What’s the difference between hospital and extras cover?


Private Health Insurance comes in two flavours: Hospital and Extras. These can be bought separately or combined to provide more comprehensive cover. If you’re looking at getting Health Insurance for the first time, it’s important to understand the differences between the two so that you can make the right choices based on your needs. Here we explain in simple layman’s terms what each type of cover means for you.

Hospital Cover helps meet the cost of private treatment in a hospital

It covers hospital costs such as accommodation, theatre fees, and Medicare recognised in-hospital procedures. What you’re covered for will depend on your level of cover. By buying Hospital Cover, you may also avoid the Medicare Levy Surcharge, Lifetime Health Cover loading (LHC), and bypass public hospital waiting lists.

Things to note:

  • You may be required to pay an excess when you go to hospital. This will be a set amount (e.g. up to $500) and varies depending on your level of cover. With AAMI Hospital Cover, you’ll only be required to pay one excess per calendar year, regardless of how many admissions you need.
  • Most levels of Hospital Cover have waiting periods. This is the period of time that you have to wait before you can claim on services. For example, procedures relating to pre-existing conditions usually have a waiting period of 12-months. But, if you’re switching from another private health insurer to an AAMI Health Insurance cover, you won’t need to re-serve waiting periods already served on equivalent services.

Extras Cover is for services that are conducted outside hospital

Extras services include those not covered by Medicare, such as physio, optical, and dental. These everyday extras can help you stay healthy and help to bring down the cost of your regular check-up at the dentist, or a new pair of prescription glasses.

Things to note:

  • Most Extras Covers have annual claim limits – this means you can only claim up to that amount per calendar year. These limits vary depending on your insurer and your level of cover. For example, with AAMI Premium Active Extras there’s a $500 limit on physio.
  • Extras Cover also often has waiting periods.
  • Depending on the provider and level of Extras Cover you choose, you will get a percentage of your claim back. For example, with AAMI Starter and Everyday Extras policies you get 60% back, while you can get 70% back with Premium Active Extras.

Having Hospital and Extras Cover offers cover for when you might need it. Whether that’s for a regular check-up at the dentist or an unexpected trip to the hospital. Use our Health Insurance comparison guide to see which AAMI Health Insurance cover suits your lifestyle and budget.

If you still have questions or would like more info, give us a buzz on 13 22 44 (MON to FRI – 8.00am - 8:00pm AEST/AEDT, SAT – 9:00am – 1:00pm AEST/AEDT).

AAMI Health Insurance is issued by nib health funds limited ABN 83 000 124 381 (nib), a registered private health insurer, and is marketed by Platform CoVentures Pty Ltd ABN 82 626 829 623 (PC), a Suncorp Group company. PC is an authorised agent of nib and receives commission from nib. Information provided is general advice only and has been prepared without taking into account any person’s particular objectives, financial situation or needs. Read the relevant Product Disclosure Statement or Policy Document available at www.aami.com.au and consider whether it’s appropriate for you before making any decisions about whether to buy or continue to hold a product. Information current as of 9 July 2015.