What is flexible extras cover?

By Dan Hatch

7 minutes

20 August 2020

girl stretching on a yoga mat

A lot of health funds say they offer flexible extras cover. That sounds good, right?

Extras cover is the part of health insurance that covers non-hospital treatment. Dental, optical, physio, natural therapies and a range of other health services can be included.

Getting covered for these everyday medical services is great and all – but it can be hard to predict which ones you’ll actually need, and how much you’ll use them.

This is where flexible extras cover comes in. It sounds good, right? But what does “flexible” really mean?

What does flexible extras cover mean?

Different health funds might give you different answers on this one. But at HBF, we’ve got a pretty good example for you.

It’s called Flex 60 extras cover.

With Flex 60, it’s a simple concept: You get at least 60% back every time you claim on a covered service. This applies across all providers recognised by HBF. That means you’ve got the flexibility to choose from a huge range of providers, and you don’t have to hunt for a ‘preferred’ provider in order to get that 60% back.

One of the key features is the combined limit of $1,000 that applies across a whole group of services and can be claimed however you like.

This combined annual limit adds heaps of flexibility. Need to claim $1,000 on remedial massage? You could use the entire $1,000 on that. Get unlucky and sprain your ankle three times in a year? You could put all $1,000 towards physio treatments.

There’s more beyond the $1,000 combined limit, too. Here’s a quick snapshot:

screenshot of Flex 60

You can view the Flex 60 Extras page for more details.

How does flexible extras cover work?

So how does all this “flexibility” work? And how could it come in handy?

Well, let’s use an example. Imagine a family that needs extras cover. Flexible extras cover could come in handy for Mum, dad and kids.

Meet our imaginary family, the Webbers.

Webber family taking a selfie

Dad Mike works in a warehouse for a logistics company. Mum Narelle runs her own business, chases after two kids, and plays social netball on Tuesday nights.

Their kids are BMX-mad 8-year-old Jack and 11-year-old future YouTube star Sophie.

They’re all covered under a Flex 60 family plan, which means they each get their own separate $1,000 annual limit – and they can all use it differently. This is just as well, because they’re all about to have very different years.

The Webbers year of Extras claims

Disclaimer

The Webber family is fictional and this scenario is hypothetical. The Webbers’ claiming activity and treatment choices are for demonstration purposes only and should not be taken as a recommendation of treatment or an indication of service fees.

Here’s what Mum claimed

Narelle’s Tuesday night netball game ended in disaster when she landed awkwardly on her knee. She was on the bench for a few weeks, and needed physiotherapy.

Physiotherapy visits: $780

Flex 60: Thanks to the $1000 combined limit, Narelle knows she will be covered. She will receive $468 – or 60% – back from HBF.

Here’s what Dad claimed

Lifting boxes in the warehouse all day sometimes leaves Mike with a sore back. After grumbling about it for months he’s finally decided to visit the doctor.

Mike’s GP recommends several visits to a chiropractor. Mike thinks a remedial massage couldn’t hurt, either.

Chiropractor visits: $550
Remedial Massage: $220
Total: $770

Flex 60: Unlike Mike’s back, his Extras cover is flexible. That means he can claim the cost of both his chiro and remedial massage under the Flex 60 $1,000 combined annual limit. He’ll receive the full 60% back for both – that’s $462 back from HBF.

Here’s what Sophie claimed

Sophie’s decided to start a YouTube channel about long-distance running. She logs (and vlogs) about 40 kilometres before developing shin splints. Narelle decides to take her to an osteopath to see if they can help.

Osteopathy fees: $400
Great content for YouTube: Priceless

Flex 60: Under Flex 60 both services are covered up to a combined $1,000 limit. She’ll receive $240 back.

Here’s what Jack claimed

Jack is a rough-and-tumble kid and, unfortunately, he keeps taking tumbles. On summer holiday he was doing jumps on his BMX and stacked it. He broke a tooth, and smashed his glasses. A few months later he managed to do it again, this time rolling an ankle. During a hospital visit for the ankle, a doctor recommended Jack sees a physio.

Major dental fees : $650
Physiotherapy visits: $300
New glasses: $200
Cost to 8-year-old pride: Beyond measure
Total: $1150

Flex 60: Major Dental and physio are covered under the $1,000 combined annual limit, so poor Jack can claim the full 60% - or $570 back for his troubles. The good news is, Optical has a separate limit of $220 – and he gets 100% back! This means Jack’s $200 glasses are fully covered with no out-of-pocket. Hopefully the new glasses will last him at least until next calendar year, when the annual limit resets.

The benefits of flexible extras cover

The Webbers paid $3,100 for various treatment and received $1,940 back from HBF.

The flexibility of Flex 60 meant they were covered for everything they needed treatment for throughout the year. Even though their year threw some curveballs, they had peace of mind knowing they were covered.

If you’re looking for extras cover that flexes with your needs, take a look at our Flex 60 option.

Get 60% or more back on Extras

Enjoy great benefits from any HBF approved provider with Flex 60 Extras.

Learn more

Disclaimer

This article contains general information only and does not take into account the health, personal situation or needs of any person. In conjunction with your GP or treating health care professional, please consider whether the information is suitable for you and your personal circumstances.

Across all HBF products and services, benefits are payable up to applicable annual limits and only for services and programs approved by HBF and delivered by providers that are approved by HBF.

Waiting periods may apply before benefits are payable.

1) HBF will cover the cost for urgent ambulance transport by road only for circumstances classified as emergency or urgent. HBF does not cover air ambulance.

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