Choosing private health insurance can feel complicated, especially when you're deciding between Hospital Cover and Extras Cover. Simply put, the difference between the two is:

• Hospital Cover can help with the cost of treatment when you're admitted to hospital as a private patient.
• Extras Cover helps with the cost of healthcare services not typically covered by Medicare, such as dental, optical and physiotherapy.

You can purchase these covers separately or combine them into one policy, depending on your health needs and budget.

If you're comparing your options, explore AAMI's Hospital Cover and Extras Cover products to see which level of cover may suit your circumstances.

What is Hospital Cover?

Hospital Cover can help eligible members meet the cost of treatment as a private patient in hospital.

The services covered depend on the level of Hospital Cover you choose and the treatments included under your policy.

What can Hospital Cover help pay for?

Depending on your policy, Hospital Cover may help pay for:

• hospital accommodation
• theatre fees
• Medicare-recognised inpatient treatment
• medical services provided during a hospital admission, and
• medication related to your inpatient treatment.

The treatments available to you will depend on the services included in your chosen level of cover.

Benefits of Hospital Cover

People often choose Hospital Cover because it can provide:

• an alternative to public hospital waiting lists
• the ability to choose your treating specialist, where available
• access to private hospital accommodation, where included
• potential savings on the Medicare levy surcharge for eligible members, and
• protection against Lifetime health cover loading if Hospital Cover is taken out before 1 July following your 31st birthday.

What is Extras Cover?

Extras Cover helps with the cost of many healthcare services received outside hospital.

These are healthcare services that aren't typically covered by Medicare and are often used as part of everyday health and wellbeing.

What can Extras Cover help pay for?

Depending on your level of cover, Extras Cover may help with the cost of:

• preventative dental
• general dental
• physiotherapy
• gym memberships
• optical
• chiropractic treatment
• osteopathy
• remedial massage
• psychology
• podiatry, and
• other eligible allied health services.

Included services vary between products and annual limits may apply.

Benefits of Extras Cover

Many people choose Extras Cover because they regularly use healthcare services, such as:

• dental check-ups and cleans
• prescription glasses and contact lenses
• physiotherapy treatment
• chiropractic or osteopathy appointments, or
• ongoing allied health treatments.

Can you have Hospital Cover without Extras Cover?

Yes. Hospital Cover and Extras Cover can be purchased separately, depending on your health needs and budget.

Hospital-only Cover may suit people who:

• want cover for treatment in hospital
• are focused on managing the cost of major medical events
• want access to the benefits associated with private hospital cover
• are looking to avoid the Medicare levy surcharge, if eligible, or
• want to consider Lifetime health cover implications.

Many Australians choose Hospital Cover because they want help managing the costs associated with hospital treatment.

Can you have Extras Cover without Hospital Cover?

Yes. Some people choose Extras-only Cover because they're mainly interested in help with everyday healthcare costs.

Extras-only Cover may suit people who:

• visit the dentist regularly
• wear prescription glasses or contact lenses
• use physiotherapy services
• access chiropractic or osteopathy treatment, or
• want benefits for ongoing allied health services.

For some people, the value comes from claiming on services they use throughout the year rather than hospital-related treatment.

Do you need both Hospital and Extras Cover?

There's no one-size-fits-all answer. The right option will depend on your healthcare needs, lifestyle and budget.

Hospital and Extras Cover may suit you if:

• You want cover for hospital admissions and everyday healthcare services.
• You regularly use dental, optical or allied health services.
• You want a broader range of private health insurance cover.

Still unsure which option may suit your needs? Compare AAMI's Hospital Cover and Extras Cover options side by side to understand what benefits are available with each level of cover.

Waiting periods and claim limits explained

Before taking out private health insurance, it's important to understand how waiting periods and claiming limits work.

Waiting periods

A waiting period is the amount of time you’ll need to wait before claiming benefits after taking out or upgrading your cover.

Both Hospital Cover and Extras Cover may include waiting periods. The length of the waiting period can vary depending on the service, treatment and your circumstances.

If you're switching health funds and maintaining the same level of cover, you generally won't need to re-serve waiting periods you've already completed on equivalent cover.

Annual limits

Most Extras Cover products include annual claiming limits.

An annual limit is the maximum amount you can claim for a service or group of services during a benefit year. Limits vary depending on your level of cover and the treatment you're claiming for.

Checking your policy documents before claiming can help you understand how much you're entitled to claim for eligible services.

Hospital vs Extras: What’s the diagnosis?

Hospital Cover and Extras Cover are designed for different healthcare needs.

Hospital Cover helps eligible members meet the cost of treatment when they're admitted to hospital, while Extras Cover helps with a range of everyday healthcare services outside hospital.

Some people choose one type of cover, while others combine both for a broader range of covered services. The right choice will depend on your health needs, how often you use healthcare services and the level of cover you're looking for.

Learn more about AAMI Health Insurance