How to add your baby to Medicare?

Generally, you’ll receive a Newborn Child Declaration form from your hospital or midwife, which must be submitted before your child’s first birthday. You can submit the form using your Centrelink online account via myGov or the Express Plus Centrelink app. Alternatively, you can send the form in by post or hand it in at a service centre.

or call 1300 795 560 to speak with a specialist

Get Affordable Health Insurance for Your Children

Megan Fraser Updated: 28 April 2021

Table Of Contents

How to add children to your private health insurance:
How long can your child stay on your health insurance plan?
What to look for in a policy that covers your kids?
Health insurance for your baby

You’ll be able to get affordable coverage for the whole family by signing up for a private health insurance policy. Generally, most private health insurance companies allow you to add children to your couples or family health plan at no additional cost. This implies “free” health care for children, making it more affordable to provide cover for your entire family.

If you’re expecting a baby, have young children or teenagers or have children that are getting ready to leave home, you might be wondering which health insurance is the best for your family.

Generally, Medicare will pay for most of your child’s immunisations. They may also provide certain subsidies for some of your child’s dental care, eye tests and certain treatments such as x-rays, pathology tests and eye tests. However, it doesn’t provide coverage for all of the medical procedures and general treatments that your children may need in the future. It is also important to note that you’ll be responsible for all of your children’s health care costs if you don’t qualify for Medicare.

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Do you need private health insurance for your child?

Children are more likely to need dependent health insurance coverage because of their accident-prone nature. They are also at risk of developing ailments like pink eye, asthma and ear infections. In addition to this, Medicare does not cover the costs of all of the medical expenses that your kids may require. This includes the fitting of braces, grommets and tonsil removal.

Benefits of health insurance for kids

Generally, some of the advantages of getting health insurance for your children can include:

Some health insurance companies may allow you to add child and student dependents at no additional cost.
Generally, you won’t need to pay an excess or make a co-payment for children admitted to the hospital.
Extras cover may help to subsidise the costs of dental, including braces, occupational therapy, rehabilitation, physiotherapy and children’s
Select funds offer a School Accident Benefit, which helps you pay for the out-of-pocket expenses incurred as a result of the general treatment required when your child gets into an accident at school (including on the way to and from school).
No-Gap Extras benefit on specific services, like dental check-ups, physio visits and podiatry consultations. Check with your insurer to see if this is available.

Take note: Terms and conditions for adding children to your health cover may vary between funds, so check with your insurer to ensure that your kids meet the required criteria.

What happens if your child doesn’t have health insurance?

Generally, children are more likely to get sick or sustain an injury in an accident. Therefore, they are more likely to require hospital treatment. If they don’t have private health cover, they’ll be placed on a waiting list for general procedures. In addition to this, you’ll need to pay for common childhood Extras such as Dental or Optical. However, applying for private health insurance for your children will help you pay for these Extras and avoid waiting lists.

Can you get health insurance for your child only in Australia?

Buying child-only health insurance in Australia is quite uncommon. Select health funds may be willing to provide cover to your kids only. However, you’ll generally be able to include your children on your couple’s policy without having to pay an additional charge. This way, you’ll be able to provide your entire family with cover at an affordable price.

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How to add children to your private health insurance:

If you’d like to add a child to your singles or couple’s policy, you’ll typically need to call your insurer and have your child added as a dependent. Although, you may need to upgrade to a family health insurance plan or a single parent policy, depending on your circumstances

Generally, upgrading from a singles plan to a policy with different or increased benefits may result in you paying a higher premium. Couples policies usually cost the same as a family policy, so upgrading won’t usually change your premium very much. However, you should take note that waiting periods apply to children as well.

It’s a good idea to contact your insurer early as some private health insurance funds require you to add a newborn before they are born while others take registrations in the first two months after the baby is born.

Important note: You may wish to upgrade your policy when you are first planning on having a child as there is generally a 12 month waiting period before you can claim any pregnancy and birth-related services.

How much is health insurance for a child?

Child health insurance costs are generally determined by the type and level of coverage you choose. For example, if you currently have a family or a couple’s policy, you might not have to pay any additional cost when adding children to your cover. However, upgrading from single’s cover to a family or single-parent plan will generally increase your premium.

You might want to gather some quotes and compare which policy will best suit your requirements and budget.

How long can your child stay on your health insurance plan?

Depending on your chosen health fund, your children will usually be covered until they turn 18 or 21. Once your child turns 21, they’ll generally have two months to find their own private health insurance. If your child is a full-time student, they’ll be able to stay on your policy as a dependent until they turn 25.

Child dependent

Generally, private health insurance companies might consider a person a dependent child when they’re between the ages of 18 and 21 and not married or in a de facto relationship. However, this may vary according to your chosen health fund.

