Get Affordable Health Insurance for Children
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While Medicare pays for all your child’s immunisations and might provide subsidies for some of their dental care, eye tests and the cost of treating a cleft palate, it doesn’t offer coverage for all possible future medical procedures and general treatments. Also, if you do not qualify for Medicare in Australia, you are responsible for all your children’s health care costs.
If you do not have private health insurance and want to ensure your children are protected, you might want to invest a family health insurance plan.
Benefits of health insurance coverage for children in Australia
Children usually have a higher probability of requiring medical assistance because of their accident-prone nature and risk of developing things like pinkeye, ear infections and chickenpox. According to the Australian Institute of Health and Welfare, 1 in 10 children get diagnosed with asthma, and there are over 1000 new cases of type 1 diabetes diagnosed in children (2014 to 2015).
As a parent or guardian, you might want to purchase health insurance for your children because:
- Child and student dependents can generally be added to your family policy at no additional cost.
- There is generally no Excess or co-payments for children admitted to the hospital.
- Extras can help you pay for dental, including braces, occupational therapy, rehabilitation, physiotherapy and children’s medicines, depending on the level of coverage you purchase.
- Select funds provide a School Accident Benefit, that helps you pay for the out-of-pocket expenses incurred because 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.
How long can kids stay on your family policy?
Australian private health funds will usually allow you to cover your kids up until they turn 18 or 21, depending on the health fund you've chosen. When a child dependent turns 21, they usually have two months in which they need to get their own private health insurance coverage. The same is true for student dependents turning 25.
Generally, private health insurance companies might consider a person a dependent child when they're between the ages of 18 and 21, depending on the health fund, and not married or in a de facto relationship.
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, and they might require a letter from the school or registered training group confirming their participating in full-time studies.
Young adults, between 18 and 24 years that are not studying full time could potentially remain covered on your policy in exchange for paying a higher premium.
Gather and review health insurance quotes for children
Finding the best health insurance for children?
Whether for a single or two-parent household, health funds generally provide no excess or co-payments for children when they need to go to the hospital. Depending on your requirements and what you can afford, the best medical insurance for children, usually 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.
Look for a policy that offers no-gap extras for your kids and make sure that you're covered for pregnancy if you're planning to have more kids.
Frequently asked questions and answers
Is it worth getting private health insurance for kids?
You never know when your child might need a paid-surgeon. Ear grommets and hernias tend to be a common procedure amongst babies; the possibility of your little one being placed on a waiting list for surgery is something every parent wants to avoid. Health cover might be especially helpful for premature births, accidents, occupational therapy, physio and dental.
When do children need dental insurance?
If you do not have Medicare or your child requires a bit more dental assistance, you might want to purchase Extras coverage that provides treatment for general and major dental, and perhaps endodontic and orthodontic.
Medicare covers some of the costs for dental examinations, including routine cleaning, repairing cracked teeth, fillings and root canals if your child is eligible for the Child Dental Benefits Schedule (CDBS).
However, not all dentists provide services under CBDS, and there are certain services that Medicare generally does not cover, for example, braces and dental or cosmetic work that needs to be done in a hospital, like removing wisdom teeth.
How much does health insurance cost for a child?
Your health insurance premium is determined by the type and level of coverage you choose. For example, if you have a family or a couple's policy, you might not have to pay anything extra when adding your children. However, upgrading from single's cover to a family or single-parent plan will generally increase your premium quite a bit, but again it depends on the type and level of coverage you choose and your health fund.
You might want to gather some quotes and compare which policy will suit your requirements and budget best.
Does private health insurance cover adopted kids, foster and stepchildren?
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 might be required to provide evidence that states the date when the child has come into your care. It’s always best to check with your respective private health fund on what information they need.
How can a parent remove a child from their health insurance?
Typically, you'll need to contact your insurer to remove someone from your policy, unless they're no longer eligible to remain on your plan in which case they will usually be automatically removed. However, it's always best to confirm with your insurer.
How to add your baby to Medicare
Generally, you’ll receive a Newborn Child Declaration form from your hospital or midwife, which you’ll need to submit 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 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.
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