A private health insurance policy is only as good as how you use it – particularly when it comes to extras. It’s an area where Aussies can leave hundreds or even thousands of dollars on the table each year.
You may have heard that shopping around can save you money, but the real secret is to make the most of your extras each year and claim back as much as possible.
I’ve worked in the industry for 14 years, so I’m going to share the questions you need to ask and give tips and tactics to help you claw back a large percentage of your premiums.
Let’s get started.
Why is it important to review your health insurance?
At Compare Club we talk to people every day who are on policies that no longer provide the right type of cover – or the best value – because their life journey has evolved.
Some examples:
- If your policy covers general dental for the family, but your children may need braces for teeth straightening.
- You took out a policy with high chiropractic rebates years ago but your back is much better and you no longer visit a chiropractor.
The point is, you want your extras to cover what you and your family need, and not the services you no longer use.
What are the ways to get the most back on your health insurance extras?
Most extras policies reset at the end of the year. A few, like ahm and Peoplecare, reset at the end of the financial year.
When the policy resets, any money you’ve not claimed – for services you’re paying for in your cover – is money you’ve left on the table. The more you claim back, the more you offset the cost of your premiums. It’s one way to extract the maximum possible value from your policy.
Dental is one of the easiest ways to get money back. And it means you’re maintaining healthy, strong teeth.
Many funds have what’s known as affiliated dentists or preferred dental providers. Some of these will give you 100 per cent back on cleans and check-ups for everyone on your policy.
The guideline set out by the Australian Dental Association (ADA) is to visit a dentist twice a year. If you’re using your fund’s preferred provider, you can get two free check-ups for the whole family. Now that’s great value.
Is an X-ray necessary?
If your dental extras include X-rays, it’s a good idea to have one done once a year or on every second visit. A good dentist will let you know when it’s time, or you can make a mental note that one will be due … or can be skipped on the next visit.
An X-ray allows dentists to see any changes in the teeth or gums and any cavities before they become a major problem. Catching tooth decay early can potentially save you money on future dental services such as root canal treatment and crowns.
Be aware: some dental extras will also cover fillings for kids and adults. Find out exactly what you’re covered for by taking a closer at your policy.
There could be no gap, or perhaps your health fund will pay a percentage, and there could be a limit to the number of fillings they’ll cover (in full or partial) each year.
The main point: being proactive with your dental health means you’ll have a pretty good idea of what you need in the future and can adjust your policy accordingly. And hopefully your teeth will be so healthy that you won’t need a more expensive policy with major dental on it.
How do I use health insurance extras to get money back on prescription glasses?
Around 12 million Australians have long-term eye conditions. That’s a lot of Aussies who might need prescription glasses or contact lenses.
Getting a pair of glasses can be costly, but there are a few ways to get around the expense.
First off: you don’t need extras for eye tests. They’re covered by Medicare. That said, your optometrist may recommend additional testing, such as an eye scan which costs extra. They should let you know if this isn’t covered by Medicare.
Where it gets expensive is in choosing the frames and having the lenses made up.
- Like dental, optometry also has preferred providers.
- Some optical extras policies have special deals typically known as purchasing two pairs of glasses for $199. This is also marketed as ‘buy one, get one free’.
Many funds offer a total of $200 on prescription glasses, so $199 would cover the frames and the lenses – two pairs in fact – with no gap to pay. That’s massive value.
Be aware: your optometrist may try to upsell you add-ons such as a special coating to filter out blue light from digital screens. These will cost a lot more, as will high-end designer frames. That’s really down to your choice and budget.
The other thing to keep in mind is these $199 deals are usually only for single vision glasses. If you need single and multi-focal glasses, you’ll need to pay the gap.
You could still take advantage of the offer and receive two single vision glasses, but the third pair for the multi-focal would be an out of pocket cost.
Is there a better way to save on new glasses?
Yes there is. As I mentioned before, your extras reset each year so there’s a hack for splitting the costs. Here’s how to do it.
Let’s say you have your heart set on a stunning pair of designer frames. You simply purchase the frames before the end of the year and then pay for the lenses in January.
Top tip: you could save a bundle if the frames you like are discounted during the post-Christmas sales.
By paying for it this way, you split the two costs across two different years and take advantage of the reset. This could be a great way to save hundreds of dollars if you know you only need new prescriptions once every couple of years or so.
Important note: check when your health fund extras reset. While many run for the calendar year, there are some that reset on 1 July each year. You can still apply the split cost rule in the middle of the year and take advantage of the EOFY sales.
How do I get money back on physiotherapy?
If you work on the tools, play sports or have kids that play sport, physiotherapy may also be an extra that should be on your policy. Injuries and accidents could mean ongoing physio appointments.
- Many funds will offer policies that have no gap on the first appointment – that means they’ll pay 100 per cent of the cost.
- Any follow up appointments will then be paid at the standard rebates that your policy offers.
- Depending on what your policy rebates are, it could be 50 per cent, 60 per cent or perhaps 70 per cent that your fund will pay.
Again, the main thing here is working out what you’ll claim on. You want to cut your out-of-pocket expenses to a minimum.
Consider these questions …
Do your kids play sports?
Does your job rely on you being physically fit?
What injuries have you had in the past?
Note: while it may cost you more in premiums, some extras may pay 100 per cent for each physio visit. Ultimately, you know your body best, so that’s your call. If you think you’ll use this, then it could be worth the cost. If you don’t but still want physio, you might want to look at a different level of cover.
Extras are one of the easiest parts of a health insurance policy to set and forget. But you’re paying for these benefits, so the more you use them, the more you save.
- Track your extras usage.
- Set yourself reminders to use up your dental appointments.
- Be smart with how you use your optical extras.
- Really interrogate whether or not you’ll use the items in your extras cover. This is something the experts at Compare Club can help guide you through.
Finally, always check the finer details so you know what you can claim, how much you can claim and when you should claim by. It’s the best way to get the most value out of your cover, year after year.
Are you getting the most out of your health cover extras? Are you aware of everything you’re covered for? Let us know in the comments section below.
Also read: Health experts warn of great GP divide
Disclaimer: Any health or financial advice is general in nature and does not take into consideration your circumstances. Always check with a financial or health professional before making any decisions.
Article first published on Expert Analysis.
