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When Do My Extras Cover Benefits Reset? Complete 2024 Calendar Guide
As an Australian with private health insurance, understanding when your dental benefits reset is crucial for maximising your coverage and maintaining optimal oral health. This comprehensive guide will walk you through everything you need to know about dental benefit resets, from common reset dates to expert tips on making the most of your extras cover.
- As of June 2024, over 14.8 million Australians1 (54.5% of the population) had general treatment cover including dental benefits.
- Dental benefits accounted for $901.2 million in claims2 during the June 2024 quarter, the largest category of general treatment benefits.
- Most Australian health funds reset dental benefits on January 1st each year
- Some funds reset on July 1st or on your policy anniversary date
- Unused benefits typically don’t roll over, so it’s important to use them before they expire
- Understanding your specific policy’s limits, sub-limits, and waiting periods is crucial
- Strategic planning of dental appointments can help you maximise your benefits
When Do Dental Benefits Typically Reset?
The majority of Australian health funds reset their dental benefits at the start of the calendar year. However, there are exceptions:
- January 1st (Calendar Year): Most major funds, including Medibank, Bupa, HCF, NIB, Australian Unity, and GMHBA.
- July 1st (Financial Year): Some funds like AHM, Defence Health, and Navy Health.
- Policy Anniversary: A few funds such as Queensland Country Health Fund and Hunter Health.
Which Dental Benefits Reset on January 1st, 2025?
We accept all health funds. Your coverage is welcome here, regardless of provider.
As a preferred provider, we can offer higher rebates and potentially lower out-of-pocket costs for eligible treatments.
Pro Tip: Always double-check your specific policy, as reset dates can change and may vary between different types of extras cover.
What Should I Know About January 1st, 2025 Dental Benefit Resets?
Why do most health funds reset dental benefits on January 1st?
January 1st marks the start of the calendar year, which many health funds use to align their benefit periods for simplicity and consistency.
What happens to my unused dental benefits on December 31st, 2024?
Typically, any unused benefits expire at midnight on December 31st. They do not roll over to the new year.
Can I use my 2025 benefits for treatments received in late December 2024?
No, benefits are usually applied based on the date of treatment. Treatments received in December 2024 will be covered by 2024 benefits, even if you claim in January 2025.
Do my waiting periods reset on January 1st, 2025?
No, waiting periods don’t reset annually. Once you’ve served a waiting period for a particular service, you don’t need to serve it again unless you upgrade your cover or switch to a new fund with higher benefits.
What is a waiting period, and how does it affect my dental benefits?
A waiting period is the amount of time you need to wait after joining or upgrading your health insurance before you can claim benefits for specific services. For dental benefits:
- General dental (like check-ups and cleanings) usually has a 2-month waiting period.
- Major dental (like crowns or bridges) often has a 12-month waiting period.
Waiting periods are typically only served once when you first join or upgrade. They don’t reset annually with your benefits.
If I join a fund with January 1st resets mid-year, when will my first reset occur?
Your first reset will occur on the following January 1st. You’ll have full annual benefits for the partial year when you join.
Tips for Maximising Your January 1st Dental Benefits
- Plan Your December Appointments: Schedule any outstanding dental work for early to mid-December to ensure you use any remaining 2024 benefits.
- Book Early for January: Many people rush to use their new benefits in January. Book your appointments in advance to secure preferred times.
- Spread Major Treatments: If you need extensive dental work, consider starting treatment in late December and completing it in early January to potentially use two years’ worth of benefits.
- Use the Holiday Period Wisely: The holiday season often offers more flexible schedules. Use this time to fit in dental appointments and maximise your 2024 benefits.
- Review Your Coverage in November: Take time in November to review your current benefits usage and plan for both the December rush and the upcoming reset.
- Consider End-of-Year Deals: We often run special promotions, including potential end-of-year deals. Visit our Exclusive Offers page to see current discounts and promotions for your dental treatments.
- Set New Year Health Goals: Use the January 1st reset as motivation to set dental health goals for the new year and plan your treatments accordingly.
