Doctors' Health extras cover · restricted fund
Is Doctors' Health Essential Extras worth it?
For one adult in NSW, it costs more than it pays back in all three of the ways of using extras worked through below. It is $99.11 a month before the rebate, $75.21 after.
Three ways of using it
Worked for one adult in NSW, under 65, on the 24.118% rebate, over a year, at typical prices: $200 for general dental, $300 for optical and $90 for physiotherapy.
One dental check-up a year
$702 behind
That costs $200 with no cover. On this policy you’d pay $902 in premiums and get $200 back.
Against the 219 policies from funds anyone can join that cover this, it would sit 130th. nib’s DentalPass does best, $693 better off over the year.
Two dental visits and new glasses
$202 behind
That costs $700 with no cover. On this policy you’d pay $902 in premiums and get $700 back.
Against the 189 policies from funds anyone can join that cover this, it would sit 47th. Latrobe’s Core Essential Extras does best, $252 better off over the year.
Two dental visits, new glasses and six physio sessions
$202 behind
That costs $1,240 with no cover. On this policy you’d pay $902 in premiums and get $700 back.
Against the 181 policies from funds anyone can join that cover this, it would sit 92nd. HCF’s Flex My Extras does best, $572 better off over the year.
Your year won’t look like any of those.
Put in what you actually use and the calculator sets this policy beside every other one, with the working.
What it pays
| Service | Benefit | Yearly limit | Wait |
|---|---|---|---|
| General Dental | 100% of the fee | $1,600shared with major dental, endodontic (root canal) and orthodontic | 2 months |
| Major Dental | $765 a visit | $1,600shared with general dental, endodontic (root canal) and orthodontic | 12 months |
| Endodontic (Root Canal) | $132 a visit | $1,600shared with general dental, major dental and orthodontic | 12 months |
| Orthodontic | 100% of the fee | $1,600shared with general dental, major dental and endodontic (root canal) | 12 months |
| Optical | 100% of the fee | $500 | 2 months |
| Non-PBS Medications | Covered, amount not published as a set figure | $300shared with vaccinations | 2 months |
| Physiotherapy | Covered, amount not published as a set figure | $900shared with podiatry, psychology, remedial massage, antenatal/postnatal, dietetics, exercise physiology, orthoptics, occupational therapy, orthotics and speech therapy | 2 months |
| Podiatry | Covered, amount not published as a set figure | $900shared with physiotherapy, psychology, remedial massage, antenatal/postnatal, dietetics, exercise physiology, orthoptics, occupational therapy, orthotics and speech therapy | 2 months |
| Psychology | Covered, amount not published as a set figure | $900shared with physiotherapy, podiatry, remedial massage, antenatal/postnatal, dietetics, exercise physiology, orthoptics, occupational therapy, orthotics and speech therapy | 2 months |
| Acupuncture | 75% of the fee | $200shared with health management | 2 months |
| Remedial Massage | Covered, amount not published as a set figure | $900shared with physiotherapy, podiatry, psychology, antenatal/postnatal, dietetics, exercise physiology, orthoptics, occupational therapy, orthotics and speech therapy | 2 months |
| Hearing Aids | $400 a visit | $800 | 24 months |
| Glucose Monitor | 75% of the fee | $250 | 12 months |
| Antenatal/Postnatal | Covered, amount not published as a set figure | $900shared with physiotherapy, podiatry, psychology, remedial massage, dietetics, exercise physiology, orthoptics, occupational therapy, orthotics and speech therapy | 2 months |
| Dietetics | Covered, amount not published as a set figure | $900shared with physiotherapy, podiatry, psychology, remedial massage, antenatal/postnatal, exercise physiology, orthoptics, occupational therapy, orthotics and speech therapy | 2 months |
| Exercise Physiology | $30 a visit | $900shared with physiotherapy, podiatry, psychology, remedial massage, antenatal/postnatal, dietetics, orthoptics, occupational therapy, orthotics and speech therapy | 2 months |
| Orthoptics | Covered, amount not published as a set figure | $900shared with physiotherapy, podiatry, psychology, remedial massage, antenatal/postnatal, dietetics, exercise physiology, occupational therapy, orthotics and speech therapy | 2 months |
| Health Management | 75% of the fee | $200shared with acupuncture | 2 months |
| Occupational Therapy | Covered, amount not published as a set figure | $900shared with physiotherapy, podiatry, psychology, remedial massage, antenatal/postnatal, dietetics, exercise physiology, orthoptics, orthotics and speech therapy | 2 months |
| Orthotics | Covered, amount not published as a set figure | $900shared with physiotherapy, podiatry, psychology, remedial massage, antenatal/postnatal, dietetics, exercise physiology, orthoptics, occupational therapy and speech therapy | 12 months |
| Speech Therapy | Covered, amount not published as a set figure | $900shared with physiotherapy, podiatry, psychology, remedial massage, antenatal/postnatal, dietetics, exercise physiology, orthoptics, occupational therapy and orthotics | 2 months |
| Vaccinations | 85% of the fee | $300shared with non-pbs medications | 2 months |
As listed for one adult in NSW. A percentage is of the provider’s fee; a dollar figure is the most paid per visit. Where a benefit differs by item, the commonest one is shown.
Conditions to know
This policy limits how often you can claim. Benefits may be reduced if you exceed the frequency cap.
Multiple services share a single annual limit pool.
What it costs
| State | Single | Couple |
|---|---|---|
| All states | $99.11 | $198.22 |
Listed premiums a month, before the rebate. The rebate takes 24.118% off for most households under 65.
What beats it
For two dental visits and new glasses, from funds anyone can join:
- 1Latrobe Core Essential Extras+$49 ahead
- 2Health Partners Flex Extras: Eyes+$47 ahead
- 3HCF Flex My Extras+$45 ahead
Worked from the Australian Government’s Private Health Open Listing, 01-Oct-2026, with the same sums as the calculator: listed premiums after the rebate, benefits capped by each policy’s limits and waiting periods. Product code I4/A0000S on privatehealth.gov.au. How the sums work.
This is general information, not personal financial advice. Confirm the premium and benefits with the fund before you buy or switch. Independent of every fund listed · No affiliate fees, no commissions.