The Problem with Extras
Reviewed June 2026 by Our Content Experts.
Dental Cover is Better with Smile™: Decoded
Compare Extras Cover: Does Smile™ Beat Medibank, Bupa, HCF, nib & HBF?
Extras cover from Australia's Big 5 Health Funds—Medibank, Bupa, HCF, nib, and HBF may seem comprehensive, but it's fundamentally restricted by complex rules, waiting periods, treatment exclusions, and annual benefit limits. There's also a lot of fine print, paying for unused services, and an expensive annual cover fee that makes dental care a costly burden, not a source of peace of mind. It's time to move past the Big 5 Health Funds traps and see how the smart, focused model of Smile™ beats the Big 5 on value, freedom, and peace of mind.
Why Members Overpay
The Big 5 Extras Traps: Hidden Cost of "Comprehensive"
The Real Cost of "Comprehensive" Extras Cover
The main goal of traditional Extras insurance is to bundle many different services (dental, physio, optical) into one high cover cost. This results in frustration for the member who only or predominantly wants quality, affordable dental care.
The 'Premium and Gap Traps'
The Reality for Big 5 Members
$1,000+ to over $5,000 a year for a bundled Extras cover — and yet, even with those hefty premiums, you still pay out-of-pocket gap costs.
The Smile™ Solution
$79 to $119 a year for a dedicated dental cover and you get reduced and capped dental fees that keep your out-of-pocket gap costs low — with a cover fee that’s only a fraction of the Big 5 cover fees.
The 'Bundle Trap'
The Reality for Big 5 Members
You pay high, constantly-increasing premiums for Extras cover that includes services you don’t or rarely need, —like chiro and podiatry to get dental coverage.
The Smile™ Solution
Pay Only for What You Actually Need. Smile™ is pure dental cover, so you only pay for what you truly need. Unlike the Big 5, you’re forced to pay for a long list of services such as, chiro, physio, etc. that you don’t or rarely need.
The 'Restrictions Trap'
The Reality for Big 5 Members
Waiting Periods, Annual Limits, & Exclusions. With the Big 5, you wait 2–12 months to claim, face annual limits (around $1,100) and run into treatment exclusions that block claims when you need them most. If you need urgent work, you either wait or pay 100% out-of-pocket — and once your limit is gone, so is your cover.
The Smile™ Solution
No Restrictions, Just Peace of Mind. No waiting periods, no annual benefit limits, and no treatment exclusions. From day one, you get reduced & capped dental fees on the spot on ALL treatments at every visit to any of our 4,000+ Smile™ dentists nationwide. It’s simple, instant, and built to cover you — not restrict you.
Real-Life Comparisons
Real-Life Comparisons: How Smile™ Beats the Big 5 on General and Major Dental
1. General Dental – The Cost of a Simple Check-up and Clean
When it comes to covering general dental, especially a routine check-up & clean, the difference in what you actually pay can be shocking. Take Mark from NSW — he just needs a check-up & clean, which standard fees can be up to $394. Here's how Smile™ stacks up against Medibank, Bupa, HCF, nib, or HBF.
General Dental - Check-up & Clean
Based on NSW check-up & clean, standard fee is up to $394
The Hidden Catch for Big 5 Members:
"Zero Cost" Illusion: Funds like Medibank, Bupa, HCF, and HBF proudly advertise 'free' or "$0" out-of-pocket for routine check-ups and cleans. However, this only refers to the treatment cost at the time of the visit. The real cost is the enormous annual premium (ranging from $1,020 (HCF) to $1,748 (Bupa)) you must pay for the Extras policy just to access this "free" service. You're effectively paying hundreds, if not thousands, for a service that costs a fraction of that.
'Bundle Trap': The Big 5 high cover fees are for bundled 'Extras' that cover a multitude of services like chiro, podiatry etc. – many of which you may don't or rarely need. This is a significant waste of money simply to get dental coverage.
'Restrictions Trap': Even after serving long waiting periods, your benefits are capped — often around $1,100. And if you haven't served them yet? You're stuck paying 100% of the cost out of pocket.
