Why Pay for Health Insurance Extras for Remaining Months of The Year When Extra Limits Are All Used up?

welcomeUniverseWorld on 18/01/2025 - 09:55
Last edited 18/01/2025 - 10:49 by 2 other users

What if I take health insurance with some extras, use up all the limits for those extras, and then cancel the extras for the remainder of the year while keeping only the hospital cover?

In January, I could switch to a new health insurance provider with extras, especially since many advertisements promote waiving two- and six-month waiting periods. Why pay for extras for the rest of the year after using up the limits, when switching to another provider next year could potentially reset those limits and waive waiting periods saving costs?

What do you guys think?

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Comments

  • AustriaBargain on 18/01/2025 - 10:02
    +10

    Wouldn't that reset your waiting periods? Why would a new provider waive the limits if you've cancelled it for months.

    • welcomeUniverseWorld on 18/01/2025 - 10:06
      -4

      However, many have advert saying "2&6 Month Wait Periods Waived"… Does that not mean when I get the extra again, the wait periods for those are waved and it no longer matters whether I had it cancelled for months?

      • AustriaBargain on 18/01/2025 - 10:07

        Which offer/provider did you have in mind?

        • welcomeUniverseWorld on 18/01/2025 - 10:10
          -4

          None at the moment. I will soon be switching from Medibank to another provider. However, I have already used up most of the extras available under my current Medibank plan. With a few surgeries lined up, I expect all extras to be fully utilized soon.

          Why continue paying for extras for the rest of the year? Even if I don’t switch providers, could I not switch to hospital cover only for the remainder of the year and reconsider extras next year? The money saved by not paying for extras for the rest of the year could add up to a significant amount.

          • YesPleaseThankYou on 18/01/2025 - 10:57
            +1

            @welcomeUniverseWorld:

            With a few surgeries lined up, I expect all extras to be fully utilized soon.

            Surgeries come from your hospital cover, not general treatments (extras).

            The money saved by not paying for extras for the rest of the year could add up to a significant amount.

            Do the math and let us know.

          • YesPleaseThankYou on 18/01/2025 - 10:59
            +2

            @welcomeUniverseWorld: For someone who apparently has:

            a few surgeries lined up

            It seems to me that you should be making your life less, not more, complex.

      • freefall101 on 18/01/2025 - 14:40
        +3

        The 12 month waiting period ones are usually the most expensive ones, you'd lose those.

      • HeWhoKnows on 19/01/2025 - 20:33
        +1

        Need to check the conditions of the offer

  • HardQuiz on 18/01/2025 - 10:09

    @easternculture knows the answer.

  • BigBirdy on 18/01/2025 - 10:21
    -2

    Kind of makes sense. Also, instead of canceling, you could switch your extras to a different provider. I assume that’d give you a fresh line of extras credit to consume, if required, and means no issue with waiting periods.

    • darkkito on 18/01/2025 - 11:30
      +1

      i believe healthfunds actually talk to each other, so when you use say an optical benefit when your switching over they will actually carry that status of used over. This may not be all cases but i know it is for some.

      • YesPleaseThankYou on 18/01/2025 - 11:34

        Yes, they do talk to each other, they have an industry group where they gossip about annoying health fund members: https://privatehealthcareaustralia.org.au/

        The above aside, by law, health insurers are required to provide you with a Transfer Certificate. The Transfer Certificate includes summary information about your membership history and claims. This information will be used by your new fund.

        Regardless, switching to a new fund where those limits have been reset, will give you a new set of extras limits to use.

        • kirkleton on 21/01/2025 - 10:47

          I had thought they would carry over any used limits to stop people from double dipping? That's why people who switch, switch between insurers that reset on the financial year and calendar years. So they reset every 6 months essentially.

  • star-ggg on 18/01/2025 - 10:25

    The extras plan packages get progressively worse with time. Lower limits and/or less coverage. If you kept cutting and going on new plans over the last 10 years you would have a worse plan now than what you had 10 years ago.

