What Type of Health Cover Do I Need? Hospital, Extras, or Both?

If navigating health insurance feels overwhelming, know you're not alone. With so many options and policies available, understanding what type of cover you truly need can feel like a puzzle with too many pieces. This guide is here to simplify the decision-making process, whether you’re looking for hospital cover, extras cover, or full comprehensive protection.  

By the end of this blog, you’ll have a clearer understanding of health cover options, their benefits, and how to make the best choice tailored to your lifestyle and priorities.  

Note: This information is general in nature and does not consider your objectives, financial situation, or needs. Consider seeking independent advice before making a health insurance decision. 

Why Health Cover Matters  

The Australian healthcare system offers the best of both public and private options. The public health system, through Medicare, provides essential services accessible to all. However, private health insurance gives you the freedom to access treatments faster, choose your preferred doctor, and claim back on services Medicare doesn’t cover (e.g., dental or physiotherapy).  

Private health insurance also has financial benefits, such as avoiding the Medicare Levy Surcharge or reducing your Lifetime Health Cover (LHC) Loading premium increases by taking out a policy before the age of 31.  

But with so many plans and terms, which type of cover is best for you? To answer that, let’s explore the key differences between hospital cover, extras cover, and when it’s worth combining both.  

Comparing Hospital, Extras, and Combined Health Insurance  

What is Hospital Cover?  

Hospital cover ensures you can be treated as a private patient in a public or private hospital. It generally covers: 

• Accommodation in private hospital rooms  
• Surgery in a private hospital (with a doctor of your choice)  
• Theatre fees  
• Intensive care costs  
• Diagnostic services such as X-rays and pathology  

This type of cover may also provide faster access to elective surgeries and specialised treatments.  

Who Benefits Most from Hospital Cover?  

Hospital cover is ideal for those who: 

• Have specific health conditions or may require surgery  
• Prefer the choice of their doctor or the comfort of private rooms  
• Want to avoid long public system wait times for elective surgeries  
• Are keen to avoid the Medicare Levy Surcharge or LHC loading  

For example, if you’re considering starting a family or have an upcoming surgery planned, hospital cover becomes invaluable for cost and timely care.  

What is Extras Cover?  

Extras cover, also known as general treatment cover, allows you to claim benefits for everyday health services not included under Medicare. This can include: 

• Dental care (check-ups, fillings, and orthodontics)  
• Optical services (glasses and contact lenses)  
• Physiotherapy, chiropractic, and remedial massage  
• Podiatry  
• Hearing aids  

Who Benefits Most from Extras Cover?  

Extras cover is perfect for individuals or families who regularly use these services. For example: 

• People who need dental work or regular eye care  
• Active individuals who frequently visit physiotherapists or chiropractors  
• Families with kids prone to accidents or orthodontic needs  

For example, extras cover is a great investment if you see your dentist twice yearly or need glasses every few years.  

What is Combined Health Insurance?  

Combined health insurance offers both hospital and extras cover, giving you the best of both worlds in one package. This is a popular option for individuals and families who want comprehensive coverage without managing two separate policies.  

Combined policies also qualify for private health insurance rebates, helping reduce the premium cost. 

The Benefits of Each Type of Cover  

Hospital Cover Benefits at a Glance: 

• Access treatment sooner without waiting in public health queues  
• Choose your surgeon or medical provider  
• Secure the comfort of a private room in a hospital  

Extras Cover Benefits at a Glance: 

• Save on regular out-of-pocket costs for dental check-ups, glasses, or physio  
• Claim for alternative therapies like remedial massage and acupuncture  
• Keep health care costs manageable for everyday needs  

Benefits of Combined Cover: 

• Peace of mind knowing both major medical care (hospital) and routine health needs (extras) are covered  
• Potential financial savings when bundling both types of cover  

How to Choose the Ideal Cover for You  

When choosing between hospital, extras, or both, consider the following questions: 

• What are Your Health Needs?  

Are you expecting major treatments (e.g., surgery or maternity care), or is routine care like dental your priority? 

• What’s Your Budget?  

Combined policies are typically more expensive than single cover options. Carefully assess whether you’ll get value from both types of cover. 

• Do You Want to Avoid Extra Taxes?  

 If your income is above the threshold set by the ATO, taking out private hospital cover could help you avoid paying the Medicare Levy Surcharge. These income thresholds are reviewed annually, so it's important to check the latest limits on the ATO website. 

• What Services Do You Regularly Use?  

If you go to the dentist yearly or wear glasses, extras cover may save you money in the long term. 

• What Stage of Life Are You At?  

Young, healthy individuals often opt for basic hospital cover. Families often prefer combined coverage. Retirees may prioritise extras for services like physio.  

Common Scenarios to Consider  

• Scenario 1: You’re young, healthy, and rarely go to the doctor.  

Recommendation: Basic hospital cover to avoid tax penalties. Extras cover can be considered later if your health needs change.  

• Scenario 2: You’re planning a family.  

Recommendation: Hospital cover with obstetrics and maternity features to minimise costs of childbirth and hospital stays. Consider extras for dental and physio, which can help during pregnancy.  

• Scenario 3: You’re an active individual who regularly sees a physio or chiropractor.  

Recommendation: Extras cover to save on frequent out-of-pocket costs.  

Empowering Yourself with a Health Plans Comparison  

Once you’ve identified your needs, it’s time to compare and select. With dozens of insurers and plans on the market, finding the ideal policy can be tricky.  

A health cover comparison platform like Econnex can streamline the process by allowing you to compare insurances side by side for benefits, pricing, and inclusions.  

Key features to look for: 

• Are there annual limits on extras like dental or optical?  
• For hospital cover, what is the waiting period for certain services?  
• Does the plan include benefits like mental health support or telehealth consultations?  

Why Compare Private health Insurance with Econnex  

Econnex makes comparing health cover easy by: 

• Providing private health insurance comparisons in minutes  
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• Helping you compare policies that align with your needs 
• May help identify lower-cost options depending on your circumstances 

Explore options today and make a confident decision about your health coverage.  

Choose Smarter Cover Today  

Health insurance doesn’t need to be complicated. By understanding the differences between hospital, extras, and combined policies, you can choose a plan that supports your health, lifestyle, and financial goals.  

Take the hassle out of decision-making by using comparison tools to explore options and make an informed choice about your health insurance.