Combine Hospital and Extras Cover

Published: November 20, 2019

When you start to review and compare Hospital and Extras cover, you may find that the price and benefits provided differ from insurer to insurer. Usually, you'll be able to purchase separate Hospital and Extras policies. However, it could be easier and more affordable to opt for combined health insurance, depending on your choice of health fund.

Combined Hospital and Extras cover provides you with access to health care treatments and services both inside and outside of the Hospital. For example, you might be able to claim in-Hospital services, like accommodation and theatre fees, as well as general treatments like dental and physiotherapy. The benefit amount you can claim depends on the insurer and level of cover you choose.

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What's the difference between Hospital and Extras cover?

Hospital and Extras cover are two different insurance policies that help you manage the cost of health care in Australia. Hospital only cover enables you to pay for treatments and accommodation received in the Hospital. Extras only cover provides a benefit towards ancillary health services received outside of the hospital, like optical, major dental and health management programs.

Hospital only cover

Different levels of cover provide you with a variety of benefits. Hospital options include Basic, Bronze, Silver and Gold. Each cover option lists various benefits, restrictions and exclusions. Generally, the higher your Hospital level, the more benefits you’ll receive and the higher your premium is likely to be.

General benefits of Hospital cover include:

  • Accommodation as a private patient in a public or private hospital.
  • You may be able to claim a rebate on your health insurance premiums.
  • Avoid paying the Medicare Levy Surcharge.
  • Choosing your doctor, specialist and hospital.
  • The waiting period for elective surgeries may be reduced.
  • Avoid paying the Lifetime Health Cover (LHC) loading when purchasing Hospital cover before your 31st birthday.

Health insurance Extras only

Generally, reduces out-of-pocket costs associated with services like dental, optical, chiropractic and physiotherapy, which is intended to prevent or manage health conditions, injuries and diseases.

When applying for Extras only health insurance, you generally have the option to choose between three different levels of cover; Basic, Medium/Mid or Top/Comprehensive cover. Comprehensive Extras usually offers the broadest range of services with higher benefit limits and will generally cost more than the Basic and Medium option.

The general advantages of Extra cover include:

  • Savings on out-of-pocket costs for general treatments received outside of the hospital.
  • You are taking control of your health by actively preventing or managing illnesses and injuries.
  • You can generally choose from an extensive list of registered providers, that might help you save even more.
  • Improves your quality of life if you have pre-existing conditions.

Do you need a Hospital policy and Extras cover?

Whether you need both a Hospital and Extras policy depends on your unique requirements and what you can afford. You might want to think about what you can afford and your current stage of life (getting married, starting a family or retiring) before you decide whether to purchase Hospital and Extras cover. Ask a health insurance specialist to assist you in assessing you and your family’s needs.

For example, if you have young children, you might want Extras cover that includes orthodontics and a Hospital policy that does not require you to pay an excess for hospital treatments. On the other hand, senior Australians might be thinking about Hospital cover that includes hip or knee replacements, heart surgery and Extras that cover endodontics and hearing aids.

Can you combine health insurance?

Yes, generally, you will be able to combine your Hospital insurance with Extras cover. Most private health insurance companies offer both types of protection, and you can link your choice of Extras with your preferred Hospital cover to create a tailored package that meets your requirements. However, some funds also offer pre-packaged options that you can choose.

How do you mix and match options?

Generally, mixing different health insurance policies is relatively simple. All you need to do is find a Hospital only policy that suits your requirements and combine it with your choice Extras only policy.

Take note: You are generally free to choose both policies from the same provider or Hospital cover from one fund and Extras from another. Make sure both funds are aware of one another and always carry your separate membership cards with you.

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Compare Hospital and Extras cover

Health Fund & Policy Hospital cover Extras cover
AHM
Deluxe Package Silver Plus
Includes 34 clinical categories, for example:
  • Cataracts
  • Dental surgery
  • Joint reconstruction & replacement
  • Rehabilitation
  • Dialysis for chronic kidney failure

Restricts cover for Hospital psychiatric services.

Exclude:
  • Pregnancy and birth-related services
  • Assisted reproductive services
  • Weight loss surgery
Claim a set amount of benefits for:
  • General dental
  • Major dental
  • Endodontic
  • Optical
  • Physiotherapy
  • Chiropractic
  • Podiatry
  • Acupuncture
  • Remedial massage
  • Chine medicine
  • Orthotics
  • Osteopath

All treatments, expect for optical, share a combined benefit limit with General dental.