    • YesPleaseThankYou on 18/01/2025 - 10:55

      The extras plan packages get progressively worse with time. Lower limits and/or less coverage. If you kept cutting and going on new plans over the last 10 years you would have a worse plan now than what you had 10 years ago.

      Citation needed for your claim— do you have one? Do you work for a health fund?

      I ask because the claim you are making is often used by health funds as a 'save' retention tactic.

      Moving to new plans (churning) would have saved much more than staying on those old plans.

      • star-ggg on 18/01/2025 - 11:55

        I don't work for a health fund but I've held extras cover for 5years+. I max out my claims every year and have researched churning like others on here. The new plan limits are like half of what I had on my 5 year old plan. It never made sense for me to churn or if I did the amount saved would be so small it's not worth the effort.

        • YesPleaseThankYou on 18/01/2025 - 12:01

          the amount saved would be so small it's not worth the effort.

          Churning through the 'pay 1 month get 6 weeks free' nets a premium saving of approximately 58%.

          There is just no way that the extras limits you would have maxed out have saved you more than you would have by churning.

          • star-ggg on 18/01/2025 - 13:09

            @YesPleaseThankYou: The limits for the services I claim for are literally half now and gap payments have increased.

            • YesPleaseThankYou on 18/01/2025 - 13:29

              @star-ggg: I haven't even factored in the resetting of limits that you would benefit from by switching to insurers with different extras reset dates (1 January, 1 July, Anniversary Date).

              I think you need to check your maths.

              • star-ggg on 18/01/2025 - 14:13

                @YesPleaseThankYou: Just checked. At my non-profit provider the current extras plan has $1000 COMBINED limit which covers nearly everything. My current plan has $800 limit for physio alone. So yeah compared to when I last checked over a year ago the plans are definitely getting worse.

                • YesPleaseThankYou on 18/01/2025 - 14:15

                  @star-ggg: I'm sorry, but what you have stated is hardly a proper analysis.

                  I'll reiterate, if you're staying with your current fund because of higher extras limits on your older policy, you are ripping yourself off.

                  Have a great day!

                  • star-ggg on 18/01/2025 - 14:22

                    @YesPleaseThankYou: Fair enough. I'm currently claiming $1000 more than the cost of the extra cover and I doubt I'm going to end up with rich profits from churning health insurance policies.

                    • YesPleaseThankYou on 18/01/2025 - 14:46

                      @star-ggg: Noted - yes, I also claim back in extras more than I pay for premiums in Hospital and Extras combined (well, that's mostly true, depending on what's going on).

                      I acknowledge that churning isn't for everyone and does take a bit of time. However, once you learn the rules of the system, it can reap savings and rewards.

                      If you churned following the promotional offers, in your case, you'd pay lower premiums (much less than by not churning) and you would have the added benefit of extras limit resets by moving to funds with different limit reset dates, allowing you to claim even more (if you needed to).

                      The above would certainly result in benefits, but perhaps not 'rich profits', I agree :)

  • boomramada on 18/01/2025 - 10:27
    +1

    then you got no ambulance cover for the reminder of the year.

    • original15 on 18/01/2025 - 10:31

      Might have separate ambulance cover eg ambulance vic $110 a yr for family

    • BigBirdy on 18/01/2025 - 10:46
      +2

      Depends which state you’re in. Here in Qld the state govt covers ambulance

      • boomramada on 18/01/2025 - 10:53

        True but your state govt doesn't cover when you travel elsewhere ie SA/TAS/WA/NT/NSW/ACT or myself travelling to QLD will it? :)

        • YesPleaseThankYou on 18/01/2025 - 10:55
          -2

          You could Google your answer in 2 seconds.

        • Brigadier667 on 18/01/2025 - 12:29
          +2

          The Qld government picks up the tab for Queensland residents (and their dependants) anywhere in Australia. Interstate (and overseas) visitors needing an ambulance in Qld are invoiced.

          Evidence is typically a Qld driver licence.

    • welcomeUniverseWorld on 18/01/2025 - 11:27

      hmm Did not think about that, I do need that

      • YesPleaseThankYou on 18/01/2025 - 16:11
        +1

        Ambulance will be included in Hospital Cover, check the Private Health Information Statement (PHIS) for your policy.

