When do health insurance benefits reset?

Extras benefits reset each year, and they don't roll over! Make sure you maximise your claims before your fund's cut off date.

Who is this cover for?

Key takeaways

  • Extras health insurance gives you a yearly benefit for treatments like optical and dental.
  • These benefits reset each year, generally either 1st of January or 1st of July.
  • Extras benefits do not typically roll over, so you should try and use them before they reset.

When do health funds reset extras benefits?

Extras benefits reset on 3 different dates: January 1st, July 1st, or the anniversary of your policy start date. This table lists the dates that each fund uses, as of April 2024.

FundWhen Extras Reset
ahm health insurance1 July
HCF1 January
Medibank Private1 January
NIB1 January
Qantas Health Insurance1 January
Suncorp1 January
ACA1 January
APIA1 January
Australian Unity1 January
Bupa1 January
CBHS Corporate1 January
CBHS Health Fund1 January
Hunter HealthPolicy start anniversary
Defence Health1 July
Doctors' Health Fund1 January
Emergency Services Health1 January
Frank1 January
GMHBA1 January
Grand United Corporate HealthPolicy start anniversary
HBF1 January
Health Care Insurance1 January
HIF1 January
Health Partners1 January
Latrobe Health ServicesNot stated
Mildura Health Fund1 January
MyOwn Health1 January
onemedifund1 July
Navy Health1 July
Nurses & Midwives Health1 January
Peoplecare Health Insurance1 July
Phoenix Health Fund1 January
Police Health1 January
Queensland Country Health FundPolicy start anniversary
RT Health Fund1 January
RBHS1 January
St.Lukes Health1 January
Teachers Health1 January
TUH1 January
UniHealth1 January
Westfund1 January

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Finder survey: Do Australians understand how their health insurance extras limits work?

Response
Yes55.79%
Somewhat38.22%
No5.98%
Source: Finder survey by Pure Profile of 1006 Australians, December 2023

What other limits can apply?

There are a few other extras cover limits you should be aware of.

  • Waiting periods: All extras policies have a waiting period before you will be able to claim (with a few exceptions). This period is typically 2, 6 or 12 months, but can be as long as a few years for things like hearing aids or braces.
  • Claim time limit: You need to make a claim within a certain time after you get a service. This time limit is typically 2 years.
  • Service limit: There may be a limit on the number of times you can claim a benefit for the same service in a year. For example, you may be allowed to only claim 2 dentists appointments per year.
  • Daily claim limit: Some health funds limit you to claiming one extras benefit per day. So if you receive multiple services within one consultation, you may only be able to claim the service which attracts the higher benefit.

What are the types of services that have annual limits?

Annual limits usually apply to a wide range of general treatments included in extras cover, such as:

However, there are certain parts of extras cover to which annual limits don't usually apply, for example ambulance cover.

Nicole T's headshot

"I've found that my go-to health providers are always busiest in the two months leading up to the time that extras benefits reset (Nov-Dec and May-Jun). So I don't miss out on making my claims before my extras reset, I make sure to plan ahead and book my appointments outside of these busy periods, particularly for my optom and dental visits. I find it easy to avoid these busy periods by pre-booking my next appointment in advance when I go for my check-up. I can then reschedule my appointment if needed once I've been sent a reminder to confirm attendance. "

Nicole T
Finder crew member

What is the difference between a combined limit and a sublimit?

When comparing extras cover, it's important to be aware that sub-limits and combined annual limits may also apply. While your policy may have an annual limit of $1,000 for general dental services, there may also be a sub-limit that sets the maximum amount you can claim for a specific dental treatment, for example a routine checkup or a basic extraction. This sub-limit is subtracted from the larger annual limit.

However, combined annual limits may also apply. For example, your policy may provide up to $300 cover for each of the following services: physiotherapy, chiropractic treatment and osteopathy. However, those services may also be grouped together into one category with a combined annual benefit limit of $750 – so the maximum yearly amount you can claim for all the physio, chiro and osteo services you receive is $750.

Tim Bennett's headshot
To make sure you get accurate and helpful information, this guide has been edited by Tim Bennett as part of our fact-checking process.
Gary Ross Hunter's headshot
Editor, Insurance

Gary Ross Hunter was an editor at Finder, specialising in insurance. He’s been writing about life, travel, home, car, pet and health insurance for over 6 years and regularly appears as an insurance expert in publications including The Sydney Morning Herald, The Guardian and news.com.au. Gary holds a Kaplan Tier 2 General Advice General Insurance certification which meets the requirements of ASIC Regulatory Guide 146 (RG146). See full bio

Gary Ross's expertise
Gary Ross has written 644 Finder guides across topics including:
  • Health, home, life, car, pet and travel insurance
  • Managing the cost of living

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