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Choosing a Family Health Insurance Plan

Megan Fraser Updated: 13 April 2022

Table Of Contents

Compare family health insurance options
How to choose a family health insurance plan?

You might be asking yourself if private health insurance is a good idea when you have a family. Private health insurance can be a great way to ensure that your family has access to high-quality healthcare. It can also provide peace of mind in case of an unexpected illness or injury.
There are many different types of private health insurance policies available, so it’s important to do your research and find the policy that best suits your needs. This article outlines the best family health insurance in Australia, medical insurance quotes for families, and general practices to consider when looking for family health cover.

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What is family health insurance?

Family private health insurance plans provide an affordable and comprehensive way to protect the whole family against major illnesses or accidents. You can cover up to six members with one policy, including yourself and your spouse and four children (or another dependent). The Australian healthcare system is world-class, and for those who access it, Medicare helps cover the cost of medical services. But what if you need some things that aren’t covered by this Government scheme?

If your family needs protection against many common procedures or consultations, then getting Family Health Insurance would be worth considering. They can protect them from any unexpected expense while also giving peace of mind knowing everything will come out okay should anything happen.

Family health insurance policies can be a great way to protect yourself and your loved ones from costly medical emergencies. These plans offer coverage for you, as well as those in similar relationships with the policy-holders such as age 21 or 25 if they’re full-time students who need additional help managing their education costs.

Typically, Hospital cover insurance policies come in four main categories – basic, bronze, medium and gold. There’s also a plus version of each tier that offers more coverage than the standard policy, such as silver plus, which provides full hospitalisation service. Below are the different types of coverage included in family health insurance plans:

Hospital cover for families

Hospital cover is important because it provides you with the necessary funds for any treatments and services performed within a hospital for you or your family. If your private healthcare provider offers hospitalisation services, they will cover all costs related to in-hospital treatments, including accommodation and even surgery. There are generally four options: Basic, Bronze, Silver, and Gold.

Each come with their own range of benefits and waiting periods.

Family Extras cover

The extras cover, also known as ancillary or general treatment services, are a benefit toward the cost of out-of-hospital treatments that manage or prevent disease. For example, optical and dental care may be covered under this policy type. Private health insurance in Australia can be purchased as a stand-alone product or combined with Hospital cover. Extras only coverage comes in three tiers, being Basic, Mid, and Top. These various levels offer a certain amount of coverage and specific excess amounts to cover your family treatments and services.

Combined Hospital and Extras

With Combined Hospital and Extras, you have access to health care treatments both inside the hospital and outside. For example, if someone has an accident in which they are treated at a dental clinic for toothache, this would count against their general medical treatment plan instead of just receiving it from inside the attending physician’s office or private patient room.

The amount that can be claimed depends on the kind of insurer with different levels providing varying benefits.

Do you need family health cover?

Buying health insurance is one of the best ways to ensure that you and your family stay healthy. It provides peace of mind and protects against high costs related to medical treatment, which can be quite expensive when not covered by an employer or personal plan alike.

Other benefits to purchasing Family Health Insurance includes avoiding long waiting periods, having the option to select your own doctor, and securing private hospital rooms when you need them.

Does your family structure affect your health insurance requirements?

The decision to buy health insurance is not an easy one. You must consider your family structure, the type of cover you require for yourself and those in it, as well as what the specific policies may cover treatments if anything were ever happening with any members.

If you’re starting a new family, choosing the right health insurance plan is important before getting pregnant. You need coverage that offers great benefits for expectant mothers, including ante-natal or postnatal training classes if you want them covered during your pregnancy. If you have young children in your family, the best private health insurance for young children is designed to cover the injuries and conditions most commonly found in childhood. As your children grow, their needs will likely change. You might want to remove some benefits and add others such as mental health cover or orthodontics to get what they need from insurance coverage without being too limited by it.

Compare family health insurance options

Healthcare is expensive. But with the wide range of health insurance companies out there, you’re sure to find one that offers cover options tailored just for your family’s needs and circumstances – whether it be medical services or treatments not covered Medicare-wise. To cater to your unique family medical requirements, it’s of vital importance to compare various insurers and cover plans before making your choice. Below is a list of the top family health insurance companies and their benefits.

