Member Insider: Understanding CBHS Extras cover

Extras cover is designed to help with everyday health services that Medicare doesn’t usually cover. Think dental check-ups, new glasses, a physio session after an injury, or even programs that support your overall wellbeing. With CBHS Extras, you can access a wide range of benefits that support your health beyond Hospital cover.

Making sense of Extras in everyday life

Choosing Extras can feel… extra. If you’re squinting at tables and percentages wondering, “But what will I actually get back?”, you’re not alone. Extras cover pays benefits towards everyday services like dental, optical and physio that Medicare usually doesn’t cover, but the amount you get back depends on your policy and the provider’s fee.

That means two people can have the same treatment on the same day and get slightly different benefits if their providers charge different amounts. That’s why you’ll sometimes hear the term “gap” — the bit you may pay if your provider charges more than your policy’s maximum for that item.

Before your appointment, ask for the item numbers and a quote so you can check your benefits.

“Is Extras even worth it for me?”

People often say having Extras cover makes sense if you regularly claim on things like dental check-ups, glasses or physio, and you’re clear on your limits and out-of-pocket costs. If you mostly want peace of mind for hospital treatment, that’s Hospital cover — Extras is designed for the day-to-day things Medicare doesn’t pay for. A quick self-check: list the services you’ll likely use this year, look up your policy’s limits for each, and compare to the typical fees from your providers.

What’s included in CBHS Extras?

At CBHS, we offer three levels of Extras cover, plus our packaged KickStart (Basic Plus) option.

KickStart (Basic Plus): A packaged cover that combines Hospital and Extras, with cover for the most popular services, like:

• Unlimited preventative dental
• General dental
• Optical
• Physio and chiro

Essential Extras: Affordable cover for the basics you use most often, including:

• Preventative dental
• General dental
• Optical
• Physio and chiro

Intermediate Extras: For day-to-day health management with wider benefits, like:

• Preventative and general dental
• Orthodontia and some major dental
• Optical, physio, chiro, and therapies

Top Extras: Comprehensive cover for a full range of Extras, including:

• Unlimited preventative and general dental
• High limits for major dental, optical, physio, chiro, and therapies
• Hearing aids and other health appliances

Wellness benefits

All CBHS Extras covers (and KickStart) include wellness benefits to help you take a proactive approach to your health.

You’ll be covered for a range of health checks (when Medicare doesn’t apply), such as:

• Breast examinations
• Bone density tests
• Skin cancer screening
• Bowel/prostate cancer screening
• Eye screenings

Plus, health management benefits that can be used towards:

• Quit smoking programs
• Weight management programs
• Stress management courses
• Gym memberships and personal training

Besides our wellness benefits, you can also find a whole lot of popular services (subject to your level of cover), like: 

• Remedial massage – to help you feel good and relieve stress
• Chiro – to manage pain
• Speech therapy - to help improve communication at any age 
• Clinical psychology – to support your mental health
• Health appliances like a blood pressure monitor or blood glucose monitor – to make it easier to manage existing conditions
• Travel & accommodation – particularly useful for our regional members

How does claiming work?

Most funds apply a waiting period for new members (or when you upgrade) before you can claim on Extras — and different services can have different waits.

Many benefits also have annual limits, and some (like orthodontics or hearing aids) can have lifetime or multi-year limits.

When you claim on Extras, CBHS pays benefits based on the maximum claimable amount or overall limit for that service.

• If your provider charges less than the CBHS maximum, you’ll get the full charged amount back
• If your provider charges more, you’ll receive up to the CBHS maximum.

So, what’s important to remember?

• Waiting periods may apply. Learn more about waiting periods.
• You’ll need to have enough overall limit remaining to claim a benefit.
• Some services also have lifetime or multi-year limits.

If you’re unsure, call us before starting a new course of treatment so you know exactly how your limits apply.

The CBHS Choice Network

Worried about choosing the “right” provider? You can usually see any recognised provider you wish, but CBHS have a preferred provider network for dental and optical that can reduce or remove the gap on common services — handy if you want more value from each claim.

With more than 9,000 dental and optical providers across Australia, the CBHS Choice Network helps you save. Many of our members pay less or nothing on:

• selected preventative dental services
• optical frames, lenses, and contact lenses

Find your nearest provider with our Choice Network search tool.

How to claim?

Claiming with CBHS is fast, simple and efficient – you can claim on the spot or online.

How to make a claim on the spot

If your service provider has HICAPS, iSOFT (also known as IBA) or CommBank Smart Health facilities, all you need to do is present your membership card and the benefit will be automatically deducted from the total service fee. If you’re visiting one of our Choice Network providers, you may not have any out-of-pocket expenses to pay.

How to make a claim online (Eclaim)

You can claim online by logging into your Member Centre account or your CBHS mobile app and following these easy steps:

1. Confirm your benefit payment details, so we know where to send the money
2. Enter the Provider Number and choose the Service Type
3. Enter your claim and review the benefit amount (for web claimable items)
4. Upload your receipts 
5. Submit your claim
   

Members who claim online typically receive their benefits within 1–2 business days. Once you have lodged your Eclaim, you will receive an email confirmation that your claim has been lodged. Once we've assessed your claim, we'll send you confirmation of your benefit.

Key things to know

• Recognised providers: CBHS pays benefits only when services are provided by recognised providers under Fund Rules and regulations
• Benefit period: Most benefits refresh each calendar year, but some services renew every 3–5 years or once per lifetime
• Waiting periods: May apply for new members or when you upgrade to higher cover.

If you’re unsure about anything, you can always give our Member Services team a call on 1300 654 123 or email help@cbhs.com.au to make sure all your questions are answered, and you can make an informed decision. 

All information contained in this article is intended for general information purposes only. The information provided should not be relied upon as medical advice and does not supersede or replace a consultation with a suitably qualified healthcare professional.

Sources:

https://www.cbhs.com.au/fund-rules

https://www.cbhs.com.au/mind-and-body/blog/make-sense-of-waiting-periods

https://www.cbhs.com.au/tools-and-support/find-a-provider

https://www.cbhs.com.au/health-insurance/extras-cover

https://www.cbhs.com.au/health-insurance/package-cover