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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.
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I'm Tim, your insurance expert.
Here to help you find the right cover for you!
Step 1/2 - About your cover
Which state do you live in?
QLD
NSW
ACT
VIC
TAS
SA
WA
NT
What's your age?
Depending on your age, you may be eligible for an
aged-based discount. This is used to estimate your
rebate.
Under 65
65 - 69
70 or older
What's your household's taxable income?
This is the combined income you and your spouse earn before tax. It's needed to calculate the correct Australian government rebate.
$93,000 and under
$93,001 to $108,000
$108,001 to $144,000
$144,001 and over
What kind of health insurance do you need?
Combined (Extras + Hospitals)
Extras
Hospital
What level of hospital coverage would you like?
You can change this at any time later.
Legend
Covered
Restricted cover, You may be partially covered for
this category.
Not covered. Optional for insurer to include.
*Prices updated November 2024, in line with Finder's database of health insurance policies. Prices reflect the cheapest available for a single individual with less than $97,000 income and living in Sydney with a $750 excess.
What extras cover do you need? (Optional)
Select as many as you want or move to the next step
Preventative & general dental
Major dental & implants
Optical
Physiotherapy
Podiatry
Non-PBS pharmaceuticals
Chiropractic
Emergency ambulance
Remedial massage
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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.
Finder survey: Do Australians understand how their health insurance extras limits work?
Response
Yes
55.79%
Somewhat
38.22%
No
5.98%
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.
"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.
Generally, your extras benefits will be the same each year. However, some policies reward you with a benefit increase each year you are a member. For example, your annual general dental cover limit in your first year of membership may be $500, but it may rise to $750 in your second year of membership. It may then continue to increase each year until you've reached a set maximum.
Yes, annual benefits are only relevant for extras cover. Hospital cover does not feature a set monetary limit on the benefit amount you are eligible to claim. You can find out more about how hospital-only cover works in our handy guide.
Was this content helpful to you?
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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 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 649 Finder guides across topics including:
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Physiotherapy services can be beneficial at any life stage, so it could be worth considering and comparing extras health insurance that can cover the cost of this type of treatment.
If you're wondering what pharmaceutical costs are covered by private health insurance, we've got a guide to health cover for non-PBS pharmaceuticals here.
Discover more about accessing naturopathy, herbal remedies, traditional Chinese medicine and other alternatives with coverage through your health insurance.
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We try to take an open and transparent approach and provide a broad-based comparison service. However, you should be aware that while we are an independently owned service, our comparison service does not include all providers or all products available in the market.
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Depending on your age, you may be eligible for an
aged-based discount. This is used to estimate your
rebate.
Under 65
65 - 69
70 or older
What's your household's taxable income?
This is the combined income you and your spouse earn before tax. It's needed to calculate the correct Australian government rebate.
$93,000 and under
$93,001 to $108,000
$108,001 to $144,000
$144,001 and over
What kind of health insurance do you need?
Combined (Extras + Hospitals)
Extras
Hospital
What level of hospital coverage would you like?
You can change this at any time later.
Legend
Covered
Restricted cover, You may be partially covered for
this category.
Not covered. Optional for insurer to include.
*Prices updated March 2024, in line with Finder's
database of health insurance policies. Prices are based
on a single individual with less than $93,000 income and
living in Sydney with a $750 excess.
What extras cover do you need? (Optional)
Select as many as you want or move to the next step
Preventative & general dental
Major dental & implants
Optical
Physiotherapy
Podiatry
Non-PBS pharmaceuticals
Chiropractic
Emergency ambulance
Remedial massage
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