Get Affordable Health Insurance for Children

Published: April 12, 2019

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.

Most private health insurance companies in Australia will generally allow you to add children to your couple’s or family health plan at no extra charge; this implies ‘free’ health insurance for children, making affordable coverage for the entire family possible.

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.

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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.

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

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Can I get private health insurance for my child only?

Buying child only health insurance in Australia is very rare. Although you might be able to find select funds that are willing to cover your kids without you, you can generally include your children on your couple’s health insurance policy at no extra cost and thus provide your entire family with private health cover.

How to add children on parents' health insurance

To add a kid to your singles or couple’s policy, you’ll typically need to upgrade to a family health insurance plan or a single-parent policy, depending on your circumstances. However, if you've upgraded from a singles plan to a policy with increased or different benefits, then relevant waiting period will apply, and you might have to pay a higher premium.

Couples policies usually cost the same as a family policy so that upgrading won't usually change your premium very much.

If you want to add your newborn to your couples or family policy, then be sure to do so within the required period as stipulated by your health fund, which is generally two months.

Important: When planning to get pregnant, you might want to upgrade your policy as soon as possible because there is generally a 12 month waiting period before you can claim any pregnancy and birth-related services.

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.

Child dependent

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.

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, and they might require a letter from the school or registered training group confirming their participating in full-time studies.

Adult dependent

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.

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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.
  • Physiotherapy.

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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4 Comments

  • Paul McCann |

    Hi,
    It’s a long story, so bear with me.

    I have recently separated. Prior to separating, my wife and our three young children (aged 6,7 and 8) had Family cover with HCF. We changed to Medibank last year.

    When we separated my ex-wife and the kids remained with Medibank. I went back to HCF and now have the top singles coverage (approx $200 month).

    My ex-wife recently cancelled her policy with Medibank and asked me to take the kids onto my policy.

    I need a policy that includes my 3 children for no extra payment. Can you recommend an Insurer? HCF want to double my premium to include the children.
    With thanks.

    • SPECIALIST
      Anneke Van Aswegen |

      Hi Paul, thank for reaching out.
      Because I’m not familiar with your specific requirements, for example, the age of your children and the type of coverage they might need, I suggest giving our consultants a call on 1300 786 328 or fill in the quote form above and one will contact you.

  • Peggy |

    I am a grandparent that needs to purchase medical insurance for my 16 year old grand daughter that lives with me. I make too much money to cover her under CHIPS. What are my options for a private policy just for her.

    • SPECIALIST
      Anneke Van Aswegen |

      Hi Peggy. Thanks for reaching out.

      Generally, you can’t purchase child-only private health insurance, but will need a policy that covers both you and your granddaughter. Please complete the quote form above and a specialist will give you a call to help find a policy suited to your requirements.