Extras cover: compare limits, waiting periods and extras-only policies
Compare extras cover by the dollar benefit it pays for each service you use, the annual limits on those services and the waiting periods. Some funds waive extras waiting periods for new members, but the standard waits on major dental, orthodontics and hearing aids are almost always 12 months or more: none of the 337 extras-only policies open at 1 October 2026 had a standard no-wait on them. Extras, which the industry calls general treatment, pays towards health services outside hospital that Medicare does not cover: dental, optical, physiotherapy, chiropractic, podiatry, psychology, remedial massage, hearing aids and similar. You can buy it on its own as extras-only cover, or combined with a hospital policy.
Unlike hospital cover, extras is not tiered or standardised. Each fund decides which services to include, how much to pay per service and how much you can claim each year, which makes extras harder to compare and easy to overpay for.
By Better Rate Mate Editorial Team · Last reviewed
Extras cover with no waiting period
Extras waits are set by each fund, not by law, so a fund can shorten or waive them. But a standard no-wait is rare. In the Government's data for the 337 extras-only policies open to new members at 1 October 2026, general dental, physio, optical and chiro had no standard wait on about one policy in twenty, psychology on about one in seven, and major dental, root canal, orthodontics and hearing aids on none. The usual standard wait is two months for general services and 12 months for major ones.
Joining offers are where most no-wait extras come from: some funds waive certain waits for new members for a limited time. Those offers aren't in the Government's data, so check three things before you rely on one:
- The policy's Private Health Information Statement, for the standard wait on the exact service you're joining for.
- The offer's terms: which services it covers, whether it waives only the two-month waits or also the 12-month waits on major dental, orthodontics and hearing aids, whether it applies to members switching from another fund as well as new ones, and when it ends.
- Any conditions if you cancel or downgrade soon after claiming, such as a minimum membership period. Ask the fund before you join.
| Service | Extras-only policies that cover it | Most common standard wait | Policies with no standard wait |
|---|---|---|---|
| General dental (check-up and clean) | 335 | 2 months (318 policies) | 15 (4%), at 3 insurers |
| Physiotherapy | 318 | 2 months (304) | 14 (4%) |
| Optical | 305 | 6 months (153) or 2 months (135) | 14 (5%) |
| Chiropractic | 294 | 2 months (280) | 14 (5%) |
| Psychology | 233 | 2 months (198) | 35 (15%) |
| Major dental (crowns, extractions) | 271 | 12 months (265) | None |
| Endodontics (root canal) | 274 | 12 months (252) | None |
| Orthodontics | 173 | 12 months (168) | None |
| Hearing aids | 120 | 12 months (60) or 36 months (50) | None |
| Blood glucose monitors | 128 | 12 months (104) | None |
Switching keeps the waits you've served
If you already have extras and switch funds at the same or a lower level, your new fund must recognise the waits you've served, so you only serve waits on benefits that are new or higher. Our guide to health insurance waiting periods covers the rules for hospital and extras.
What extras cover typically includes
Extras packages are built from a menu of services. The more services and the higher the limits, the higher the premium. The common ones, as defined by privatehealth.gov.au:
- General dental: check-ups, cleans and simple fillings.
- Major dental: complex fillings, extractions, crowns and bridges. Each fund decides which items count as general or major.
- Orthodontics: braces and other appliances, usually with a lifetime limit rather than an annual one.
- Optical: prescription lenses, frames and contact lenses. Optometrist consultations are generally claimed through Medicare, not extras.
- Physiotherapy, chiropractic, osteopathy, podiatry, exercise physiology and dietetics.
- Psychology, where the policy includes it.
- Remedial massage, acupuncture and Chinese medicine, where included.
- Hearing aids, orthotics and blood glucose monitors, often from a shared 'health aids' limit.
- Non-PBS pharmaceuticals, usually after you pay the normal PBS co-payment.
- Speech pathology, audiology, eye therapy (orthoptics) and home nursing, where included.
- Ante-natal and post-natal classes, approved health management programs and some vaccinations, on some policies.
How to compare extras cover
Start with the services you will actually use in the next year. Then use each policy's Private Health Information Statement, which gives an example of the maximum benefit for common items, to fill in a table like the one below for each policy you're considering. The policy that pays the most for your services within its limits, after the premium, is the one to beat.