  • YesPleaseThankYou on 18/01/2025 - 10:52

    Alternatively, you could switch to a fund that resets limits on anniversary (on joining) and reset your limits immediately. There are a few that do this.

    Then, come 1 July, switch to a fund that resets limits at that time.

    • andylch on 19/01/2025 - 00:46

      Which fund can do this? You can PM me, thank you so much :)

      • YesPleaseThankYou on 19/01/2025 - 09:38
        -4

        Yes, I can PM you, but I won't

        There's no secret about the dates. Use Google.

  • Muppet Detector on 18/01/2025 - 21:00
    -1

    Any annual limits you use with one PHI, carry over to the second PHI.

    Only way to game the PHI system is to change insurer before April 1 and pay full years fees in advance. This way, you pay fees based on last years prices as opposed to the new ones that come into affect for the current year after April 1.

    • YesPleaseThankYou on 18/01/2025 - 21:10

      Any annual limits you use with one PHI, carry over to the second PHI.

      Correct, but funds reset them at different times:

      • 1 January
      • 1 July
      • Anniversary Date (Date of joining)

      Join a fund with a different reset date to yours and you can claim extras again.

      Only way to game the PHI system is to change insurer before April 1 and pay full years fees in advance. This way, you pay fees based on last years prices as opposed to the new ones that come into affect for the current year after April 1.

      Wrong. Anyone who pays their private health insurance 1 year in advance is a fool.

  • Cerdig on 21/01/2025 - 15:48
    -1

    I've concluded that extras aren't worth it. I see the hospital component as actual insurance, whereas extras are a package of things you purchase that will seldom pay you back their cost and rarely much more. I'm going to pay for hospital cover plus ambulance but put what I would've paid for extras into a bank account and use when needed.

    • welcomeUniverseWorld on 23/01/2025 - 08:16
      +1

      It may be true for you. However, it did help people like me for things like TMJ fixes, Dental, Physio, and glasses. I needed all of those this year along in last 23 days :). I am not certain whether to keep the extras once the limits are over

    • YesPleaseThankYou on 24/01/2025 - 19:44

      As I have pointed out in other posts, if you follow promotions like 'pay 1 month get 6 months free', which are usually available for combined policies (hospital and extras), it is cheaper than just taking out hospital-only for the same period.

      Based on the above, why wouldn't I take out extras? I'm getting a cheaper overall health insurance cost and then able to claim back for things like optical and dental.

  • Cerdig on 23/01/2025 - 20:58
    -1

    Estimate what extra's you will use in an average year and compare it to the cost of the extras cover. I'm with Bupa, who are shit on a pointy stick, but maybe your fund is better.

    • YesPleaseThankYou on 25/01/2025 - 09:25
      +1

      Estimate what extra's …

      Extra's what?

      • Cerdig on 25/01/2025 - 10:52
        -1

        What is your question?

  • eltito on 29/01/2025 - 10:50
    +2

    OP wrote: What if I take health insurance with some extras, use up all the limits for those extras, and then cancel the extras for the remainder of the year while keeping only the hospital cover?

    Nothing will happen as you are able to do this.

    OP wrote: In January, I could switch to a new health insurance provider with extras, especially since many advertisements promote waiving two- and six-month waiting periods. Why pay for extras for the rest of the year after using up the limits, when switching to another provider next year could potentially reset those limits and waive waiting periods saving costs?

    The 2/6 month waiver usually includes moving hospital over, so yes provided (1) you are happy to move hospital over to the new fund; (2) the offer of 2-6 months waiver is available; (3) limits reset calendar year - you'll be fine. The reason why (3) is important, is because when you move to the new fund, and they request your clearance certificate from your old fund, the old fund may send clearance certificate for both your hospital and extras, of which your new fund may just automatically apply.

    In terms of extras, from the top of my head - major dental; orthodontics are both 1 year waits - this is non-negotiable, you must have a compelling (and by that, previous cover basically) to have this waived. Pretty sure everything else, including health aids and appliances is either 2/6 month wait.

