Is Ancillary Cover Worth Having?

Saturday, May 05, 2012 at 10:06 am

You can’t compare health insurance without noticing the range of extras on offer. If you have not previously looked at your health insurance options, you may wonder whether these are worth having. Here is some information on what is likely to be covered and why you might need it.

What does hospital cover include?

As the name suggests, you are covered for in-hospital services. For out-of-hospital services, you can arrange additional extras cover. Extras cover is often combined with hospital cover. This may be a set package of extras, or you may be able to choose which extras you want. Having hospital cover alone will help to keep health care costs down. However, you may also want cover for many non-hospital services that you may need.

Why you might need ancillary cover?

Ancillary cover will help with out-of-hospital costs. Just a few of the options include dental, optical, podiatry and pharmacy. Many of these are not covered through Medicare. Here are a few examples of ancillary options for which Medicare only provides basic cover, or none at all.

  • Dental. Basic dental treatment is covered for teens through the Medicare Teen Dental Program. The chronically ill can get some dental care through the Chronic Disease Management Program. For the latter, the health condition must be likely to affect oral health.
  • Optical. Eye tests performed by optometrists are covered by Medicare. If you need glasses or contact lenses, these are not covered by Medicare.
  • Complementary therapies. These are not usually covered. For example, acupuncture is only covered if it forms part of a doctor’s consultation.
  • Physiotherapy/podiatry/chiropractic. None of these are covered by Medicare unless you qualify for the Chronic Disease Management program.
  • Ambulance services. These are not covered by Medicare. Queensland and Tasmania have free ambulance services, but in other states you may need ambulance cover.
  • Pharmacy. Many medicines are subsidised through the Pharmaceutical Benefits Scheme (PBS).  However, not all medicines are. This extra insurance covers non-PBS medicines.

Waiting periods

Many extras carry waiting periods that must be served before you can claim. How long you have to wait depends on the extra in question. Extras such as general dental, physiotherapy, palliative care and psychology carry two month waiting periods. Major dental cover has a longer wait time of twelve months. The lesser waiting periods may sometimes be waived by health funds as a sign up bonus.

Cover levels

Depending on your policy, you may not be covered for everything. For example, having dental cover does not mean that you are covered for all dental work. Having basic cover means that there will be limits. This makes it crucial to compare health funds to look at your options. Expect out-of-pocket expenses if you need treatment that is not covered by your policy.

Ancillary cover will provide benefits for out-of-hospital services. Exactly what you are covered for depends on your policy level. Basic cover is cheaper, but not very broad. Be sure to compare health insurance policies as not all are the same.