Excludes:
  • Blood glucose monitors
  • Hearing aids
  • Non-PBS pharmaceuticals
  • Orthodontics
  • Psychology
Australian Unity
Top Choice Silver Plus
Get cover for 34 clinical categories, such as:
  • Back, neck and spine
  • Insulin pumps
  • Implantation of hearing devices
  • Lung and chest
  • Medically necessary plastic and reconstructive surgery

Restricts cover for Hospital psychiatric services.

Exclude:
  • Pregnancy and birth-related services
  • Assisted reproductive services
  • Weight loss surgery
A set benefit amount for Extras cover:
  • General dental
  • Major dental (sub-limits apply)
  • Endodontic
  • Optical
  • Physiotherapy
  • Chiropractic, combined with Acupuncture and Osteopathy
  • Podiatry
  • Remedial massage

No out-of-pocket costs, up to a yearly limit, for preventative dentistry when performed by a preferred provider.

Excludes:
  • Blood glucose monitors
  • Hearing aids
  • Non-PBS pharmaceuticals
  • Orthodontics
  • Psychology
Bupa
Prime $750 Excess Silver Plus
Covers 35 clinical categories, including:
  • Full coverage for Hospital psychiatric services
  • Blood
  • Insulin pumps
  • Hernia and appendix
  • Lung and chest
  • Ear, nose, and throat
Excludes:
  • Pregnancy and birth-related services
  • Assisted reproductive services
  • Weight loss surgery
Members are covered for set benefits, including:
  • General dental
  • Major dental combined with Endodontic
  • Optical
  • Non-PBS pharmaceuticals
  • Physiotherapy combined with Occupational therapy
  • Chiropractic combined with Osteopathy
  • Podiatry
  • Psychology
  • Combined Acupuncture, Remedial massage, Chinese medicine, Dietetics/dietary advice and Exercise physiology
  • Combined limit for Hearing aids, Blood glucose monitors and Orthotics
  • Health management/ healthy lifestyle

A yearly top-up could help to cover some of your out-of-pocket costs.

Excludes:
  • Orthodontics
GMHBA
Silver Package
This package covers 27 clinical categories, including:
  • Rehabilitation
  • Joint reconstruction
  • Digestive system
  • Medically necessary breast surgery
  • Dental surgery

Palliative care and Hospital psychiatric services are restricted.

Excludes:
  • Assisted reproductive services
  • Cataracts
  • Dialysis for chronic kidney failure
  • Insulin pumps
  • Joint replacement
  • Pain management with devices
  • Pregnancy and birth-related services
  • Sleep studies
  • Weight loss surgery
Receive a set benefit for Extras like:
  • General dental
  • Major dental combined with Endodontic
  • Orthodontics
  • Optical
  • Combined limit for Physiotherapy, Chiropractic, Osteopathy and exercise physiology
  • Podiatry combined with Orthotics
  • Psychology
  • Combined limit for Acupuncture and Remedial massage
  • Dietetics/dietary advice
  • Vaccinations
Cover is not included for
  • Blood glucose monitors
  • Hearing aids
  • Non-PBS pharmaceuticals
HCF
My Family Silver Plus $750 Excess
Provides members with for 30 clinical categories, including:
  • Kidney and bladder
  • Miscarriage and termination of pregnancy
  • Implantation of hearing devices
  • Gastrointestinal endoscopy
  • Blood

Hospital psychiatric services are restricted.

Excludes:
  • Assisted reproductive services
  • Cataracts
  • Dialysis for chronic kidney failure
  • Insulin pumps
  • Joint replacement
  • Pain management
  • Weight loss surgery
Examples of Extras that are covered are:
  • Combined limit for General dental, Major dental and Endodontic
  • Optical

The below Extras benefit is all in combination with the General dental limit:

  • Non-PBS pharmaceuticals
  • Physiotherapy
  • Chiropractic
  • Psychology
  • Acupuncture
  • Remedial massage
  • Chinese medicine
  • Dietetics/dietary advice
  • Exercise physiology
  • Health management/ healthy lifestyle
  • Osteopathy
  • Vaccinations
Cover does not extend to:
  • Blood glucose monitors
  • Hearing aids
  • Orthodontic
  • Podiatry
HIF
Silver Plus No Maternity Combo
Offers cover for 34 different clinical categories such as:
  • Palliative care
  • Rehabilitation
  • Sleep studies
  • Joint reconstructions and replacement
  • Heart and vascular system

Restricts cover on Hospital psychiatric services.

