Extras cover (also called ancillary cover or general treatment) and hospital cover can be taken out separately as hospital only or extras only cover. When they are taken out together, it is called combination cover. This guide explains the key features of extras cover and how it differs from hospital cover.
The RBHS Extras covers members against a wide range of dental, optical and other healthcare expenses. The RBHS’s benefits are mostly set at 90% of the fee charged (subject to maximum limits). This also covers purchase costs and repairs to items such as glasses, dentures and hearing aids.
Benefits are set and regularly reviewed by the RBHS, taking into consideration the costs set by associations of medical providers and other trends in health costs.
Advantages of extras cover
Get a rebate
Members can access a rebate (depending on your income) from the government to reduce the cost of extras and hospital cover premiums (whether taken alone or together). It is called the Australian Government Rebate on Private Health Insurance. View the income thresholds here.
RBHS Extras offers superb cover on a wide range of dental, optical and other healthcare expenses:*
- remedial massage
- hearing aids
- laser eye surgery
Extras cover is popular because of core dental and optical benefits – which are relatively predictable and expensive necessities.
Extras cover differences to Hospital cover
- Extras cover has no impact on whether you pay Medicare Levy Surcharge or Lifetime Health Cover loading (that is hospital cover).
- Extras benefits are usually subject to limits such as annual limits. Most services with RBHS have a calendar year limit. Benefits that can only be claimed once a year renew on 1 January each year.
- Extras benefits are usually paid on a percentage of the total cost. The RBHS offers exceptional annual limits and a generous 90% back on most services
- Unlike Hospital cover, you will not have to pay an excess to your health fund when you claim.
*There are some government programs, generally means-tested (subject to income and/or social background criteria), that can help pay for some extras services. An example is the Child Dental Benefit Schedule. Another exception is treatment received under a Chronic Disease Management Plan. RBHS cannot provide benefits if you are receiving a benefit through one of these government programs/plans.
The RBHS extras cover advantage
There are some important things you need to know about your cover.
- Waiting periods (including those for pre-existing conditions).
- Cooling-off period - A new member may cancel their policy within 30 days of joining the RBHS on the following basis:
- If the member has not made a claim in the 30 days from the commencement date of their policy, they will receive a full refund of all premiums paid.
- If the member has made a claim in the first 30 days of their policy, the cooling off period is null and void.
- Yearly limits - Yearly limits are based on a calendar year (1 January to 31 December).
- Rolling year limits are based on the first date of service.
- Optical benefits (glasses and contact lenses) are paid only when prescribed by a registered optometrist. Benefits will only be paid where sight correction is necessary. No benefit is payable for non-prescription sunglasses.
- Pharmacy benefits apply after the standard Pharmaceutical Benefit Scheme (PBS) amount has been deducted. The PBS amount changes every year on 1 January and is $42.50 as at 1/1/22. This means that you will pay the first $42.50 and the RBHS pays a benefit up to $160 per claim on the balance. Annual limits apply.