Health insurance for ageing in place
Expert tips for choosing the right health insurance
Our health insurance expert, Steven Spicer, offers some tips on choosing health insurance for those wanting to age in place.
Steven Spicer
Executive General Manager – Health, Life & Energy
Adapt your policy as you age
Everyone’s health needs change as they age. The great news is that some health funds let you adapt your health insurance policy to suit your requirements. For example, some clinical categories, such as pregnancy and birth-related services, aren’t going to be necessary once you’re finished having kids. However, your chance of needing a joint replacement may increase in later life due to wear and tear. Taking factors like these into account will help you choose the best level of cover for you.
Consider ‘plus’ policies
Many procedures that seniors may need, such as cataract removal and joint replacement, are typically only available in Gold level policies. However, some funds may offer these clinical categories as part of a ‘plus’ policy (e.g. Silver plus). The right ‘plus’ policy could allow you to get additional inclusions while potentially paying less in premiums than the next level of cover.
Cheapest isn’t always best
Everyone loves to save money, especially during retirement, but you don’t want this to come at the expense of something you need. Instead of sacrificing the inclusions you need, consider comparing different policies from different health funds to look for the best deal for you.
What is ageing in place?
geing in place refers to older people choosing to stay in their home as they get older and their health needs change, rather than moving to a nursing home or residential aged care.1 Ageing in place doesn’t necessarily mean the person will remain in their current home; for example, they may choose to move closer to family, to a retirement village or downsize.
Ageing in place can be assisted through aged-care services and government initiatives such as the Support at Home program.2 In the right circumstances, ageing in place can contribute to healthy ageing and maintaining physical and mental health.
Advantages of ageing in place
With an ageing population in Australia, remaining at home is becoming more common. Some of the advantages of ageing in place include:3
- Independent living: Staying in your home can enable you to remain self-reliant.
- Maintain social connections: If you live near family members and friends, you can maintain these connections as you age at home.
- Maintain lifestyle: Keep your current lifestyle, hobbies and interests in a familiar environment.
- Reduce loneliness: Some people find the transition to aged care difficult and isolating, which can affect mental wellbeing.
- Keep familiarity: Moving is stressful and ageing in place allows you to stay in the comfort of your own home.
Potential downsides
Ageing in place won’t be the best choice for everyone, with some of the potential cons being:1
- Lack of access to assistance: Some older Australians require specialised healthcare and it may be difficult to receive this if they remain at home, especially if they live in a remote area.
- Costs of home modifications: Depending on the modifications required, the costs can begin to add up (however, aged care facilities can also be expensive).
- Safety issues: As we get older, everyday tasks become riskier. If an older person hurts themselves, they may struggle to get help, especially if they live alone.
- An unmanageable home: What was once a great family home may be too big for one person and many seniors wish to downsize.
Is ageing in place or aged care the best option?
Like many life decisions, there isn’t a universal answer that will suit everybody. The best choice will be the one that provides the best quality of life for a person and meets their care needs.
Signs that someone may be better off in aged care than ageing in place include:
- Difficulties with memory, thinking and planning
- Mobility difficulties
- Incontinence problems
- Communication problems.
What is the Support at Home program?
From 1 November 2025, the Australian Government will be replacing the Home Care Packages program with the Support at Home program.2 The federal government have designed the program based on recommendations from the Royal Commission into Aged Care Quality and Safety to support older people to live at home longer.
The goals of the Support at Home program include
- Helping with home maintenance and home modifications, including handrails and ramps
- Improved assessment and classification arrangements to provide better access to the program
- Bringing together existing in-home programs
- Improving daily living social support, home support and local community services
- Provide higher levels of care and caregiving services to allow more people to remain at home
- Better levels of care for those with complex health needs
- Improved focus on early intervention.
Am I eligible for Support at Home?
You’ll need to have an aged care assessment to determine what services and assistance you’ll require. The eligibility requirements for an aged care assessment are that you must be over 65; if you’re Aboriginal or Torres Strait Islander, or a person at risk of or experiencing homelessness, you must be over 50.
Health insurance for seniors in Australia
If you decide to age in place, health insurance can help cover the costs of staying healthy with necessary medical treatments and health services. While there isn’t a specific product called ‘senior health insurance’, you should still be able to find a policy that suits your health needs.
Unfortunately, as we age, we’re at a higher risk of many diseases. For example, while both prostate cancer and breast cancer have been diagnosed in younger adults, they’re far more likely in people over 50.
Factors that will help you decide on the right cover for you include:
- Your current health status
- Family and personal medical history
- Your age and the conditions you’re at a higher risk of developing
- Your lifestyle.
Hospital cover
Private hospital insurance may cover some or all of your costs for in-hospital treatments as a private patient; you can choose to be treated as a private patient in either a private or public hospital. Hospital cover is available in four tiers: Basic, Bronze, Silver and Gold.
While everyone’s health needs are different, here are some clinical categories worth considering for seniors:
- Heart and vascular system
- Joint replacements
- Cataracts
- Palliative care
- Insulin pumps
- Pain management
- Gastrointestinal endoscopy (including colonoscopy).
Extras cover
Extras health insurance covers out-patient treatments that aren’t typically covered by Medicare. Without insurance, you may need to pay the costs for many of these services entirely out of pocket.
While everyone is going to have their own unique health needs, certain health concerns are going to become more prominent with age. It’s a good idea to consider cover for:
- Dental: For dental check-ups, cleanings, fillings and some tooth extractions.
- Major dental: For more extensive procedures including complex fillings and dentures.
- Physiotherapy: This can help with muscle pain, mobility issues and recovery from some surgeries.
- Prescription glasses: While eye tests are typically covered by Medicare, without extras cover, you’ll likely have to pay for prescription glasses out of pocket.
- Non-PBS prescription medicines: Your policy may pay benefits towards some medications not covered under the Pharmaceutical Benefits Scheme.
- Hearing aids: The odds of hearing loss increase with age and some extras policies may pay benefits towards hearing aids.
How much does health insurance cost for seniors
Everyone’s health insurance needs are going to be different, so the exact cost of your policy will depend on your specific circumstances. The total cost of health insurance will vary depending on various factors, including:
- The type of hospital cover you choose
- The level of extras cover you choose
- Whether you hold a single or family policy
- Your choice of health fund
- Your age when you first purchase health insurance
- Where you live
- Whether you’re eligible for the Australian Government rebate.
Meet our health expert, Steven Spicer
As the Executive General Manager of Health, Life and Energy, Steven Spicer is a strong believer in the benefits of private cover and knows just how valuable the peace of mind that comes with cover can be. He is passionate about demystifying the health insurance industry and advocates for the benefits of comparison when it comes to saving money on your premiums.
Want to learn more than health insurance?
1 Australian Institute of Health and Welfare The desire to age in place among older Australians. Accessed July 2025
2 Australian Government Department of Health and Aged Care – Support at home handbook. Accessed July 2025.
3 irt.org.au – What is ageing in place? Accessed July 2025
4 My Aged Care – Caring for someone in an aged care home Accessed July 2025
5 Australian Housing and Urban Research Institute – What’s needed to make ‘ageing in place’ work for older Australians. Accessed July 2025