Extras Cover
Physio, dental, optical, chiro or massage. Extras cover is here to help you for the life you choose and the one you don't.
What is extras cover?
Extras health insurance cover helps cover some of the cost of certain things that are generally not covered by Medicare. This includes physio, optical, dental, chiro and more. It's best to think about extras as a way that you can make common health treatments more affordable.
Whatever your budget or lifestyle, there’s an extras cover to suit you. View covers
What about hospital cover or combined covers? Learn more about what private health insurance covers.
Smart, like SmartCare Extras
With SmartCare Extras you can choose how you'd like to spend your Smart Limit on a range of included services each year. Choose from one flexible annual limit of $500, $1,000 or $1,500 and when combined with eligible hospital cover^, get a separate optical limit* and annual limit rollover!
^SmartCare Extras can only be paired with GMHBA hospital covers that are open for sale.
*Optical has a separate standalone annual limit on SmartCare Extras (when combined with eligible hospital cover) and is not included in the annual limit rollover.
Member Benefits
If you hold GMHBA extras cover with optical, you'll unlock additional member discounts and benefits at GMHBA Eye Care and more.
We have partnered with smile.com.au to make dental care more affordable and accessible for our members across Australia.
Understanding extras cover
Extras cover is health insurance that covers you for non-hospital services and treatments that aren’t generally covered by Medicare. You can purchase extras cover as a standalone extras-only policy, or as part of a combined hospital and extras package.
With health insurance extras cover, depending on the level of your cover and inclusions on the policy, you can save money on common things like optical, dental, physio, chiro and even remedial massage and acupuncture.
You can choose which level of extras cover suits you best and whether you would prefer to get your benefit as either a set amount or a percentage amount back for each visit, up to your annual benefit limits.
GMHBA has a range of extras covers to suit the varying budgets, lifestyles and health needs of our members, from the more traditional ClassicCare Extras to SmartCare Extras.
Benefit limits
A benefit limit is the maximum amount of money GMHBA will pay towards a service during a specific period of time (usually per calendar year). If you have already claimed up to your extras benefit limit, any additional services won’t be covered by GMHBA until your limits reset or rollover* on 1 January.
It’s important to check the various benefit limits on your policy to make sure you’ve got the right level of coverage. You can find this information in your fact sheet. If you think you might exceed your benefit limit, that could be a sign that you need a higher level of extras cover.
*Rollover excludes optical. Available after 12 months of continuous cover on SmartCare Boost Extras at the same level (Starter, Everyday or Complete). Unused eligible annual limits roll over on 1 January and expire after 12 months. SmartCare Boost Extras available when combined with eligible hospital covers only. Waiting periods may apply.
Why choose GMHBA
For over 90 years now, we believe health insurance should be run to benefit members, not shareholders.
If you're a new member and change your mind, we will refund any premiums paid as long as you haven’t made a claim.
Committed to supporting local communities, we embrace opportunities to connect in positive and meaningful ways.
How does extras cover work in Australia?
While Medicare contributes towards things like GP visits, care plans and the public hospital system, extras cover in Australia is all about giving you more choice. It helps you get covered for a broader range of services that Medicare doesn’t typically cover, like physio or dental.
When you're picking an extras plan with us at GMHBA, you'll want to think about how you prefer to get money back on your claims – through set benefits or percentage back benefits. This choice usually shapes how much you'll pay out-of-pocket.
- With GMHBA's SmartCare Extras, you'll get 60% back on popular services and 100% back on preventative dental at any dentist, up to your annual limit or sub-limit.
- With our ClassicCare Mid Extras, you'll have a choice of either 65% back across all services or set benefits, with each service having its own unique limits.
- Set benefits means you get a specific amount back for each claim, up to your annual limit.
To make a successful extras claim, the health provider you choose must be registered in their field, in private practise and recognised by GMHBA (annual limits and waiting periods apply).
How do I claim?
With most providers, you’ll be able to claim at the time of the appointment by swiping your member card, so that GMHBA can pay the benefit directly to the provider and you just pay the difference. If your provider does not accept electronic claims at the point of service, then you will be required to pay the bill in full and then submit a claim directly to GMHBA to receive the benefit you're eligible for.
Keep in mind different extras products have different limits and waiting periods, and different services have different claiming criteria. Our Important Information Guide offers a comprehensive guide on how to claim with us, and your Fact Sheet or Private Health Insurance Statement (PHIS) gives you the specifics of your chosen cover. But we're also here to help answer any questions you may have around extras and claiming.
The claims process
There are a number of ways to claim your extras benefits:
On the spot: Most claims can be processed when you have your appointment. Just swipe your GMHBA membership card and we’ll pay the provider directly. You’ll just need to pay the difference. Note: some providers may not have this facility.