- Coordinate Family Treatments: If you have family cover, coordinate appointments for all family members to efficiently use shared benefits before and after the reset.
- Check for Loyalty Bonuses: Some funds increase annual limits for long-term members. Check if you’re eligible for higher limits in the new calendar year.
- Understand Rollover Options: A few funds offer limited rollover of unused extras benefits. Check if your fund offers this and how it applies to dental benefits in the new year.
What Health Funds Reset Dental Coverage on July 1st, 2025?
We accept all health funds. Your coverage is welcome here, regardless of provider.
As a preferred provider, we can offer higher rebates and potentially lower out-of-pocket costs for eligible treatments.
Pro Tip: Always double-check your specific policy, as reset dates can change and may vary between different types of extras cover.
What Should I Know About July 1st Dental Benefit Resets?
Why do some health funds reset dental benefits on July 1st?
July 1st marks the beginning of the Australian financial year. Some health funds align their benefit resets with this date for administrative and budgeting purposes.
What happens to my unused dental benefits on June 30th?
Typically, any unused benefits expire at midnight on June 30th. They do not roll over to the new financial year.
Can I use my new financial year's benefits for treatments received in June?
No, benefits are usually applied based on the date of treatment. Treatments received in June will be covered by that financial year’s benefits, even if you claim in July.
Do my waiting periods reset on July 1st?
No, waiting periods are typically only served once when you first join or upgrade your cover. They don’t reset annually.
If I switch to a July 1st reset fund mid-year, when will my benefits reset?
If you switch to Peoplecare (or another fund with a July 1st reset) mid-year, your first benefit reset will typically occur on the next July 1st after you join. Here’s an example to illustrate:
Let’s say you switch to Peoplecare on February 15, 2025:
- Your initial benefits with Peoplecare will start from your join date (February 15, 2025).
- These benefits will continue until June 30, 2025.
- Your first full reset will occur on July 1, 2025.
- From July 1, 2025 onwards, your benefits will reset annually on July 1st.
So, in this scenario, your first period with Peoplecare would be shorter (about 4.5 months), but you’d still have access to the full annual benefits during this time. After the first July 1st reset, you’ll fall into the regular annual cycle.
Tips for Maximising Your July 1st Dental Benefits
- Plan Your June Appointments: Schedule dental check-ups and any known treatments for May or early June to use any remaining benefits before they expire.
- Book Early for July: Many people rush to use their new benefits in July. Book your appointments early to secure your preferred times.
- Spread Major Treatments: If you need extensive dental work, consider starting treatment in June and completing it in July to potentially use two years’ worth of benefits.
- Review Your Coverage in May: Take time in May to review your current benefits usage and plan for the upcoming reset.
- Consider End of Financial Year Deals: Some dental practices may offer special deals in June. Check if your preferred dentist has any EOFY promotions.
- Use Your Health Fund’s Apps: Many funds with July 1st resets offer apps to track your benefits. Set up notifications to remind you of your remaining benefits.
- Coordinate Family Treatments: If you have family cover, coordinate appointments for all family members to efficiently use shared benefits before and after the reset.
- Check for Loyalty Bonuses: Some funds increase annual limits for long-term members. Check if you’re eligible for higher limits in the new financial year.
- Understand Rollover Options: A few funds offer limited rollover of unused extras benefits. Check if your fund offers this and how it applies to dental.
- Plan for the New Financial Year: Use the July reset as an opportunity to plan your dental care for the entire upcoming year, ensuring you make the most of your new benefits.
Which Insurers Have Anniversary-Based Dental Benefit Resets?
We accept all health funds. Your coverage is welcome here, regardless of provider.
As a preferred provider, we can offer higher rebates and potentially lower out-of-pocket costs for eligible treatments.
Pro Tip: Always double-check your specific policy, as reset dates can change and may vary between different types of extras cover.
Queensland Country Health Fund
Last Claim: 1 Day Before Anniversary
Reset Date: Policy Anniversary
Frequently Asked Questions About Anniversary-Based Dental Benefit Resets
How do I find out my policy anniversary date?
