Private Health Insurance Extras Cover can be confusing! Patients often ask us for advice or recommendations when it comes to extras cover.

Here are our Top 5 Tips for getting the most out of your cover! 

tip 1: know your cover rollover or ‘reset’ date

Did you know that your private health insurance extras cover rebate ‘resets’ each year? This means that once you have ‘used up’ all of your rebates, your cover will refresh annually.

Each Private Health Insurance company has a different reset or rollover date. Most commonly extras rebates reset with the new calendar year on the 1st of January. However AHM and other various companies will reset on the 1st of July with the new financial year.

tip 2: understanding combined/sub limits of your cover

The next important thing to understand with private health insurance extras cover is what your total/combined extras limits are. These are the rebate amounts that you are able to uses on health services/treatment over a 12 month period.

private health insurance extras cover
private health insurance extras cover

Looking at the two tables above from the PDS of two different private health insurance extras cover, we can see the blue table includes a combined limit of $1000 across all services. Compared to the table in black, which includes sub-limits of $600 on Dental, $200 on Remedial Massage and $350 combined for Chiro & Physio.

Understanding your combined & sub limits for your extras cover helps you know how much rebate you are entitled to for each service.

tip 3: how much rebate will i get back?

private health insurance extras cover

“How much will I get back from my extras cover?” – this is another common question we get from patients!

There are a huge amount of different extras covers out there with different rebate/benefit amounts. The best way to find out how much your private health fund will pay towards any treatment is to contact them. You can look through your PDS on the cover, call your fund directly or even check if they have the info available in an app!

The two example tables above give show the rebate amount for the cover. These examples are both percentages of the total treatment fee. Most commonly private health funds will pay a percentage based benefit or a fixed fee towards each consultation.

tip 4: understanding waiting periods

To get the most out of your private health insurances extras cover, it is important to understand waiting periods.

With most new private health insurance policies you will have to serve a two month waiting period before using your cover. Companies will sometimes offer ‘no waiting period’ promotions, which mean that you can use your cover straight away!

When changing policies or moving from one fund to another, you may have to serve another waiting period if you have added new services or upgraded your cover. We always recommend checking this with your individual private health fund.

tip 5: review and compare your private health insurance annually

private health insurance extras cover

Looking at our first 4 tips, you may feel a little overwhelmed! Yes there can be a lot to it when it comes to understanding your private health insurance extras cover and how to get the most out of your cover.

As with any insurances, we recommend reviewing your cover on an annual or periodical basis to make sure you are still getting what you need from your private health extras cover. 


We’re here to help!

Here at Fortitude Chiropractic we utilise a HICAPS terminal which is similar to a normal EFTPOS machine but allows you to claim back the rebate towards your treatment instantly. This means that you only pay the gap on your consultation fees and saves you the time of claiming back the rebate from your private health fund.

Schedule your consultation today by calling us on (08) 6184 8835 or you can Book Online instantly through our website.

Please Note

This advice is general in nature and the information contained within this blog post is not to be considered as individual or financial advice.

We encourage you to review your individual circumstances and clarify/discuss your needs with your private health insurance company.

The two tables inserted above are used for example/demonstration purposes only and we are not recommending these covers or private health companies