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Family Health Insurance in Australia

Megan Fraser Fact Checked Updated: 20 November 2023
Types of Health Insurance

Family health insurance in Australia covers medical expenses for all members without high out-of-pocket costs. Services include hospital treatments, GP visits, and allied health services. Premium rates depend on coverage type, eldest member’s age, and family size. Government rebates make it affordable for many families.

Australia’s healthcare system has two models: public and private. Public healthcare, funded by Medicare, is free or low-cost but has limitations in waiting times and doctor choice. Private health insurance fills these gaps by offering faster access to specialists, choice of hospital, and additional services not covered by Medicare. Private health insurance is popular among Australian families.

Key facts

  • Family health insurance covers medical expenses for all members, ensuring reduced out-of-pocket costs.
  • Private health insurance offers benefits like faster access to specialists, choice of hospital, and services not covered by Medicare.
  • Choosing the right cover involves considering family structure, medical needs, budget, age of members, pre-existing conditions, and lifestyle.

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Types of family health insurance

Type of CoverKey Features
Family Hospital Cover– Cover for private patient treatment in hospitals.
– Choice of doctor for in-hospital treatment.
– Four main tiers: Gold, Silver, Bronze, Basic. Plus versions for extra treatments.
Family Extras Cover– Cover for non-hospital services (e.g., dental, optical).
– Coverage varies by insurer.
– Benefits can include dental, optical, physiotherapy, chiropractic, and more.
– Check policy for specific treatments covered.
Combined Family Hospital & Extras Cover– Both Hospital and Extras cover in one.
– Option to mix and match policies to fit family requirements.

Which type of cover is right for my family?

When choosing health insurance for your family, it’s important to consider your medical needs, financial situation, and future plans. If you prioritise hospital treatments, Hospital Cover is suitable, while Extras Cover may be more appropriate for services like dental or physiotherapy. For comprehensive protection, Combined Hospital & Extras Cover is a good choice. Be sure to carefully review policy details and anticipate future needs to make an informed decision.

Additional considerations

There are several benefits to having family health insurance, including the ability to claim additional benefits that are not covered by Medicare, avoiding the Medicare Levy surcharge, reducing wait times for surgeries, choosing your preferred doctor, and providing peace of mind. However, it is important to keep certain considerations in mind. For instance, some treatments may have exclusions, not all dependent children may be covered, and there can be waiting periods.

Family Health Insurance and the LHC Loading

The LHC Loading is vital in Australian family health insurance. It encourages early and consistent private hospital insurance. Not having it after turning 31 results in 2% loading on premium per year. Eldest members’ LHC status affects family premiums. The loading can reach 70% but is removed after 10 years of payment. Special provisions exist for those born before July 1934 or those overseas during their 31st birthday.

Considerations for Families:

Compare family health insurance policies

Deluxe Flexi Silver Plus – AHM Health Insurance

Gold Ultimate Health Cover – Bupa HI Pty Ltd

Premium Package (Gold) – CBHS Corporate Health Pty Ltd

Premium Package (Gold) – CBHS Corporate Health Pty Ltd

Silver Plus Hospital $750 & Premium Extras – Peoplecare Health Insurance

How to choose a family health insurance plan

Selecting the right one for your family is a crucial decision, but it can sometimes be overwhelming. For comprehensive coverage, it’s advisable to combine hospital care with additional benefits like prescription medications and mental health support. This way, you’ll have continuous support in multiple healthcare domains, even if challenges arise in one area. It’s worth noting that you can tailor and mix different Hospital and Extras policies to best fit your family’s unique requirements.

When evaluating options, consider the following factors:

  • Family Dynamics: Whether you’re just beginning your family journey, navigating the challenges of raising children, or adjusting to an empty nest as kids head to college.
  • Coverage Needs: The number of family members needing insurance.
  • Budgetary Constraints: Your financial limits and the associated costs of potential policies.
  • Age Factors: The age of each family member, as this can influence policy terms and premiums.
  • Medical History: Any hereditary or pre-existing conditions in the family.
  • Lifestyle Considerations: Your family’s overall way of life and the consequent healthcare requirements.

Frequently Asked Questions and Answers

  • Which health insurance is best for family?

    The best health insurance for a family largely depends on the specific needs and circumstances of that family. Factors to consider include the number of family members, their ages, any pre-existing conditions, and the desired range of coverage. It’s essential to compare various policies, taking into account the coverage they offer, their premiums, and any additional benefits. Consulting with an insurance advisor or using online comparison tools can help in making an informed decision.
  • Is family private health insurance worth it?

    Investing in family private health insurance can offer peace of mind, ensuring that your family has access to timely medical care without the long wait times that can sometimes be associated with public healthcare systems. Additionally, private health insurance can cover services not always available or fully covered by public health, such as certain dental, optical, and physiotherapy treatments. However, whether it’s “worth it” depends on your family’s health needs, financial situation, and personal preferences regarding healthcare providers and facilities.
  • What is the difference between couples and family health insurance?

    Couples health insurance is designed to cover two adults, typically in a romantic relationship, without any children. On the other hand, family health insurance is tailored to cover a family unit, which usually includes two adults and their dependent children. Some family policies might offer coverage options for extended family members or allow adjustments based on the number of children or their ages.
  • What age does health insurance stop covering children?

    The age at which health insurance stops covering children as dependents varies by policy and region. Typically, many insurance plans will cover children up to 18. However, if the child is a full-time student, the coverage might extend to ages 23 or 25. Some policies also have provisions for children with disabilities, allowing them to remain covered under the family policy beyond the typical age limit. It’s crucial to check the specific terms of your insurance policy to determine the exact age limit.
  • Why should you get private health insurance before 30?

    Private health insurance before turning 30 can be financially advantageous in many regions. In some countries, government policies impose a Lifetime Health Cover (LHC) loading, which means that for every year you are aged over 30 and do not have private hospital cover, a 2% loading is added to your premium. Securing private health insurance before 30 allows you to lock in a lower premium rate and avoid these additional charges. Additionally, having insurance early on ensures coverage should unexpected health issues arise.

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