Your policy anniversary date is typically listed on your policy document. You can also check it by logging into your health fund’s member portal or contacting their customer service directly.
Do unused dental benefits roll over to the next year?
Generally, unused benefits do not roll over. It’s best to use your dental benefits before your policy anniversary date to avoid losing them.
Can I change my policy anniversary date?
In most cases, the policy anniversary date is set when you join and cannot be changed. For any specific requests or changes, please contact your health fund directly.
What happens if I get dental treatment right before my anniversary date?
Treatments are usually covered based on the date of service. If you receive treatment just before your anniversary date, it will typically be counted towards that year’s benefits, even if the claim is processed after the reset date.
How do anniversary-based resets affect my waiting periods?
Waiting periods are usually calculated from your join date, not your anniversary date. Once you’ve served your waiting periods, they don’t reset annually.
How Do I Maximise My Anniversary-Based Dental Benefits?
- Mark Your Calendar: Set a reminder 2-3 months before your policy anniversary date to review your unused benefits and schedule any needed dental work.
- Plan Major Treatments Strategically: If you need extensive dental work, consider timing it around your reset date to potentially utilise two years’ worth of benefits.
- Regular Check-ups: Schedule routine check-ups and cleanings well before your anniversary date to address any issues early and plan for potential treatments.
- Track Your Benefits: Regularly monitor your remaining benefits through your health fund’s online portal or mobile app to ensure you’re making the most of your coverage.
- Understand Your Coverage: Familiarise yourself with what treatments are covered under your policy and any sub-limits that may apply to specific services.
- Coordinate with Your Dentist: Inform your dentist about your policy anniversary date. They can help plan treatments to maximise your benefits.
- Consider Family Needs: If you have family coverage, coordinate dental appointments for all family members to efficiently use shared benefits before the reset date.
- Use Preferred Providers: Many health funds have agreements with “preferred providers” or “member plus” dentists. Visiting these dentists can often result in higher benefits or lower out-of-pocket costs.
(Podcast) 2024 APRA Private Health Insurance Insights
Get the big picture on Australian health insurance trends. In this quick podcast, we break down the latest APRA report. We cover recent trends in hospital treatment cover, the growth in extras cover, and what these changes might mean for you. This overview helps explain why extras resets occur and how they fit into the larger insurance picture.
Listen on
2021 – 2024 Australian Dental Health & Insurance Statistics. The Numbers Behind Your Smile
Did you know that Australians claimed over 2.6 million dental services in just three months of 2024, with health funds paying out nearly $180 million in benefits? Knowing when your benefits reset could save you hundreds of dollars, reduce your out-of-pocket expenses, and help you make the most of your coverage before it resets.
52
In 2022–23, around 52% of Australians aged 15 years and over saw a dental professional in the last 12 months1.
11
In 2021–22, around $11.1 billion was spent on dental services in Australia1.
30
Around 1 in 3 (30%) people who needed to see a dental professional delayed seeing or did not see one at least once in the previous 12 months1.
18
Cost was reported as a reason for delaying or not seeing a dental professional by around 1 in 6 (18%) people1.
66.97
The average benefit paid per dental service was approximately $66.97 in the June 2024 quarter2.
54.10
The average out-of-pocket expense per dental service was about $54.102.
Dental benefits accounted for $901.2 million out of $1,612 million total general treatment benefits paid in the June 2024 quarter, representing over 55% of all general treatment benefits3.
258.20
For the year ending June 2024, dental benefits averaged $258.20 per insured person, making up the largest component of the $471.34 total general treatment benefits per person3.
Dental benefits account for over half of all general treatment claims. Despite this, members still face significant out-of-pocket expenses for dental services. Understanding when your benefits reset is crucial to maximise your coverage and minimise these costs.
1 Source: Australian Institute of Health and Welfare, “Oral health and dental care in Australia” report, last updated October 2024. Learn More.
2 Source: Quarterly Private Health Insurance Statistics, June 2024. Learn More.
3 Source: APRA June 2024 Membership & Benefits Summary Learn More.
