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How to Choose a Family Health Insurance Plan
AHM
AIA Health Insurance
Australian Unity Health
HCF
HIF
NIBWhether you are planning on starting a family, have dependant children or are a single parent, you may be wondering whether it is a good idea to get private health insurance. When looking for family cover, people generally look for an insurance fund that covers the broadest range of services and treatments while still offering value for your money.
There are a wide variety of health insurance companies that offer a range of cover options that may suit your families requirements and circumstance. This can be used to help pay for medical services and treatments that may not be covered by Medicare.
Use this article to learn more about selecting private health insurance for your family and how to choose the best family health cover to suit your requirements.
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What is family health insurance, and how does it work?
Generally, a family health insurance policy will combine both hospital and extras cover to provide protection for you, your partner and your children to cover the costs of medical services and treatments such as dental, pregnancy services, optical and physiotherapy.
A family health insurance plan generally gives you access to a private room in a private or public hospital. It also gives you the ability to choose your doctor, gives you access to dental services including orthodontics and wisdom teeth removal, optical including glasses and contact lenses, physiotherapy and ambulance services. However, this may vary according to the type of policy you opt for.
Hospital cover for families
This type of health insurance generally covers the costs associated with in-hospital treatments and accommodation as a private patient in a public or private hospital. There are several different levels of cover available to choose from when you are looking to apply for hospital cover. Depending on the level of cover you opt for, your insurance may include things such as prostheses, ambulance services, and pregnancy-related treatments.
Although private hospital insurance generally covers the cost of in-hospital services performed by a doctor, as well as accommodation and theatre fees, you might be required to pay an excess upon admission. In addition to this, your policy might cover the cost of the remaining Medicare Benefits Schedule (MBS) fees not covered by Medicare. However, this will generally depend on the amount your doctor wishes to charge for treatment and the level of care that you have chosen. Some funds also include gap cover, which can help to reduce your out-of-pocket expenses when you receive treatment in a hospital.
Family Extras cover
Extras cover is also known as ancillary cover or general treatment services. This type of cover provides a benefit towards the cost of out-of-hospital treatments that are intended to manage or prevent a disease, injury or condition. Extras cover usually helps to reduce out of pocket costs for services such as physiotherapy, vaccinations or chiropractic care.
Generally, you have the option to take Extras cover as a standalone policy, or you have the option to combine it with Hospital cover. Whether you chose a standalone policy or combined cover depends on several factors. This includes past and current health conditions, your family structure, your age and budget.
Combined Hospital and Extras
Most private health insurance companies provide you with the option to combine Extras cover with your preferred Hospital cover. This allows you to create a tailored package to suit your unique requirements. Some funds also provide pre-packaged options that you can choose from. This generally, can help to reduce out of pocket costs associated with services and treatments such as ear, nose and throat, dental and acupuncture.
However, it is important to note that there are different levels of cover that will provide you with a varied range of benefits, depending on your cover choice. Generally, Hospital cover options include Basic, Bronze, Silver and Gold. Each cover option lists various benefits, restrictions and exclusions. Usually, the higher your Hospital cover, the more benefits you’ll receive and the higher your premium will likely be. When applying for Extras cover, you generally have the option to choose between three different levels of cover; Basic, Medium/Mid or Top/Comprehensive cover. Just like with Hospital cover, the higher the tier, the more extras options will be available to you, and the more you will be likely to pay.
Why do you need health insurance for your family?
There are several benefits to taking out private health insurance for your family. It can help to support your family financially by covering some or all of the costs for treatments and services not paid by Medicare. The wide range of cover options on offer by health insurers generally means that you’ll be able to choose a policy to suit your unique requirements.
Some of the advantages of family private health insurance include:
- Only having to pay a single premium and receive coverage for your entire family.
- Simplify your admin by only having to keep track of one policy.
- Save money on your taxes. You could be eligible to receive the Australian Government Rebate, thus reducing the premium you pay, or you can claim it through your tax return.
- Some health funds do not require that you pay Hospital excess for children under 21 years old.
- Avoid waiting lists for elective surgeries.
- Typically, a family policy will include emergency ambulance services.
