What's the difference between Hospital & Extras cover?

ABC blocks

Extras cover (also called ancillary cover or general treatment) and Hospital cover can be taken out separately as Hospital only or Extras only cover. When they are taken out together, it is called Combo cover (short for Combination).

Did you know about Peoplecare’s combo discount? Get 10% discount off any Peoplecare Extras cover when combined with any Peoplecare Hospital cover. Sweet!

The similarities

  • Score a rebate

Members can score a rebate (depending on your income) from the government to reduce the cost of Extras and Hospital cover premiums. It’s called the Australian Government Rebate on Private Health Insurance. View the income thresholds here.

  • Serve your waiting periods

Nobody loves waiting. But all health funds have waiting periods to protect their whole membership from ‘hit and run’ claims from new members, people who might join a health fund to claim after the event and existing members who upgrade to a higher level of cover for services not on their previous cover. Sort of like trying to get car insurance after you’ve already had an accident. (We know you wouldn’t do that, but there are some people out there who do!)

Any waiting periods you have served or partly served when transferring from another a similar level of cover with Peoplecare or another health fund within 30 days will be recognised. When upgrading your cover, the full waiting period applies to new services. .

The differences

Here we go into more detail by taking a look at each cover separately.

Hospital cover

Hospital cover is more like traditional insurance – insuring yourself against very expensive yet irregular hospital surgery.

Advantages of Hospital cover

• Choose your doctor.  

• Access both public and private hospitals (some doctors don’t work in public hospitals, and vice versa). Learn more about the difference between using a public hospital versus private hospital here.

• Avoid long public elective surgery waiting lists by using private hospitals. For more details on how long you could wait as a public patient, read the statistics here.

• Pay less on tax if you’re a high-income earner. For details on the extra tax, called the Medicare Levy Surcharge, read here.

• No annual limits.

Expenses hospital cover can pay

Hospital accommodation (100% if the treatment is included on your cover)

• Theatre fees (100% if the treatment is included on your cover)

In-hospital medicine (100% if the treatment is included on your cover)

Doctor’s fees. Peoplecare pays a minimum of 25% on each Medicare Benefit Schedule fee if the treatment is included on your cover (we kick in more if your doctor uses our Access Gap scheme) and Medicare pays 75%.

The Peoplecare Hospital cover advantage

Hospital covers in Australia are now relatively standardised, with four categories: Basic, Bronze, Silver and Gold. However, there are some things that make Peoplecare’s hospital cover different.

1. Ambulance cover

One thing that Peoplecare includes as a bonus is 100% land, air and sea ambulance cover with no annual limits with every hospital cover.* A short trip in an ambulance can be eye-wateringly pricey. To view what you get, read here.

*State-recognised ambulance providers only.

2. Customer service

Peoplecare was rated as the top call centre of all the health funds surveyed as part of the IPSOS Healthcare and Insurance Australia 2017 Report.

It’s no surprise then that 96% of our members love us (Discovery Research 2019 Member Satisfaction Survey).

Extras cover

Advantages of Extras cover

Extras cover helps with things you generally don’t get for free from the public health system in Australia like:*

• dental

• optical

• physio

• chiro

• osteo

• acupuncture

• remedial massage

• hearing aids

• laser eye surgery

Extras cover is pretty popular because of core dental and optical benefits – which are relatively predictable and expensive necessities.

Extras cover differences

• Extras cover has no impact on whether you pay Medicare Levy Surcharge or not.  

• Extras benefits are usually subject to limits such as annual limits. Most services with Peoplecare have a financial year limit. 

• Extras benefits are usually paid on a percentage of the total cost.

• Unlike hospital cover, you won’t have to pay an excess to your health fund when you claim.

*There are some government programs, generally means-tested (subject to income and/or social background criteria), that can help pay for some Extras services. An example is the Child Dental Benefit Schedule. Another exception is treatment received under a Chronic Disease Management Plan. Peoplecare can’t provide benefits if you’re receiving a benefit through one of these government programs/plans.

The Peoplecare Extras cover advantage

1. Health management benefits

We pay benefits for diagnostic health screening services such as blood pressure testing, cholesterol checks, mammograms and hearing tests can be claimed if Medicare don’t pay a benefit.

2. Freedom to use your benefits where you want

You can take Peoplecare’s generous advertised benefits to any registered provider you’d like. Many health funds only pay generous benefits when you go to their brand-owned clinics. However, you can get great benefits at your favourite dentist, physio, optical store and more!