NOTE: The policies provided below are general family health care plans and can differ from the plan you select for your family.

Types of family structures

The type of health insurance you opt for will generally depend on your family structure. Whether you are a new family, or you have grown children who are still studying or are a single parent may influence the type of cover you require for your family and their requirements.

Defence Health Limited

Premium: $729.38 (Gold Package)

Common inclusions:

Assisted reproductive services
Back, neck and spine
Bone, joint and muscle
Heart and vascular system
Palliative care
Pregnancy and birth
Chemotherapy, radiotherapy
Ear, nose and throat

Exclusions:

None from Gold Policy

Waiting periods:

2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
12 months for other pre-existing conditions
12 months for pregnancy and birth (obstetrics)
2 months for all other treatments

ahm Health Insurance

Premium: $584.00 (deluxe flexi silver plus)

Common inclusions:

Back, neck and spine
Eye (not cataracts)
Miscarriage and termination of pregnancy
Blood
Gastrointestinal endoscopy
Pain management
Bone, joint and muscle
Gyneacology
Pain Management with device
Brain and nervous system
Heart and Vascular system
Pallivative Catre
General Dental
Chinese medicine
Orthotics (podiatric orthoses)
Physiotherapy

Exclusions:

Blood glucose monitors
Non-PBS pharmaceuticals
Psychology
Hearing aids
Orthodontic

Waiting periods:

2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
12 months for other pre-existing conditions
2 months for all other treatments

CBHS Health fund

Premium: $754.34 (Gold Package)

Common inclusions:

Heart and vascular system
Palliative care
Brain and nervous system
Breast surgery (medically necessary)
Pregnancy and birth
Chemotherapy, radiotherapy and
immunotherapy for cancer
Diabetes management (excluding
insulin pumps)
Joint replacements
Dialysis for chronic kidney failure
Ear, nose and throat

Exclusions:

None on Gold Policy

Waiting periods:

2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
12 months for other pre-existing conditions
12 months for pregnancy and birth (obstetrics)
2 months for all other treatments

GMHBA Limited

Premium: $471.30 (Silver Package)

Common inclusions:

Back, neck and spine
Eye (not cataracts)
Miscarriage and termination of
pregnancy
Blood
Gastrointestinal endoscopy
Pain management
Brain and nervous system
Heart and vascular system
Rehabilitation
Chemotherapy, radiotherapy and
immunotherapy for cancer
Implantation of hearing devices
Skin

Exclusions:

Assisted reproductive services
Insulin pumps
Pregnancy and birth
Cataracts
Joint replacements
Dialysis for chronic kidney failure
Pain management with device
Weight loss surgery

Waiting periods:

2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
12 months for other pre-existing conditions
2 months for all other treatments

Peoplecare Health Insurance

Premium: $693.38 (Gold Hospital $750 & High Extras)

Common inclusions:

Chemotherapy, radiotherapy and
immunotherapy for cancer
Insulin pumps
Rehabilitation
Dental surgery
Joint reconstructions
Skin
Diabetes management
Joint replacements
Sleep studies
Dialysis for chronic kidney failure
Digestive system
Lung and chest
Weight loss surgery
Ear, nose and throat
Male reproductive system
Podiatry
Physiotherapy

Exclusions:

None on this policy

Waiting periods:

2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
12 months for other pre-existing conditions
2 months for all other treatments
12 months for pregnancy and birth (obstetrics)

Medibank Private Limited

Premium: $1,060.00 (Gold Package)

Common inclusions:

assisted reproductive services
Eye (not cataracts)
Miscarriage and termination of
pregnancy
Palliative care
Brain and nervous system
Breast surgery (medically necessary)
Pregnancy and birth
Chemotherapy, radiotherapy and
immunotherapy for cancer
Insulin pumps
Rehabilitation
Major dental
Chiropractic
Acupuncture

Exclusions:

None under the Gold policy

Waiting periods:

2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
12 months for other pre-existing conditions
2 months for all other treatments
12 months for pregnancy and birth (obstetrics)

AIA Health Insurance

Premium: $725.57 (Silver Plus Hospital Ultimate 750 and Enhanced Extras)

Common inclusions:

