When Do Health Fund Extras Reset? A North Beach Dental Guide

If you have private health insurance with extras cover, you have probably asked yourself when do health fund extras reset. It is one of the most common questions we hear at North Beach Dental, especially towards the end of the year. The answer depends on your fund and your policy, but there are some general patterns worth knowing before you plan your next check-up.

In this post we will walk through the different types of extras resets, how to find out what you have left to claim, and why it is worth booking a visit before your limits disappear. We will also explain how this fits in with care at our North Beach practice, and how to check your own fund's rules.

What does a health fund extras reset actually mean?

Extras cover is the part of your health insurance that helps pay for things Medicare does not cover, such as dental check-ups, cleans, fillings and other general treatment. Most policies set an annual limit for each type of service.

Once you reach that limit, your fund will not pay any more benefit for that service until your limits reset. Unused amounts generally do not carry over to the next period, so if you have not used what you are entitled to, it is simply gone once the reset happens.

The three types of extras reset dates

Not every health fund resets at the same time. Broadly, there are three patterns used across the industry.

Calendar-year reset (1 January)

This is the most common type of reset. The annual maximum limits reset each year, and most funds use the calendar year, so the reset occurs on 1 January. This is the pattern that applies to HBF, where most extras annual limits reset on 1 January each year.

Financial-year reset (1 July)

A smaller number of funds base their extras year on the Australian financial year rather than the calendar year. Some funds use the financial year (1 July to 30 June) and a few reset on the date you joined.

Join-date or anniversary reset

A few funds use your own join date as the reset point, so your extras year runs from your anniversary date rather than a fixed date on the calendar. This means two people with the same fund can have completely different reset dates, depending on when they signed up.

HBF, HCF, nib and Medibank reset dates

If you are asking about an hbf extras reset date, an hcf extras reset, or an nib extras reset specifically, here is what is generally understood about these larger funds.

• HBF: Most services have annual limits which reset on the 1st of January every year.
• nib: Your nib Extras limits reset on 1 January each year.
• HCF and Medibank: these funds are generally understood to follow the same 1 January pattern as most of the larger insurers, though specific covers can vary.

These are general patterns only, and policies can change. The safest way to know your exact when do extras limits reset date is to check your policy documents or log into your fund's member portal. You can also call your fund directly and ask them to confirm your reset date and what you have left to claim.

How to check what extras you have left

Before you can plan a visit around your reset date, you need to know what is actually left on your policy. A few simple steps can help.

• Log into your health fund's app or online member portal to see your claims history for the year.
• Look at general dental and major dental separately, as they often have different limits.
• Call your fund if you are not sure how to read your statement, and ask them to talk you through your remaining balance.
• Ask our team for the item numbers for any treatment you are considering, so you can check them against your policy before you book.

At North Beach Dental, we are a preferred provider for HBF, Medibank, HCF and nib. Being a preferred provider usually means a smaller gap on eligible treatment, though it is not free and the amount still depends on your level of cover. If you hold a different fund, you can usually still claim, just check your own policy for the details.

Planning your visit before extras reset

Many of our patients like to book their scale and clean, or any outstanding treatment, in the months before their extras reset. This is simply good planning rather than anything urgent, and there is no need to rush into treatment you do not need.

Our usual recall advice is an exam and scale and clean about every six months, with bitewing X-rays (a type of dental X-ray that shows the areas between your teeth) about every two years. Your dentist will set the exact timing that suits you, based on your own teeth and gums.

If you do need treatment such as a filling, crown or other general dental work, our dentist will explain the treatment plan and its costs before anything starts, so there are no surprises. You are always welcome to ask for the item numbers so you can check them with your fund in advance.

If you are new to the practice, you can find out what to expect on your first visit on our new patients page. It is a helpful read if you are organising dental care for yourself or a parent for the first time in a while.

Why October, November and December get busy

Because most extras limits reset on 31 December, but you should always check your own fund's reset date, this time of year tends to be busy for dental appointments across Perth's northern beaches. People in North Beach, Carine, Marmion and Karrinyup often try to fit in a check-up or outstanding treatment before the year ends.

If you think you might want an appointment before your own reset date, it is worth getting in early rather than leaving it to the last week of December. You can choose a time online whenever suits you, rather than waiting on hold with the practice.

What about children's dental benefits?

If you have children, it is worth knowing that eligible children may also be covered under the Medicare Child Dental Benefits Schedule (CDBS), which is separate from private health extras. We do see children under this scheme at our practice. For current eligibility and limits, the Services Australia website has the up to date details, since the rules can change from year to year.

DVA (Department of Veterans' Affairs) card holders are also welcome at North Beach Dental. If this applies to you or a family member, DVA's own website has the current information on what is covered.

Frequently asked questions

Do all health funds reset extras on the same date?

No. Most major funds reset on 1 January each year, but some use the financial year starting 1 July, and a few reset on your own join date. Always check your specific policy to be sure.

What happens to extras I do not use before the reset?

In most cases, unused extras simply expire and do not carry over into the new period. This is why many people plan a dental visit shortly before their reset date if they have benefit left to use.

Can I still claim if my fund is not HBF, Medibank, HCF or nib?

Yes. We are a preferred provider for those four funds, which usually means a smaller gap for eligible treatment. If you hold a different fund, you can still claim, though your gap payment may be different, so it is worth checking with your fund.

How do I find my exact reset date?

The easiest way is to log into your health fund's app or member portal, or call your fund and ask them directly. Your policy documents will also usually state the reset date.

Is it worth booking a dental visit before my extras reset?

If you have benefit left that you have not used, and you are due for a check-up anyway, it can make sense to book before your reset date. There is no need to rush into any treatment you do not actually need.

If you would like help working out what your extras cover for a visit to North Beach Dental, our friendly team is happy to talk you through it. You can learn a little more about our practice on our about us page, reach out through our contact page with any questions, or go ahead and book an appointment online at a time that suits you. You can also call us directly on (08) 9447 1514. We are located at 17 Lawley St, North Beach, and we look forward to seeing you.