Get Affordable Health Insurance for Children: It’s Practically Free

Published: February 28, 2018

You can get health insurance for children, generally at no extra cost when upgrading to a family plan or a when purchasing a single parent membership. Whether you’re planning to start a family or have teenagers, as a parent you always want to make sure your kids are protected. Your children can be covered as your dependants, with many health funds providing coverage up until they reach the age of 21, depending on your insurer.

If you do not have health insurance, or if you are wanting to find cover that is better suited to your changing circumstances, start by comparing quotes from some of Australia’s top private health insurers.

Features and benefits may vary between health funds, so check the Standard Information Statement carefully to determine whether cover for dependents is included and which benefits you can claim for.

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Private health insurance companies in Australia will generally allow you to include children on your policy at no extra charge. This implies “free” private health insurance for children, making affordable coverage for the whole family possible.

However, every family is different, and you might want to make adjustments to your cover to allow for kid-specific benefits, like orthodontic work, speech therapy and physiotherapy.

In the health insurance industry children are defined as dependents, which refers to an unmarried person under the age of 18.  Some private health insurance companies will consider persons between the ages of 18 and 24 years as dependents, but will usually have certain conditions that need to be met for your cover to continue without an increase in premium.

There are 4 categories of membership that provide cover for family groupings:

  1. Family: 2 Adults and children or student dependants(s).
  2. Single parent family: 1 Adult and dependants(s), child or student.
  3. Single parent extension: 1 Adult and any dependants(s), including child, student and young adults.
  4. Family extension: 2 Adults and any dependants(s), including child, student and young adults.

Take note; although adopted, foster or stepchildren are generally covered in the same way as biological children, some private health insurers may require people to be related by birth or in a relationship to be covered by the same policy.

Finding the best health insurance for your children

Whether for a single or two-parent household, health funds generally provide no excess or co-payments for children if they need to go to the hospital.

Below premiums are based on 2 Adults with children living in NWS choosing combined cover of the Hospital and Extras, as at February 2018. This excludes the 1st of April 2018 premium increases.

List of Australian private health funds providing health insurance for kids

Health Fund Details Features
Budget Family with $500 Excess
  • $377.60 per month.
  • No excess paid for kids.
  • $400 per person for orthodontic work.
  • Each year receive a top-up bonus to help cover out-of-pocket expenses.
Frank Essential Bundle
  • $324.08 per month.
  • Zero waiting period for partial cover or ambulance.
  • Includes speech therapy, orthodontics and dietetics.
  • $300 per person for physiotherapy.
For Settled Families – Essential $500 Excess
  • $364.70 per month.
  • Comprehensive cover for ambulance.
  • Covers accidents and removal of wisdom teeth.
  • $100 annual membership bonus.
Family Basic Saver $500 Excess
  • $262.85 per month.
  • No excess for child dependents up to age 21 years.
  • $220 per person for Optical.
  • Up to 4% discount for payments by direct debit.

Be sure to compare a variety of funds offering family health insurance before making a purchase.

What you need to know about health insurance coverage for children

Do children need health insurance?

Yes, children do need health insurance. Health cover is especially helpful for premature births, accidents, occupational therapy, physio and dental.

You never know when your child might need a paid-surgeon. Ear grommets and hernias tend to be common procedures amongst babies; the possibility of your little one being placed on a waiting list for surgery is something every parent wants to avoid.

What does Medicare cover?

Medicare provides basic health care for parents and children for free or at a reduced price. Although Medicare might be considered adequate at times, it does not provide coverage for all possible future medical procedures.

Medicare cover for children includes:

  • Free immunisation shots.
  • Free access to public hospitals as a public patient.
  • Cheaper access to both private and public hospitals when you are a private patient.
  • Some prescription medications.
  • As a private patient, Medicare will pay for 75% of the Medicare Schedule fee when your children need to see a doctor.

If you are only relying on Medicare and have children or planning to start your family, you might want to consider supplementing coverage with a private health plan to provide complete cover.

Don’t forget about dental insurance for children

Taking care of your child’s teeth start as soon as those first tiny pearls appear. One of the best ways to do this is with regular visits to the dentist.

Medicare runs a scheme called the Child Dental Benefits Schedule (CDBS). This scheme provides eligible children with a range of dental services to the value of up to $1000 over two years and can either be used all at once or spread out over the two year period.

These CBDS payments can also be used to pay for some or all of the treatments at a private dentist. Eligibility is assessed at the beginning of each calendar year and depends on whether your child:

  • Is eligible for Medicare,
  • Between the ages of 2 and 17 years,
  • Receives a relevant Australian government payment, such as Family Tax Benefit Part A.

If your child is eligible, CDBS will cover dental examinations, including routine cleaning, repairing cracked teeth, fillings and root canals.

Orthodontic work (braces, etc.) are not covered, and neither are any dental or cosmetic work that needs to be done in hospital (like removing wisdom teeth).

Not all dentists provide services under CBDS. It’s advisable to check this with your dentist before you book an appointment.

Finding the best health insurance for your children

Whether for a single or two-parent household, health funds generally provide no excess or co-payments for children if they need to go to the hospital.

Below premiums are based on 2 Adults with children living in NWS choosing combined cover of the Hospital and Extras, as at February 2018. This excludes the 1st of April 2018 premium increases.

  • 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.
  • Theatre fees charged by the hospital.
  • Prescription drugs.
  • Physiotherapy.

Look for a policy that offers no-gap extras for your kids and check that you’re covered for pregnancy if you’re planning to have more babies.

Children on parents’ health insurance

Raising kids is expensive. Fortunately, putting your children on your health insurance generally won’t cost you a cent. Your private health insurance will usually allow you to choose when and where your kids are treated.

There are also many lifestyle benefits that come with having them on your private health insurance, like dental, optical and physio. Besides that, generally no hospital excess is charged for children.

Take note; if you want to get pregnant and add your newborn to your health insurance, there is generally a 12 month waiting period before you can claim any pregnancy related services.

Can I buy health insurance for kids only?

Buying private health insurance for your child alone is rarely available in Australia. Although you might be able to find a fund that is willing to cover your kids without you, it may not be in your best interests, because most couple type policies provide cover for your children at no extra cost.

When will my kids stop being covered by my health insurance?

Australian private health funds will usually allow you to cover your kids up until they reach the age of 18. However, select health funds will extend this period when:

  • Your child is financially dependent on you, under the age of 21 and unmarried.
  • Your child is studying full-time, younger than 25 and unmarried.

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