Assisted reproductive services
Eye (not cataracts)
Pain management
Back, neck and spine
Gynaecology
Palliative care
Bone, joint and muscle
Heart and vascular system
Optical
Major Dental
Physiotherapy

Exclusions:

Weight loss surgery

Waiting periods:

2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
12 months for other pre-existing conditions
2 months for all other treatments
12 months for pregnancy and birth (obstetrics)

Phoenix Health Fund Limited

Premium: $583.61 (Silver Plus Advantage 750 & Everyday Extras 60)

Common inclusions:

Back, neck and spine
Pain management
Bone, joint and muscle
Brain and nervous system
Breast surgery (medically necessary)
Cataracts
Podiatric surgery
Joint replacements
Dialysis for chronic kidney failure
Digestive system
Lung and chest
Ear, nose and throat
Male reproductive system
Orthodontics
Podiatry
Remedial massage

Exclusions:

Hearing aids
Assisted reproductive services
Sleep studies
Pregnancy and birth
Weight loss surgery

Waiting periods:

2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
12 months for other pre-existing conditions
2 months for all other treatments

How to choose a family health insurance plan?

Health insurance for a family can be difficult to manage, but it’s important that you find the right company. To make sure your needs are met and covered fully under any plans offered by various providers consider combining hospital coverage with extras such as prescription drugs or mental health services. This way, if there is an issue in one area of care, someone will still provide access until they get back on their feet. Remember that you have the option to combine a range of Hospital and Extras policies to cater for your unique family situation.

Below are a few aspects you may want to take into consideration:

Your family structure, whether you’re starting a family, have growing children, or your kids are leaving for university.
The number of family members that require coverage.
Your specific budget and the costs of each policy.
The age of each family member.
Any pre-existing conditions that run through the family.
Your family’s overarching lifestyle and healthcare needs as a result of it.

Your family’s overarching lifestyle and healthcare needs as a result of it.

The cost of family health cover in Australia varies depending on your choice. The average monthly premium you can expect for a Gold policy with Top extras combined is around $222 up until $950, while a Bronze plan can cost around $100 per month.

It’s important to note that each hospital has different rates, so make sure before buying anything too soon. Some may contain extra fees, which could eventually bring the total price over what was expected. The higher your choice of Hospital and Extras excess, the lower your premium will generally be.

Frequently asked questions and answers

Which policy is best for family health insurance?
The policy you require depends entirely on your family’s healthcare needs and your budget. One important factor that you should consider when selecting an appropriate plan for your needs is whether any members in tow have chronic conditions which may lead them towards certain types of injuries specific illnesses such as diabetes. A Family Health Insurance Policy can be beneficial because it provides coverage no matter how old anyone becomes and ensures peace of mind knowing there’ll always be someone who cares if anything happens unexpectedly.
How many times we can claim health insurance in a year?
Private health insurance is an excellent way to ensure that you’re fully covered for any medical services not available or only partially covered by Medicare. The insurance company will generally cover unlimited claims during the policy tenure, depending on what you are insuring and how much it costs. There’s always a chance that your limit for the sum insured might get exhausted in two or three initial incidents.
Can I add my wife to my health insurance?
Yes, you can add your wife to your health insurance plan as a dependant, although this depends entirely on your level of coverage. After getting married, you have up until 60 days before the new year (or longer), at which time it’s possible for one spouse or other family members could enrol with their plan. But this will only work if they don’t already have coverage through an employer who offers dependent benefits-eligible candidates.
What should I check before getting health insurance?
You might want to take into account the age and lifestyle of your family members, as well as their medical history. There are also some other factors that you should consider before deciding on what kind of extras cover would be appropriate for them: How long will this policy last? What does it include? Does my loved one need emergency care? Always review and compare multiple health insurance companies and their different policies before making your final choice.
Who should opt for a family medical insurance plan?
Generally speaking, all families should consider taking out a family health insurance plan to protect each family member from the hefty costs linked to medical care. It’s especially important for new families getting ready for their first children or having kids prone to pre-existing medical conditions. Large families may find it near impossible to cover the costs of medical conditions, services, and treatments. That’s where health insurance comes in, as it assists in paying for the variety of expensive treatments.