Student dependent

Children up to the age of 25, might be able to continue on your family health insurance plan at no extra cost if they are full-time students. However, this depends on your insurer. They might also require a letter from the school or registered training group confirming their participation in full-time studies.

Adult dependent

Young adults, between the ages of 18 and 24 years that are not studying full time could potentially remain covered on your policy in exchange for paying a higher premium.

Health insurance rules for dependents

Child dependents on your health insurance will generally need to adhere to the following rules:

Age 25: Following your 25th birthday, you generally won’t be able to be listed as a dependant on your parents’ health insurance policy. The maximum age for student dependants is 25. If you’re not a full-time student, the cut-off age for dependants on many kids’ health insurance policies is 18 or 21 years.
Employment: To qualify as a dependent, your child should be financially reliant on you. Once they are employed full-time and earn a stable income, most health insurance companies won’t classify them as a dependant.
Students: Once your child graduates from university or TAFE, they generally won’t be classified as a student dependent any longer.
Marital status: Your children can be listed as dependents on your private health insurance as long as they are unmarried and not in a de facto relationship.

What to look for in a policy that covers your kids?

Whether for a single or two-parent household, health funds generally provide no excess or co-payments for children when being admitted to hospital. Depending on your requirements and what you can afford, the best medical insurance for children may include coverage for:

Rehabilitation fees
Ambulance services
Theatre fees charged by the hospital
The 25% not covered by the Medicare Schedule fee
Glasses and contacts lenses
Dental check-ups, teeth cleaning, fillings etc
Prescription drugs
Physiotherapy

It may be worthwhile to look for a policy that offers no-gap extras for your kids and make sure that you’re current policy will cover you for pregnancy if you’re planning to have more children.

happy young family with baby pediatrician doctor

Health insurance for your baby

How to add your baby to Medicare? Generally, you’ll receive a Newborn Child Declaration form from your hospital or midwife, which must be submitted before your child’s first birthday. You can submit the form using your Centrelink online account via myGov or the Express Plus Centrelink app. Alternatively, you can send the form in by post or hand it in at a service centre.

If you do not have a Newborn Child Declaration form, you can instead submit a Medicare enrolment form with all supporting documentation, including your child’s birth certificate.
When to get health insurance for your baby? You will never know when your child might need surgery. Ear grommets and hernias tend to be a common procedure amongst babies; the possibility of your baby being placed on a waiting list for surgery is something every parent wants to avoid. Private health insurance might be especially helpful for premature births, accidents, occupational therapy, physiotherapy and dental treatments.
How to get health insurance for your baby? To get your child covered by private health insurance, you can fill in the quote form below and a specialist will provide you with an online comparison quote to meet your requirements. Alternatively, you can call a specialist directly on 1300 795 560.
How much does baby health insurance cost? Many health funds in Australia will allow you to add children to your couples or family health insurance policy free of charge. You’ll generally find yourself paying between $200 and $1,000 (depending on the level of Hospital and Extras chosen) for a family policy regardless of how many children you have.

Frequently asked questions

How to get health insurance quotes for children?
If you’d like to buy health insurance for a child, you can request a health insurance quote for your child by completing the quote form. A specialist will give you a call to help you choose a policy that meets your requirements and budget. Alternatively, you can request a quote directly from the health insurance company of your choice by visiting their website, giving them a call or visiting your local branch.
Can you upgrade your current policy to include children?
Yes, you’ll generally be able to upgrade your singles or couples health insurance policy to include your children. However, it’s important to note that you may have to pay more on your premiums if you switch from a singles policy to a family policy. You may also want to take note of any waiting periods that may apply to your child’s cover.
Can stepchildren, adopted or foster children be added to health insurance policy?
Generally, yes. Although these kids might not be related by blood; foster kids and stepchildren are usually covered in the same way as biological children. However, to add a foster child, you may be required to provide evidence showing the date the child first came into your care. It’s always best to check with your respective private health fund on what information they need.
How to remove a child from your policy?
If you’d like to remove a dependant from your private health insurance, you should contact your health insurance provider directly. Generally, an authorised person can add or remove dependents from the policy at any time.
Is dental free for kids in Australia?
Some children in Australia may be eligible for the Child Dental Benefits Schedule (CBDS). Medicare will assist in covering some of the costs of dental services such as cleanings, x-rays, fillings, fissure sealing, extractions and root canals. Your child may be eligible for the CBDS if they are aged between 2 and 17 years, are eligible for Medicare or if you or they receive at least one eligible payment per year.
It is important to note that not all dentists will provide their services under the CBDS. The CBDS will not cover your child for services such as braces or wisdom teeth removal so you may want to look at purchasing extras cover to help cover some of the costs.
Which health funds offer rewards or discounts for kids?
Several health funds such as AHM, Bupa and GMHBA will offer an age-based discount of up to 10% for those aged between 18-25 years old. You may also be able to find affordable health insurance policies specifically targeted to families.