won’t apply to your family members.

Because of the wide range of policies available, it’s difficult to provide an accurate estimate of the premiums you can expect to pay on a family extras policy. Typically, the cost of your extras cover will depend on where you live, the fund you choose, and your level of cover.

However, depending on your eligibility, you could significantly reduce the cost of your health insurance through the Australian Government Rebate. This rebate will refund a percentage of your premiums based on your family income and the age of the oldest person on the policy.

If you’re currently on a couples policy, many health funds will give you the option to upgrade to a family policy at no additional cost.