Online: You can either claim via our mobile app or the member area. With the app it’s simple, login to the app, head to “Make a claim”, take a photo of your receipt and press submit.
In a branch: You can always drop by a GMHBA branch to make a claim in person. Check out our branch locations here.
You can visit and claim on any provider who’s registered with the appropriate board for their field, and practicing in a private practice. You just have to be covered for the relevant service at the time you receive it.
Whether you’re young and single, a family or recently retired, extras cover is a great way to reduce the costs of maintaining your health by reducing out-of-pocket costs on routine treatments, like getting a dental check-up or seeing a physiotherapist.
Finding the right extras cover
Like most insurance, the trick is to pick the policy that has the bundle of services most suited to your needs. That way you’re not paying any unnecessary premiums. Here’s a few tips for finding the most suitable extras cover.
Services included: Make sure you review the services covered in your policy and consider which services you may need in the future.
Benefit limits: If you need additional, ongoing treatment in a particular area, such as physiotherapy, check the benefit limits to make sure you’re maximising your coverage. You don’t want to be caught short or reach your claim limit too soon.
Waiting periods: Extras covers have waiting periods, and these waiting periods will differ based on the type of treatment and when you took out cover. We’ve outlined these wait periods in more detail here.
More from your extras cover
To get the most out of your extras cover, it's smart to consider a few things: the cost of your policy, how often you expect to use the various services, the benefit and service limits (which contribute to your annual limits), and any relevant waiting periods.
With GMHBA extras, provided they are included on your cover, you can claim on popular services like physio, chiro, optical, dental, remedial massage, psychology and more. Most GMHBA benefit limits reset every year on 1 January. It's a great idea to use as much of your limits as you can before this reset to ensure you're getting the best value from your cover.
However, for those with SmartCare Boost Extras, we offer an annual limit rollover. This means you can carry over any unused annual limits (sorry, not on optical) into the next calendar year when you have served a full 12 months on your chosen cover, giving you even more flexibility.
Extras health insurance is not tax deductible and won’t exclude you from the Medicare Levy Surcharge (if you are a high-income earner); you must hold either hospital cover or combined hospital and extras cover to exempt you from paying MLS (if applicable to you).
If you have extras cover – even without hospital cover – you’re able to claim the Australian Government Rebate on private health insurance as either a premium reduction, or as a lump sum in your annual tax return. Keep in mind, your eligibility for the rebate is still determined by your age and income – you don’t automatically receive a rebate simply by having extras cover.
At GMHBA, we’re committed to providing flexible extras cover for all Australians, regardless of budget or circumstance. To find out which extras policy is right for you, give one of our friendly team members a call or view our covers online.
Frequently asked questions about extras cover
Extras cover is a type of private health insurance. It pays benefits towards health services you might use like dental, physio, optical and massage. Provided you’re covered for the relevant service, haven’t used all of your benefit limits and have served any relevant waiting periods at the time you receive the service, with private extras insurance, you’ll pay less out-of-pocket every time you use these services (up to your benefit limits).
When selecting extras cover, we offer a range of options designed to align with your budget and health requirements.
Our SmartCare Extras range provides flexibility, allowing you to choose a flexible limit that suits your needs while bundling popular services. With this range, you receive 60% back on main services and 100% back on preventative dental at any dental provider. This range extends from SmartCare Starter Extras, Everyday Extras and the more comprehensive SmartCare Complete Extras.
Alternatively, if you prefer a more traditional structure, our ClassicCare Extras is available, offering either set benefits or 65% back across services.
When you use a registered health service that’s covered by your policy, GMHBA will pay a benefit towards your treatment. You can usually claim this at the time of the appointment electronically, meaning you’ll just pay the difference – the “out-of-pocket” – to the provider. Or, if you pay the provider in full, the benefit can be paid straight into your nominated bank account when you submit your claim to GMHBA using the mobile app or your member area. View more information on how to make a claim.
That all depends on your lifestyle, health needs, and your budget. If you find yourself using common health services, like dental, physio and optical regularly it might make sense to take out extras cover to help make the treatment more affordable.
Of course. You can buy an extras-only cover and forgo hospital cover or vice versa. It’s entirely up to you and your personal circumstances. Extras-only policies are generally much cheaper, although keep in mind you won’t be covered for any hospital related treatment, and it won’t help to avoid the Medicare Levy Surcharge if you’re a high-income earner.
No, extras cover is not considered a deductible expense. However, by taking out extras cover, and depending on your annual income, you may be eligible to receive the Australian Government Rebate on private health insurance, as a premium reduction or a lump sum when you lodge your annual tax return.
Extras cover, by itself, will not exempt you from the Medicare Levy Surcharge if you are a high income earner. For that you’ll either need hospital cover, or combined hospital and extras cover. You can learn more about the Medicare Levy Surcharge over here.