Insurance brokers are being encouraged to remind health insurance policyholders that millions of Australians risk losing thousands of dollars in unused extras benefits when annual limits expire on Dec. 31.
Most health funds reset extras limits on Jan. 1, leaving an estimated 15 million Australians with extras or combined policies only a short window to use remaining allowances for services such as dental, optical, physiotherapy, and other ancillary treatments before they lapse, according to comparison site Money.com.au.
New research from Money.com.au indicates that a substantial proportion of policyholders are unclear on how much of their extras benefits they have left as the year-end deadline approaches. According to the survey, 40% of Australians with health insurance do not know whether they have any unused extras remaining on their policy. Another 31% report that they have used some extras but still have benefits available, while 15% say they have used none or very little of their annual limits. Only 14% indicate they have fully used their extras entitlements this year.
Extras policies typically apply a dollar cap per service category over a 12‑month period, such as general dental, optical, or physiotherapy. Once that annual limit resets, any unclaimed portion is forfeited. For example, a member with a $1,800 annual general dental limit who has claimed only $800 during the year will lose access to the remaining $1,000 when the policy period rolls over.
Money.com.au general manager of health insurance Chris Whitelaw said many members are not actively tracking these thresholds. “Australians are effectively walking away from thousands of dollars in value every year. Depending on your policy, extras limits can range from $200 to $1,800 for services like general dental. Many people don’t realise those benefits vanish overnight on December 31. It’s a classic ‘use it or lose it’ scenario,” he said.
With the reset approaching, Whitelaw said the period leading up to Dec. 31 is a key time for policyholders to review their usage and, where appropriate, bring forward routine care. “If you're due for a visit, use the next few weeks to book a dental clean, renew your glasses or lock in that one last physio appointment before your extras reset. Appointment books fill up quickly in December, so securing those final bookings now can make a big difference,” Whitelaw said.
Whitelaw highlighted insurer apps and online portals as primary tools for checking claims and remaining limits. “You can check your claims history through your insurer’s app or online member portal. If you’re still unsure, contact your fund directly, and they’ll be able to provide your full claims history for the calendar year. Ideally, you want to use as much of the extras benefits you pay for all year through your premiums. And if you consistently underuse your benefits, it may be worth switching to a policy with lower annual limits,” he said.
The year-end cycle has implications for how insurers, brokers, and advisers communicate with members about benefit usage, appointment availability, and whether current products match claiming patterns, particularly for those who regularly under-claim.
The Money.com.au survey also highlights generational differences in awareness and utilisation of extras, with older Australians more likely to be unsure of their balances and younger adults more likely to underuse their cover. The research finds that 45% of Baby Boomers with health insurance are unsure whether they have unused extras remaining. Similar uncertainty is reported by 41% of Generation X and 27% of Millennials. “What we see is that older generations tend to claim when something breaks or hurts, not to maximise their extras value. This means they’re less aware of their annual limits,” Whitelaw said.
However, Millennials are the most likely to have used none or very little of their extras this year, with 19% reporting minimal use, compared with 13% of Gen X and 11% of Baby Boomers. These patterns may inform how product and distribution teams structure benefits, reminder programs, and member education across different age cohorts.
These utilisation trends sit against a backdrop of relatively strong perceived value for health insurance compared with other personal lines. In a separate Money.com.au nationwide survey released in July 2025, respondents identified health insurance – particularly extras cover – as delivering comparatively strong perceived value for money against other retail insurance lines. Of those surveyed, 20% said extras policies provided the greatest savings, while 19% nominated hospital cover. In contrast, 10% selected car insurance or life/income protection as offering the most financial benefit. Travel insurance was cited by 7% of respondents, and 4% pointed to home and contents cover as delivering the highest savings.
Most major Australian health funds, including Medibank, Bupa, HCF, HBF, and NIB, operate extras on a calendar-year basis, with benefits expiring on Dec. 31 and renewing on Jan. 1. Some insurers, however, instead align extras with the financial year, resetting limits on July 1 after they expire on June 30. A smaller group of products resets benefits on the policy anniversary date, meaning renewal timing can differ between individual members.
While a minority of funds offer limited rollover features, these usually apply only to specific services, such as general dental or optical, and under defined conditions. For most policyholders, unused extras cannot be carried into the new year, so any entitlements not claimed before the reset are lost.