The Unbeatable Smile™ Peace of Mind
Even with that small reduced and capped fee, Mark's total annual spend is a fraction of the Big 5 extras cover costs up to $1,748. Why pay over a thousand dollars to cover a $394 treatment? With Smile™, you don't—you simply get reduced and capped fees right away leaving more money in your pocket to spend with the ones you love and on the things you love!
2. Major Dental – The Financial Shock of a Root Canal Treatment
Now meet Sarah from NSW. She needs a Root Canal (1 canal) treatment with a filling, a critical procedure that is often unexpected, carrying a high fee of up to $1,842. See how Smile™ is the best solution for Sarah, better than Medibank, Bupa, HCF, nib, or HBF.
Major Dental – Root Canal Treatment
Based on NSW root canal treatment, standard fee is up to $1,842
| Smile™ Single Dental Cover | Medibank Single Top Extras | More Details | |
| Annual Cover Fee | $79 | $1,676 | |
| Treatment Cost Paid By Member | $789 | $642 | |
| Sarah Pays Up To | $868 ($79 annual cover fee + $789 capped fee) | $2,318 $1,676 annual cover fee + $642 gap fee | |
| The Winner is... | Winner! | Pay $1,450 more |
The Traps Big 5 Members Face:
'Premium and Gap Traps': With the Big 5 funds, you're already out of pocket before you even sit in the dental chair — paying up to $1,748 a year for "Top Extras" cover. Yet your benefit is capped at around $1,100, meaning you'll never come out ahead and still face a hefty gap on top. You pay more, get less, and lose before treatment even begins.
'Restrictions Trap': Imagine needing urgent dental care, only to find out you're not covered yet — or that your yearly limit's already maxed out. That's the reality for Big 5 members. With 2–12 month waiting periods, fixed benefit caps, and endless exclusions, you end up paying more, waiting longer, and stressing over costs when you should be focusing on your health.
'Bundle Trap': Every year, you're paying higher premiums to Big 5 health funds for Extras cover packed with services you don't or rarely need like podiatry just to claim back a small portion, mostly for dental. The rest? It stays with them. You lose more, they profit more — and that's the real trap.
The Unbeatable Smile™ Difference
For a major dental procedure, Sarah's total annual cost with Smile™ is just $868. Compare this to the Big 5 funds, where the total cost often exceeds $2,000. Why pay up to three times more for a complicated system that traps you with expensive premiums, high gaps, and endless restrictions? Smile™ just makes better financial sense.
The Numbers Don't Lie
Smile™ vs the Big 5 Health Funds: Why Smile™ Members Come Out Ahead
Australia's largest health funds — Medibank, Bupa, HCF, nib, and HBF — charge hefty premiums for extras cover that's meant to reduce routine dental, optical, and physio costs.
1. The Real Cost of Big 5 Health Funds Extras
According to Canstar (2025) [6], the average annual extras-only premium is:
Basic / Entry Level
Mid-Level Extras
High / Comprehensive Extras
2. What Members Actually Get Back from the Big 5
So what do Australians really receive in return for those premiums? According to the Australian Prudential Regulation Authority (APRA), for the year to June 2025, health insurers paid an average of $493.75 per person in extras benefits [7].
That means members are effectively getting back only 40 – 55 cents in benefits for every $1 paid in extras premiums.
Even when you include hospital claims, the industry-wide average sits around 84 cents per $1 — meaning a significant portion of premiums goes to overheads, marketing, and their profits [8].
Did You Know that Dental Dominates Extras Claims?
55% of extras goes towards dental, so you're paying for many services you don't or rarely need ($273 of $494 on average per member) [9].
You are Paying for a Bundle you Don't Need
Behind that so-called 'comprehensive' label, most of your expensive premiums are spent on things that rarely benefit you:
- Services you don't or rarely need – like chiro etc.
- Marketing and administration costs for services you don't even use.
- Cross-subsidising other members' expensive health costs that aren't relevant to you.