- Depending on your choice of family health cover, you might have access to pregnancy and birth-related services, assisted reproductive services like IVF and can claim benefits on pre-natal classes.
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.
- New or growing family: You may wish to choose health insurance with good pregnancy benefits as well as other benefits such as ante-natal or post-natal classes. It is important to note that you cannot claim pregnancy-related services until you have served the 12 month waiting period.
- Family with young children: When you have young children, it may be better to look for private health insurance that covers injuries and health conditions that may commonly occur in childhood. You may want cover for treatments and services like physiotherapy, optical, dental, ambulance cover, occupational therapy and speech therapy.
- Family with older kids: As your kids grow, their needs will likely change. Therefore, you may want to remove some benefits and add others, such as mental health cover or orthodontics.
Which health insurance is best for a family?
Generally, most private health insurance funds in Australia allow you to combine a Hospital policy with an Extras policy. This will enable you to create a personalised private health insurance plan. However, some health funds also allow you to choose from their pre-packaged family health insurance plans. Refer to the table below for some examples of the cover options available:
| Health Fund | Policy Name | Benefits Provided |
|---|---|---|
| AHM health insurance | Classic package- Silver Plus |
|
| Australian Unity Health Limited | Advantage Choice Combination (Silver Plus) |
|
| GMHBA Limited | GMHBA Silver Package |
|
| HCF | HCF MY FAMILY SILVER PLUS $750 EXCESS |
|
| Medibank Private Limited | Medibank Silver Plus Families |
|
| AIA Health Insurance | Silver Plus Hospital Advantage 750 and Lite Extras |
|
Source: privatehealth.gov.au. The above information was based on Combined Hospital, and Extras cover for two adults with dependents, living in NSW (March 2020).
How to choose a family health insurance plan?
When looking for the best family cover health insurance, you should remember that every family is different. Therefore, you may want to look for a health insurance company that will best suit your requirements, and family structure or that will allow you to create your policy. To do this, you can combine a range of Hospital and Extras policies to cater for your unique situation. Things you may want to take into consideration when creating your family plan include:
- Your family structure, for example, if you are starting a family, have a growing family, are a single parent, or an established family.
- How many family members you want to be covered.
- What you can afford.
- The age of each person in your family.
- Specific health care needs of each family member.
- Whether any of you have pre-existing medical conditions.
- If and when you’re planning to get pregnant.
- Your family’s overall lifestyle. For example, whether your kids participate in sports.
How much does family health insurance cost per month?
The average monthly premium you can expect to pay for family health cover in Australia is between $222 up to $970, depending on the Hospital policy (Gold, Silver, Bronze or Basic) you combine with your chosen Extras plan (Top, Medium or Basic). Likewise, the higher your choice of Hospital excess, the lower your premium will generally be.
Frequently asked questions and answers.
How do you add a family member to your health insurance?
Your children can generally remain on your family policy until they’re considered adults, typically age 18. However, if your child is between the ages of 21 and 25, they can usually stay covered when studying full-time and are unmarried or if they’re still financially dependent and under the age of 21 and unmarried.What is the best health insurance for military families?
The Defence Health Fund offers ADF personnel private health insurance. They have 3 Hospital and 3 Extras policies to choose from as well as 2 ADF specific pre-packaged options that combine a range of Hospital and Extras into one policy.Can you put non-family members on your health insurance?
Generally, you’ll only be able to add family members to your health insurance. You do, however, have the option to add your de facto spouse to your private health insurance. A de facto relationship is made valid when a couple lives together for two years without any separation.What is the average cost of health insurance for a family of 4?
Many health funds in Australia will allow you to add children to your health insurance policy free of charge. So, you’ll essentially pay between $200 and $1,000 (depending on the level of Hospital and Extras chosen) for a family policy regardless of how many children you have.Can you get ambulance insurance for your family?
If you don’t live in Queensland or Tasmania, you generally won’t receive free ambulance insurance from your government. So you may want to consider purchasing ambulance cover from a private health insurance company. Emergency ambulance services for the whole family is generally included in both Hospital and Extras plans, although select insurers do sell ambulance only coverage.