  • Muppet Detector on 29/01/2025 - 21:42

    UNLIMITED DENTAL COVER

    I'm with Bupa. I have been with them for as long as I can remember. I don't know if that has anything to do with what benefits I get.

    Anyway, I have top hospital cover with $0 excess or co payment. I also have the highest extras cover (might be called premium or platinum?)

    I have limits on some things, but I have unlimited dental care. I can go to the dentist as often as I want to and they do whatever it is they do (one kid just had all their wisdom teeth out which was surgery in the dentist office (regular dentist couldn't do it, wasn't simple extraction) for example, sometimes it might just be fillings or cleaning etc. We have unlimited dental allowance and the dentist only charges us whatever the health fund (and Medicare - is that applicable?) we never pay any extra money or excess or copayment. Direct out of pocket cost to all of us on this policy is $0 after dentist puts card into machine.

    It is a family policy (so covers both parents and all children under the age of 32 whether they live with me or not (some even live interstate). Once they are 32, I presume they have to get their own insurance.

    Every one who is on this policy are all listed on the card (like Medicare card) but we each have our own logins and accounts) so I can't see what my adult children have used their health insurance for or know their health details) and own cards.

    Pretty sure we have limits on glasses as sometimes I pay extra for mine depending on what frame and lense I choose) and I know I can only get one test and set per year.

    Obviously, some PHI extras have no limits, so don't max out part way through year.

    • YesPleaseThankYou on 30/01/2025 - 20:54
      +1

      I'm with Bupa. I have been with them for as long as I can remember.

      I'm sorry for your loss. But hey, at least they sent you your matte black platinum cards in a nice matte black box. WOW!

      but I have unlimited dental care

      I doubt that it is truly unlimited. I'd love to see the Private Health Information Statement ('PHIS') for your policy.

      Pretty sure we have limits on glasses

      Yes, I am sure you do. In exactly the same way you have limits on your dental, limits that you seem to be unaware of.

      If you had been churning, you would have saved much much more than by staying with Bupa for your 'free dental'.

  • bhunter101 on 15/02/2025 - 10:18
    Merged from Health Insurance Double Dipping

    Hi guys,

    I have GMHBA insurance at the moment.

    I need to renew. I’m just trying to understand how limit reset works. Can you explain me like I’m 10 year old?

    Most insurers limits rest on 1 Jan. ahm resets on 1 July.

    How do I take advantage of extras limit multiple times?

    Say for example limit was $1000 all up.

    So I use up those 1K before December with (other providers)
    then sign up to ahm on or after 1 Jan
    Use up 1K (as old insurers limits resets on 1 Jan)
    Then switch another provider after 1 July as ahm limit resets then?

    Edit: Also is there a wiki on this if it gets asked/discussed regularly?

    • MS Paint on 15/02/2025 - 10:20
      -1

      Use the forum search function. Been covered with monotonous regularity. FFS

      • bhunter101 on 15/02/2025 - 10:21
        -4

        Thanks for your input and helpful comment.

        • MS Paint on 15/02/2025 - 10:22
          +1

          Also, why start a new thread when you haven't bothered to reply to this one? FFS

            • MS Paint on 15/02/2025 - 10:26
              +1

              @bhunter101: I did contribute. Do you want me to use the search function for you and send you direct links to the previous threads?

              • bhunter101 on 15/02/2025 - 10:27
                -6

                @MS Paint: That response was for your comment forcing me to reply when I’m not ready. Not the first comment. FFS

    • Downvoter on 15/02/2025 - 10:36
      +8

      Ohhh dear ^

    • Emphasise on 15/02/2025 - 10:52
      +1

      https://www.finder.com.au/health-insurance/extras-cover/heal…

      My strat is churn for free weeks, but save up the ones that reset in July, then swap to those ones when it gets closer to the month.