Does not include cover for:
  • Assisted reproductive services
  • Pregnancy and birth
  • Weight loss surgery
Get 60% back on benefits:
  • General dental combined with Major dental and Endodontic
  • Optical
  • Non-PBS pharmaceuticals
  • A combined limit for Physiotherapy, Chiropractic and Podiatry
  • Acupuncture combined with Remedial massage and Chinese medicine
  • Health management/ healthy lifestyle programs
There is no cover available for:
  • Blood glucose monitors
  • Hearing aids
  • Orthodontic
  • Psychology
myOwn
Silver Plus Hospital 750 and Comprehensive 70 Extras
Cover 33 different clinical categories, including:
  • Skin
  • Tonsils, adenoids, and grommets
  • Insulin pumps
  • Chemotherapy, radiotherapy, and immunotherapy for cancer
  • Back, neck, and spine

Hospital psychiatric services are restricted.

Cover excludes:
  • Assisted reproductive services
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
Claim 70 back on Extras like:
  • General dental
  • Major dental combined with Endodontic
  • Orthodontic
  • Optical
  • Non-PBS pharmaceuticals
  • Combined limit for Physiotherapy and Exercise physiology
  • Chiropractic combined with Osteopathy
  • Podiatry
  • Psychology
  • Acupuncture combined with Remedial massage
  • Combined limit on Hearing aids and Blood glucose monitors
  • Audiology
  • Dietetics/dietary advice
  • Eye therapy (orthoptics)
  • Health management programs
  • Occupational therapy
  • Speech therapy

There are no exclusions on general treatments

NIB
Mid Plus - Silver Plus $750 Excess
Get Hospital cover for 32 different clinical categories, including:
  • Dental surgery
  • Digestive system
  • Kidney and bladder
  • Palliative care
  • Lung and chest

Restricted cover for Hospital psychiatric services.

Excludes cover for:
  • Assisted reproductive services
  • Cataracts
  • Joint replacements
  • Pregnancy and birth
  • Weight loss surgery
65% back on Extras cover, including:
  • General dental
  • Major dental combined with Endodontic
  • Orthodontic
  • Optical
  • Non-PBS pharmaceuticals
  • Combined limit n Physiotherapy, Chiropractic, Exercise physiology and Osteopathy
  • Psychology
  • Acupuncture combined with, Remedial massage, Chinese medicine and Dietetics/dietary advice
  • Health management/ healthy lifestyle
There is no cover available for:
  • Blood glucose monitors
  • Hearing aids
  • Podiatry
PeopleCare
Silver Plus Hospital $750 & Premium Extras
Includes benefits for 30 clinical categories, including:
  • Gynaecology
  • Eye (not cataracts)
  • Diabetes management
  • Brain and nervous system
  • Joint reconstructions

Restricts cover for Rehabilitation, Palliative care and Hospital psychiatric care.

This policy does not include cover for:
  • Assisted reproductive services
  • Pregnancy and birth-related services
  • Cataracts
  • Joint replacements
  • Weight loss surgery
Ger 80% back on Extras cover, including:
  • General dental
  • Major dental combined with Endodontic
  • Orthodontic
  • Optical
  • Combined limit on Non-PBS pharmaceuticals and vaccinations
  • Physiotherapy combined with, Chiropractic, Exercise physiology, Eye therapy, Osteopathy and Occupational therapy
  • Podiatry
  • Psychology
  • Combined Acupuncture, Remedial massage and Dietetics/dietary advice
  • Hearing aids combined with Audiology
  • Blood glucose monitors
  • Ante-natal/Post-natal classes
  • Health management/ healthy lifestyle
  • Home nursing (sub-limits apply)
  • Speech therapy
Source: privatehealth.gov.au

Take note: The above is based on a single adult living in NSW, applying for a combined Hospital and Extras policy on 6 November 2019.

Frequently Asked Questions and Answers

Is it cheaper to combine health insurance?

Generally, this will depend on the insurer, and the specific Hospital and Extras cover you choose. However, you might find it cheaper to buy a combined policy from the same health insurance company as they might offer discounts.

Do you have to get Hospital and Extras from the same fund?

Generally, no. If you decide to mix and match policies, you do not have to use the same health insurance provider. However, if you are opting for a pre-packaged insurance policy, you will need to purchase it from one fund.

Where to find the cheapest Hospital and Extra cover?

When looking for the most affordable combined insurance plan, you might want first to determine your requirements and budget, then compare similar policies from some of Australia's major health insurance companies.

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