Ask the fund or check its website for the benefit on the exact item numbers you use, such as a check-up and clean, a physio consultation or a pair of glasses. A generous headline limit means little if the benefit per visit is low. If dental is the main reason you're buying extras, our guide to dental cover goes through general, major and orthodontic benefits; if you're also weighing hospital cover, see comparing combined hospital and extras cover.
| Service you use | Benefit per visit or item | Annual limit (per person or per policy) | Waiting period | Better benefit at a network provider? |
|---|---|---|---|---|
| Check-up and clean | From the PHIS example | Check whether it's shared with other dental | Generally 2 to 6 months | Check the fund's dental network |
| Physiotherapy consultation | From the PHIS example | Check whether it's combined with chiro and osteo | Generally 2 to 6 months | Check the fund's network |
| Glasses or contact lenses | From the PHIS example | Check whether optical has its own limit | Generally 2 to 6 months | Check the fund's optical network |
| Major dental (crown, extraction) | From the PHIS example | Check whether major dental has its own limit | Longer; check the PHIS | Check the fund's dental network |
| Your own service |
How to choose the best extras cover for you
There's no best extras policy for everyone, and we don't name one. The best extras cover is the one that pays the most back on the services you'll actually use, after its premium. These are the criteria, in the order we'd check them:
- The dollar benefit on your services: use the example benefits on each policy's information statement for a check-up and clean, a physio visit or a pair of glasses.
- Annual limits and sub-limits: whether the service has its own limit or shares one with others, and whether limits are per person or per policy.
- Percentage back or fixed benefit: a percentage of the fee suits expensive providers; a fixed dollar amount suits cheaper ones.
- Gap-free items at network providers, and whether your own dentist or physio is in the network.
- Waits on the services you need soon, from the table above.
- The premium after the rebate, set against what you'd claim in a year.
Start with what Australians claim most
Dental is the extras service most people use. In the June 2026 quarter insurers paid $1,804.16 million in extras benefits, of which $1,001.79 million (about 56%) was for dental, followed by optical ($229.59 million), physiotherapy ($140.70 million) and chiropractic ($82.01 million), APRA's figures show. If you'll use dental and optical every year, compare policies on those benefits first.
Cheapest extras cover: what you give up
The cheapest extras policies usually cover a short list of everyday services at modest benefits, and leave out the expensive ones. Of the 337 extras-only policies open at 1 October 2026, 335 covered general dental, but only 271 covered major dental, 173 orthodontics and 120 hearing aids. A cheap policy can be good value if all you claim is a check-up and clean, glasses and the odd physio visit.
What you typically give up on a lower-cost policy: major dental, orthodontics and hearing aids, or long waits and low limits on them; lower benefits per visit; combined limits shared across several services; and fewer extras such as psychology, podiatry and dietetics. Extras-only cover is cheaper than hospital cover, but it doesn't count for the Medicare Levy Surcharge or Lifetime Health Cover. The rebate applies to it.
Basic, mid and top extras: what changes
Extras isn't tiered by law the way hospital cover is, but most funds package it in levels with names like basic, mid and top. Moving up a level can add services (major dental, orthodontics, hearing aids, psychology), raise the annual limits and raise the share of each bill the fund pays. Because the levels aren't standardised, one fund's 'mid' can match another's 'top'. Compare the services and limits you need rather than the level's name.
Natural therapies funds can no longer cover
Since 1 April 2019, insurers cannot pay benefits for 16 natural therapies as part of a health insurance policy: Alexander technique, aromatherapy, Bowen therapy, Buteyko, Feldenkrais, western herbalism, homeopathy, iridology, kinesiology, naturopathy, Pilates, reflexology, Rolfing, shiatsu, tai chi and yoga. If one of these is why you are buying extras, no complying policy will pay for it.
How benefits and limits actually work
Funds pay either a percentage of the provider's fee or a fixed dollar amount per service, and then cap what you can claim. There are usually several caps stacked together: a per-service limit (for example, a yearly optical limit), sometimes a combined limit shared across several services, and for high-cost items like orthodontics a lifetime limit.
Most limits reset on a calendar or financial year basis set by the fund, and unused benefits are generally lost rather than carried over. A few funds reward loyalty by increasing some limits the longer you hold the policy. Your policy's Private Health Information Statement shows example benefits for common services, which is the easiest way to compare two extras policies on the same footing.
Is extras cover worth it? Do the arithmetic
Extras pays for itself only if what you claim back exceeds what you pay in. Write down a realistic year: two dental check-ups and cleans, a pair of glasses, a course of physio. Apply the fund's benefit per service and its limits to that list, then compare the total with twelve months of premiums.
People with predictable, recurring costs, such as families with children in orthodontics or anyone with regular physio, often come out ahead. People who see a dentist occasionally usually do not, and may be better off paying as they go and putting the premium aside.