      Claim glasses/dental etc while doing so. Bear in mind for waiting periods for some policies won't be 1:1

      • bhunter101 on 15/02/2025 - 10:54
        -5

        That is super helpful thank you.
        Do you have fixed anniversary dates structure you use each year for churning? I’d be keen to see estimated dates.

        • simplystu on 15/02/2025 - 11:05

          that will be provider dependent … not any fixed date.

          EG. my health provider … anniversary date == the date you signed up on … NOT 1 Jan or 1 July.

    • simplystu on 15/02/2025 - 10:56

      @bhunter101 … breath +++ breath

      sheesh.

    • Protractor on 15/02/2025 - 11:02
      +4

      10 YO eh? OK.
      Is mummy or daddy around? We have some grown up things to discuss.
      The cricket set is in the hall cupboard.Don't break any windows,love.

      • bhunter101 on 15/02/2025 - 11:03
        -7

        Here’s the trophy 🏆 for being the best teacher 👨‍🏫 🫃

        • simplystu on 15/02/2025 - 11:08

          @bhunter101 … you need more sleep.
          stop being such a tool - ESP to those that are trying to help you.

    • Miss B on 15/02/2025 - 11:08

      For calendar year:
      Limits for 1 Jan - 31 Dec 2025 will be used up with claims with a date of service in 2025.

      For financial year:
      Limits for 1 July '24 - 30 Jun' 25 will be used up with claims with a date of service between those dates.

      It doesn't matter if it's your current fund or from your transfer certificate from your previous fund/s.

      They don't really reset so much as you get a new limit for every year. You can still claim for dates of service within the previous year/s (if you were with that fund on that date) for a couple of years (not sure if some funds allow more or less time). Otherwise the limits will just sit there unused forever (there are some funds who roll over some limits).

      Your transfer certificate will show the types of service you have claimed and how much you have claimed, separated into the current and previous 6 month periods. So at the moment it would be 1 July - 31 Dec '24 and 1 Jan - 30 Jun' 25. If you moved to a financial year reset fund now they would take into account claims for both periods, if you moved to a calendar year reset fund now they would only take into account the 1 Jan - 30 Jun '25 claims.

    • Protractor on 15/02/2025 - 11:13
      +1

      Just remember one man's double dipping is every man's annual price hike spike.

      (If ever there was an industry that ramps up prices at the drop of a hat is this one.They don't need any persuading )

      • Jolakot on 15/02/2025 - 11:24

        If they don't need any persuading to raise prices, then why not take advantage if they will raise them regardless?

        • Protractor on 15/02/2025 - 11:27

          Cool!. Sounds like a plan. I'm sure capitalism won't get wind of it.

          • Jolakot on 15/02/2025 - 13:05

            @Protractor: Capitalism already charges the maximum amount that the market can bear. They are not a charity, they have a fiduciary responsibility to their shareholders to squeeze every cent from you.

      • jrvb42 on 16/02/2025 - 10:05

        Doesn't that logic also apply to churners?

        • Protractor on 16/02/2025 - 10:06

          Well are prices on the long term graph rising or falling?

      • tenpercent on 16/02/2025 - 12:31

        If double dipping was having a significant impact on insurer profitability and the source of health insurance inflation then they would just put a stop to it. But they don't, so it's not. The true source of health insurance inflation is the same as the true source of grocery price inflation - greed (me shareholder me want growth growth growth) and money printing (whether by the government and RBA or by commercial banks every time they issue a loan out of thin air thus inflating the money supply - more money chasing the same amount of stuff leads to higher prices for stuff).

    • askbargain on 15/02/2025 - 11:55
      +1

      isn't it rude to double dip?

      • Protractor on 16/02/2025 - 12:22
        +1

        only for the ethically inclined

    • djsweet on 15/02/2025 - 12:27

      Ask your mum or dad and stop talking to strangers on the internet.

    • simplystu on 15/02/2025 - 12:42

      Which GMHBA fund to be specific ?!?!? !!!

      As different levels of health cover within same provider.

    • YesPleaseThankYou on 16/02/2025 - 12:33

      This so-called 'double-dipping' is by design, by the insurers themselves.

      There's no moral quandary or illegality with this.

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