Have you thought about a couples policy instead of two singles policies?
There’s virtually no difference between singles and couples health cover in terms of what’s offered. However, couples health insurance allows you and your partner to hold the same benefits under one account and pay one premium.
Plus, you might pay less in total on a couple’s policy than two singles policies – as we’ll explain.
It’s simply two adults under one health insurance policy, and it covers you and your partner as a private patient in a private or public hospital. Hospital cover helps you avoid public waiting list, choose your doctor and receive your own private room (if available).
While extras cover helps you pay for out-of-hospital services, such as dental, optical, physiotherapy and chiropractor, which aren’t covered by Medicare.
If you’re legally married or in a de facto relationship, you have two options when it comes to couples health insurance:
You can choose to have hospital cover only, extras only or hospital and extras (you can also include ambulance cover with your policy).
Do you need hospital and extras (combined policy)? Perhaps, you just need a standalone hospital or extras policy? Couples insurance inclusions will vary between health insurers and their levels of cover.
Hospital insurance helps cover the cost of your medical treatment when you’re admitted as a private patient in either a public or private hospital. A hospital policy can also include cover for:
All hospital insurance policies are now classified under Gold, Silver, Bronze or Basic tiers. The tier will determine which procedures will be covered (e.g. Gold is more expensive than Bronze, but includes more treatments).
There are also ‘Plus’ options of 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.
Sometimes called ‘general treatment’ or ‘ancillary’ cover, this type of policy helps pay for out-of-hospital medical services, such as:
Ambulance insurance 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 stand-alone policy.
In Queensland and Tasmania, state governments provide emergency ambulance services to residents for free. Pensioners and concession cardholders across the country also get some discounts on the price of ambulance transportation.
Additional waiting periods may also apply to your partner if they weren’t previously covered by any of the above policies (disregarding ambulance cover), or if you’re upgrading to a higher level of cover.
Taking out cover for two is the easiest way to ensure the following:
Couples health insurance can be of great value if you and your partner have similar needs. However, you don’t necessarily save.
For example, Sam and Jen have identical health needs, and they want to get health insurance. They compare their options separately, and each finds that the best-value singles policy for them costs $50 per month. They also research couples policies and find that this same policy has a ‘couples’ alternative, which costs $100 per month.
While there’s no guarantee that couples insurance is cheaper than a singles policy, you may find it handy that both of you are listed under one policy.
There are, however, a few caveats to consider. If you found that one of you had 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 some Plus hospital policies (e.g. Silver Plus). However, you don’t really need all the coverage that comes with a Gold policy and would rather a Bronze policy. Therefore, it might be cheaper if you each take out a singles policy.
No, whether you’re in a de facto relationship, married, or you fell in love overnight; health insurance premiums aren’t affected by marital status.
Yes, you can add your partner to your policy which will change the cover from a singles to a couples cover. Waiting periods for your partner and any additional services you add will apply.
It’s best to speak to an expert or your provider. In general, divorced couples shouldn’t share health insurance if they’re no longer in a relationship. Health insurers require you to be honest when it comes to your policy and when your circumstances change – including if you’re no longer married.
Failing to disclose this information may mean you’re not covered if you make a claim. Keep in mind that if you moved to a singles policy at the same level of cover as your couples policy, you’ll still be offered the same cover and won’t be subject to additional wait times.
You’ll also be able to add your kids to a single parent hospital or extras policy, which will entitle them to the same benefits as you – providing you’ve served your waiting periods. Find out more about how single-parent policies work.
It depends on the couple! For those with similar health statuses, a couples policy may be right for them. If, however, one of you wants cover for pregnancy, for example, you may be better off getting two singles policies instead – one that covers pregnancy, one that doesn’t.
In terms of providers, that’s something only you and your partner can decide on by comparing policies, prices and features on offer.
The Australian Government Private Health Insurance Rebate, which helps many Australians pay for private health, can be affected if you’re insured by a couples policy. The income of you and your partner are combined, and it’s this figure that determines a rebate suitable for you both.
From 1 April 2020, the thresholds for singles and couples are as followed.
|Policy Type||Base Tier||Tier 1||Tier 2||Tier 3|
|Singles||Less than $90,000||$90,001-$105,000||$105,001-$140,000||$140,001 and over|
|Families (couples)*||Less than $180,000||$180,001-$210,000||$210,001-$280,000||$280,001 and over|
*This includes single-parent families. The income thresholds are adjusted for families with more than one child, being increased by $1,500 for every dependent child after the first.
|Age||Base Tier||Tier 1||Tier 2||Tier 3|
Source: The Australian Government’s Private Health website1
1 PrivateHealth.gov.au – ‘Australian Government Private Health Insurance Rebate’ – Accessed 14/2/2020