Preferred providers and gap-free services
Most funds have networks of dentists, optometrists and allied-health providers with agreed prices. At a network provider you may pay no gap for some services, such as a check-up and clean, or a set range of frames. Outside the network the benefit can be noticeably lower. If you want to keep your current dentist or physio, check whether they are in the network before you choose a fund.
Extras cover at a glance
Extras waits are set by each fund, not by legislation. privatehealth.gov.au notes they generally run from two to six months for items such as general dental, optical and physiotherapy, and 12 months or more for major items such as orthodontics and hearing aids. Some funds waive certain extras waits for new members as a promotion; the policy's PHIS shows what applies. The other features to check are below.
| Feature | How it works | What to check |
|---|---|---|
| Benefit per service | Percentage of the fee or a fixed dollar amount | The dollar benefit for the services you use most |
| Annual limits | Per service, per category or combined; reset yearly | Whether the limit is realistic for your usage |
| Lifetime limits | Common for orthodontics | How much of the treatment cost it covers |
| Waiting periods | Set by the fund; commonly 2 to 12+ months | The wait for the specific service you need |
| Provider network | Agreed prices at preferred providers | Whether your own dentist or physio is in it |
| Surcharge and loading | Extras does not count for the MLS or Lifetime Health Cover | Whether you also need hospital cover |
Extras-only cover and the tax rules
You can hold extras without hospital cover, and many people do. Two consequences are worth knowing. Extras-only cover does not exempt you from the Medicare Levy Surcharge, because only hospital cover does. And extras does not count towards Lifetime Health Cover, so holding extras before 31 will not protect you from the loading if you later take out hospital cover. The government rebate does apply to extras premiums.
What to watch for
- Extras cover on its own does not exempt you from the Medicare Levy Surcharge or count for Lifetime Health Cover.
- A big headline annual limit means little if the per-visit benefit is low. Compare the dollar benefit for the services you use.
- Unused limits are generally forfeited when they reset, so time your claims within the limit year.
- Switching funds does not usually carry over accrued loyalty benefits or orthodontic limits already used.
- Check the waiting period for the specific service you are joining for. Major dental and orthodontics commonly carry 12 months.
Common questions
Can I get extras cover without hospital cover?
Yes. Most funds sell extras-only policies. They do not exempt you from the Medicare Levy Surcharge and do not count towards Lifetime Health Cover, so if you earn above the threshold or are approaching 31, consider hospital cover as well.
Is extras cover worth it?
Only if your realistic yearly claims exceed your yearly premium. List the dental, optical and allied-health services you actually use, apply the fund's benefit per service and limits, and compare the total with the premium.
Can I get extras cover with no waiting period?
For general services, sometimes; for major items, almost never. In the Government's data for extras-only policies open at 1 October 2026, about one in twenty had no standard wait on general dental, physio or optical, and none had a standard no-wait on major dental, orthodontics or hearing aids. Some funds also waive waits as a joining offer for new members, so check the offer's terms and the policy's information statement for the exact service.
What is the difference between general and major dental?
General dental covers check-ups, cleans and simple fillings. Major dental covers complex work such as extractions, crowns and bridges. Each fund decides which items fall in each group, and major dental usually has a longer wait and a different limit.
Do extras limits roll over?
Usually not. Most limits reset each year and unused benefits are lost. Some funds increase certain limits the longer you stay, which can be worth weighing if you plan to keep the policy for years.
What are the most claimed extras in Australia?
Dental, by a wide margin. In the June 2026 quarter insurers paid $1,804.16 million in extras benefits, of which $1,001.79 million (about 56%) was for dental, followed by optical ($229.59 million), physiotherapy ($140.70 million) and chiropractic ($82.01 million), APRA's figures show. The best extras for you are the ones you'll use: compare the benefit and limits on those services.
What is the best extras cover?
There's no single best extras policy, and we don't name one. Compare the dollar benefit on the services you'll use, the annual limits and whether they're shared, percentage-back or fixed benefits, the provider network, the waits on what you need soon, and the premium after the rebate. The best policy pays back the most on your own year of claims.
What is the least expensive type of health insurance?
Ambulance-only cover, then extras-only cover. In the Government's data for singles policies open in NSW at 1 October 2026, ambulance-only policies had the lowest median premium, extras-only policies the next lowest, and hospital cover rose tier by tier from Basic to Gold. Neither ambulance-only nor extras-only cover counts for the Medicare Levy Surcharge or Lifetime Health Cover: for those you need hospital cover, where Basic with a high excess is the cheapest that counts.
About the figures on this page
Extras benefits, limits and waiting periods are set by each fund and can change at any time, usually with the 1 April premium round. The rules on this page were checked against privatehealth.gov.au on 10 October 2026. Check a policy's Private Health Information Statement for its current benefits.
