If you have extras health insurance, you’re running out of time to use your annual benefits before they expire!
Extra benefits for the majority of health insurance funds expire on December 31, 2022, and are reset on January 1, 2023. This means that any unused 2022 benefits such as dental or optical benefits will more than likely not roll over into the next year. If you don’t use them, they will be gone forever.
Billy Explores thought it best to help every day Aussies get an understanding of how these extras benefits work, as well as any annual benefits associated with current health insurance. Of course, when extras cover resets, it’s a great opportunity to remind yourself to compare health insurance and compare extras cover through Billy Explores. Also, keep in mind those pesky gap fees.
What Is An Annual Limit?
The highest amount you can reimburse your health insurance company for a particular supplementary treatment is known as an annual limit. Various levels of coverage and health funds have different annual limits.
Many extras cover health treatments, such as dental (general and major), orthodontics, optical, physiotherapy, chiropractic, osteopathy, podiatrist, speech pathology, massage, counselling, and health management programmes, generally have annual limits.
The annual maximum benefit for each type of service is often capped at a predetermined benefit per visit or service.
You have until the end of December to schedule an appointment and take advantage of your health benefits before they reset if you have been delaying using a service that is covered by your supplemental coverage, such as any last-minute dental work for the year.
Typical annual limits for extras are:
- $700 for general dental
- $250 for optical (glasses and contact lenses)
- $450 for physiotherapy
- $400 for chiropractic
- $375 for massage
The benefits for each treatment vary between policies, but median health insurance benefits per service are:
- $33 for general dental (examination)
- $200 for optical (single vision spectacles)
- $40 for physiotherapy
- $39 for chiropractic
- $30 for massage
(Note that these figures represent the median for the first visit for a service – benefits usually decrease with subsequent services.) It’s also a good idea to check out with your health fund regarding the actual benefit limit on your health insurance policy.
When do your extra benefits reset?
The annual maximum limits reset each year. Most funds use the calendar year, so this means the reset occurs on 1 January. Some funds use the financial year (1 July to 30 June) and a few reset on the date you joined. It’s important to note that annual benefit limits only apply to extras, as hospital cover doesn’t involve a limit on benefits.
It’s important that you check with your health fund if you are unsure of when your benefits reset, so you can know exactly what they call the new year.
Health funds that reset their extras benefits on 1 January:
- ACA Health Benefits Fund
- Australian Unity
- CBHS Corporate Health
- Doctors’ Health Fund
- Emergency Services Health
- Frank Health Insurance
- Health Partners
- Mildura Health Fund
- Nurses and Midwives Health
- Phoenix Health Fund
- Qantas Health Insurance
- rt health fund
- Teachers Health
- Transport Health
- Union Health
Health funds that reset their extras benefits on 1 July:
- ahm health insurance
- Defence Health
- onemedifund (OMF)
- Navy Health
- Peoplecare Health Insurance
Queensland Country Health Fund resets their extras benefits based on the membership year.
What Do Combined Limits And Sub-limits Mean?
There may also be combined limits and sub-limits for additional coverage. An additional restriction placed on your medical insurance claim by your health insurance company is known as a sub-limit. For instance, your policy might include a combined yearly limit of $500 for dentures, crowns, and bridges, with a sub-limit of $300 on each service within that overall limit. The total annual limit is reduced by this sub-limit. As a result, you could only make a total of $300 in claims for any of those services in a given year. If you made $300 in claims for bridges, however, you would still have $200 in claims left over for either one or both of the other services.
Your combined yearly limit is the total sum that can be claimed for a variety of services. The following services, for instance, might each be covered by your policy up to $300: physiotherapy, chiropractic care, and osteopathy. These services might then be merged into one category with a combined limit of $700.
How To Keep Your 2022 Extras Benefits
The time is now to take advantage of any extra services that still have benefits accessible to you as we approach the conclusion of 2022. get in touch with your health fund and see how much of your extras benefits remaining, then use what you can to ensure they don’t go!
Compare Extras Cover Through Billy Explores
Of course, it’s a perfect opportunity to compare private health insurance through Billy Explores when you’re reviewing your annual benefits and extras insurance. You might be able to get a better deal on your private health insurance and extras benefits! Compare health insurance now through Billy Explores.
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