- Maintaining vast provider networks you'll likely never visit.
In the end, you hand over your hard-earned money to Medibank, Bupa, HCF, nib, or HBF only to get back a fraction of it—mostly for dental care—while the rest fuels overheads and profit margins for the insurers.
3. The Smile™ Difference: Low Annual Cover Fee
Most people take out Extras Cover mainly for dental benefits, yet end up paying for extras they don't need — like chiro and podiatry. Smile™ focuses solely on what you actually need most: quality, affordable dental care. Instead of paying $1,000+ annually for capped rebates, Smile™ members pay from $79 per year and instantly get reduced & capped dental fees at 4,000+ Smile™ dentists nationwide.
Real Smile™ Member Savings
Smile™ members save more than the cost of their cover, with many saving hundreds to thousands each year on treatments.
Smile™ isn't insurance — it's better. While the Big 5 health funds return only 40–55% of extras premiums as benefits, Smile™ provides members on the spot reduced and capped dental fees from the first appointment. You don't overpay for services you rarely or never need - just dental, done right.
The Final Verdict
Smile™ Beats the Big 5 on Value and Cost
Is Smile™ the Best Extras Cover in Australia? Side-by-Side Comparison
While the Big 5 health funds continue to raise premiums and shrink returns, Smile™ members enjoy real, immediate benefits. Here's how Smile™ dental cover beats the Big 5 health funds (Medibank, Bupa, HCF, nib, and HBF).
Smile™ Flips the Script: With Smile™, you break free from the complex traps set by the Big 5: the Premium and Gap Traps, the Bundle Trap, and the Restrictions Trap. Why deal with these traps when you don't have to?
Dental Cover is Better with Smile™
Enjoy peace of mind with cover for $79 to $119 a year, no waiting periods, no treatment exclusions, no annual benefit limits, no annual cover fee increase, no overpaying for cover for services you rarely or never need - just dental, done right.
Simple as 1, 2, 3
Here's How Smile™ Works and How You Can Benefit Instantly!
Visit
Visit any of 4,000+ Smile™ dentists, show your Smile™ card, & pay reduced & capped dental fees!
Check Savings
Request your printed invoice from the Smile™ dentist then use the Smile™ app to Check Savings!
Got Questions
Frequently Asked Questions
Quick Facts About Smile™ Dental Cover
1. What is Smile™ dental cover and how is
it different from extras cover from Medibank,
Bupa, HCF, nib, or HBF?
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2. How much does Smile™ dental cover cost
compared to the Big 5 health insurance extras
policies?
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3. Does Smile™ dental cover have waiting
periods, limits, or exclusions?
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4. Do I still need a health insurance extras
cover if I have Smile™?
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5. How do Smile™ members claim or receive
benefits?
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6. Is Smile™ accepted nationwide, and how
do I find a dentist?
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7. Does Smile™ dental cover increase in
price each year, like health insurance cover
fees?
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8. Can I switch to Smile™ at any time, or
do I need to wait until my current extras cover
renews?
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10. What dental treatments are included with
Smile™?
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11. Does Smile™ cover cosmetic dentistry
such as whitening or veneers?
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12. How quickly do I receive my Smile™
card after joining?
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References
- Medibank Single Top Extras for a single person with top extras in NSW on an annual income under $101,000, as of June 2026 - Link
- Bupa Single Top Extras Boost for a single person with top extras in NSW on an annual income under $101,000, as of June 2026 - Link
- HCF Single Top Extras for a single person with top extras in NSW on an annual income under $101,000, as of June 2026 - Link
- nib Single Top Extras for a single person with top extras in NSW on an annual income under $101,000, as of June 2026 - Link
- HBF Single Top 70 for a single person with top extras in NSW on an annual income under $101,000, as of June 2026 - Link
- Canstar Health Insurance Costs 2025 - Link
- APRA Quarterly Private Health Insurance Statistics, 2025 - Link
- Private Healthcare Australia, 2025 - Link
- Canstar Health Insurance Costs 2025 - Link