Compare health insurance for couples

A couples policy usually includes the same services you can find under a singles policy, such as hospital cover (for hospital treatment as a private patient) and extras cover (for outpatient services such as dental, optical and physiotherapy). Like with singles cover, the specific inclusions, limits and benefits included in a couples policy will depend on the health fund and level of cover. Always refer to the relevant policy documentation for details about your cover.

The exact treatments and services you’re covered for will depend on the specific policy and whether you have a hospital, extras or combined policy.

Hospital cover

Hospital cover pays a benefit towards the cost of your medical treatment when you’re admitted as a private patient in either a public or private hospital and meet the relevant eligibility criteria. A hospital policy can also pay a benefit towards:

• Theatre and hospital accommodation fees
• Patient meals
• Palliative care
• Prostheses
• Diagnostic tests
• Drugs, dressings and other medical supplies.

All hospital insurance policies are now classified under Basic, Bronze, Silver and Gold tiers. The tier will determine the hospital treatments you’re covered for (e.g. a Bronze hospital policy is generally cheaper than Gold, but covers fewer treatments).

There are also ‘Plus’ policy options for the Basic, Bronze and Silver tiers, meaning they offer more than the minimum cover of the category but not all of the services in the next category up. For example, a Bronze plus policy might cover you for lung and chest which is typically not in a standard bronze policy.

Extras cover

Sometimes called ‘general treatment’ or ‘ancillary’ cover, extras cover helps pay for eligible out-of-hospital medical services, such as:

• Preventative and general dental treatment (including dental check-ups)
• Optical, including glasses and contact lenses
• Physio and remedial massage therapies
• Orthodontic treatment
• Chiropractic treatment.

If you and your partner are covered under the same extras policy, you will most likely share your annual limits and may be subject to additional limits, such as per-person limits.

Ambulance cover

Ambulance cover can help you cover the cost of emergency transport or other ambulance services, as Medicare doesn’t cover this. You can get this type of cover as part of your hospital or extras cover or as a standalone policy.

Not everyone will need this cover, though. In Queensland and Tasmania, residents are not required to pay for emergency ambulance services within their state. In Victoria, South Australia and Western Australia, you can get an ambulance subscription through the government. However, you can also get ambulance cover through some private health insurance policies if you prefer. In the ACT and New South Wales, you can only get ambulance insurance through private health cover. Pensioners and concession cardholders across the country can get discounts on ambulance transportation costs.

For more information on ambulance cover and the differences between states, see our guide to ambulance cover here.

No, usually couples health insurance costs the same as two singles policies which offer equivalent cover. This is due to Australia’s community-rating rules which ensures health insurers don’t increase premiums for members based on health status, age or claim history. The main benefit of a couples insurance policy is convenience rather than direct dollar savings. If you and your partner have different cover needs, it may be more cost-effective to purchase two separate policies rather than couples cover.

For example, Sam and Jen have identical health needs, and they want to get health insurance. They compare their options separately and discover that the best-value singles policy for them costs $50 a month. They also research couples policies and find that this same policy has a ‘couples’ alternative, costing $100 a month.

While their couples insurance policy isn’t cheaper than two singles policies, they may find it helpful to be covered under the same policy and only pay one premium.

However, there are a few caveats to consider; if one of you has different, more expensive health needs, it may be cheaper for you to take out separate singles policies.

For instance, let’s say your partner needs a joint replacement. This service is only available under a Gold hospital policy or certain Plus hospital policies (e.g., Silver Plus). However, you might be fine with a lower level of hospital cover and would rather have a Bronze policy. In this case, it might make more sense if you each take out a singles policy. Otherwise, you’ll both be paying higher premiums for a Gold-tier policy when only one of you is taking advantage of this comprehensive cover.

Your marital status won’t affect your insurance premiums. Premiums will be the same whether you’re in a de facto relationship or married. Details such as your respective health needs will play a bigger role in determining your premiums.

The Australian Government rebate, which helps many Australians pay for private health insurance, can be affected if you’re insured by a couples or family policy. The income of you and your partner may be combined, and it’s this figure that determines a rebate suitable for you both.

The federal government plans to remove higher age-based private health insurance rebate tiers from April 1, 2027. For Australians aged 65-69 earning under $105,000 as a single or $210,000 will see their rebate dropped from 28 to around 24 per cent. For those above 70 in the same income brackets, their rebate will drop from 32 to around 24 per cent.

The Lifetime Health Cover (LHC) loading is designed to encourage Australians to take out hospital cover earlier in life by increasing their hospital premiums by 2% for each year they don’t hold hospital cover after the age of 30. For a couples policy, LHC loading will be calculated by averaging the individual loading percentages of each policyholder.

For example, say you’re 40 years old and have never held a hospital policy. If you choose to take out hospital cover now, you’ll have to pay an additional 20% on top of your base hospital premium. For couples, your LHC loading is averaged between the two of you. So, if you’re 40 years old and paying a 20% loading, and your partner is 50 years old paying 40%, your loading on a couples health insurance policy would be 30%.

As with any policy, the best policy for young couples varies depending on their specific needs. For those with similar health statuses, a couples policy may be the right cover for them. However, if one of you wants cover for pregnancy and obstetrics, for example, you may be better off getting two singles policies instead – one that covers pregnancy and one that doesn’t. Whether you purchase two singles policies or a couples policy, your policy can still help you avoid Medicare Levy Surcharge and Lifetime Health Cover Loading.

In terms of providers, that’s something only you and your partner can decide on by comparing a range of policies, prices and features on offer.

Yes, you can add your partner to your policy (provided your policy is available to couples), changing your cover from a singles to a couples policy. Be mindful that your partner will need to serve the waiting periods for any additional or upgraded services that have been added.

Usually, a divorced couple won’t be able to share health insurance, as couples health insurance is designed for those in a domestic or romantic relationship. While every relationship is different, health funds may require you to fit their definition of a couple to qualify for a couple’s policy (e.g. marriage, de facto or domestic relationship).

Since there is no financial benefit to staying on the same cover, it’s strongly recommended that you switch to separate singles policies after a divorce. While there’s no legal reason a couple can’t stay on the same health insurance after separating, doing so is against the rules of many health funds. If you fail to inform your health fund that your details have changed, you may no longer be covered and, therefore, be unable to make a claim. These rules vary between health funds, so you should reach out to your insurer to learn how you could be affected.

If you move to a singles policy with the same level of cover and benefit limits as your couples policy, you’ll still be offered the same cover and won’t be required to re-serve your waiting periods.

You’ll also be able to add your kids to a single-parent hospital, combined or extras policy, which will entitle them to the same benefits you have – provided you’ve all served your waiting periods. Find out more about how single-parent policies work.