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We all want to make sure our children are protected, and private health insurance is one of the best ways to make sure they’re covered if a medical need arises. Fortunately, you can cover your children and dependents with health insurance using a family policy.

The benefits of health insurance for kids and dependents

When your child falls sick, it can be an incredibly stressful time. So, if you can ensure they’re seen to faster, by specialists you select, it can be well worth the investment into private cover.

With private hospital cover for your family, you’ll receive benefits towards being treated in a private hospital, meaning you get to avoid public waiting lists for elective surgery. Your child will get to stay in a private room, if one is available, and there might even be a bed for a parent or family member to stay with the child during their stay.

Private health insurance also lets you choose the doctor or specialist your children see, which can be comforting for parents as you see a familiar face during treatment.

You can get some of the cost for treatment undertaken outside of hospital paid back with an extras policy. Also known as ancillary cover, it can cover services like dental treatment, prescription glasses, physiotherapy, psychology, pharmaceuticals and medical devices like hearing aids.

Depending on the healthcare needs of your child, extras cover can help reduce out of pocket costs for a number of medical expenses (e.g. if they require braces).

How can I cover my dependent children with health insurance?

Dependent children can be covered under your health insurance policy as long as you select the correct family status and provide their details on your application. Your kids and dependents will fall into one of three different categories:

  • Child dependents: unmarried children under 18 years old (although some funds allow up to 25, even if they are not studying)
  • Student dependents: single full-time students, trainees or apprentices generally between 18-25 years old
  • Adult dependents: single adults not studying full-time aged between 18 and 25 years old

Your family status can be for either two-parent or single-parent households. Dependant children rules vary from fund to fund, so talk to your Health Fund to ensure that your child can be covered.

Adding a new baby to your family’s policy

a father holds his son in the nursery

If you’re welcoming a new addition to your family, there are a few things to sort out to get them added to your Medicare card and health insurance policy.

  • Newborn Child Declaration form: this will be provided by the hospital or midwife in a Parent Pack, and must be signed by a doctor or midwife when the baby is born.
  • Birth certificate: this is also necessary when enrolling your child into Medicare. You’ll receive a new Medicare card which has their name and Medicare number.

Having proof of birth and Medicare details for your baby will help when it comes to any paperwork that may be required by your health insurer when adding your child to your family health insurance policy.

It’s vital that you add them to your policy as soon as you can, as there are time limits for when a child can be added to your family’s health insurance before waiting periods will begin to apply to them. For example, you may have two to six months, depending on your insurer, to add your new arrival to your family’s health insurance. Some funds may also require you to add your baby 2 months before their due date, in order for them to be covered.

Adding them within that time frame gives them the same coverage you have – so any waiting periods you’ve already served will count as being served by your baby. However if you still have any waiting periods to finish, so will they.

Should you have couples or singles cover, you’ll need to upgrade to a family policy. In some cases, this may mean upgrading your cover if your health fund doesn’t offer the same level of cover that you’re currently on to families. Upgrading to a higher level of cover might mean that new waiting periods will apply – for benefits you weren’t previously covered for. Any waiting periods you have already served on your singles or couples cover will transfer across with to your new cover.

For example, if you were covered for heart surgery previously, and your new policy also covers this, you’ll be covered straight away, but if your old policy excluded benefits towards Joint Replacements, and your new policy includes Joint replacements – then you’ll need to serve the relevant waiting period for that new service.

Contacting your insurer a couple of months beforehand can help you start organising your family’s cover, and your private health fund will be able to walk you through any paperwork and requirements. However, it may also be a good time to review family health insurance policies to ensure yours is still suitable.

Frequently asked questions

Will my dependents affect the price of my health insurance?

Adding additional dependent children and students on your health insurance doesn’t typically affect the cost of your health cover, as they’re normally covered at no additional cost. However, young adult dependents may attract additional cost to your health insurance premium and they may have to meet particular conditions.

For example, they may need to be unmarried and not in a de facto relationship in order to be covered, and some health funds might have criteria regarding any income or full-time employment.

Additionally, some health funds don’t charge a hospital excess for dependent children admitted to hospital under your private hospital policy, though this may not apply to dependent students and adults.

Conditions vary between health funds, so check with your health fund for details regarding age limits and criteria for your dependents.

How much can I claim on my family’s extras policy?

Depending on the level of your extras cover, there will be limits to how much you can claim for each person in a year, for each treatment covered by the policy. There may also be group limits for certain services (e.g. lifestyle services), as well as policy limits for the whole family insured by the policy.

Details for these limits should be available in your policy brochure.

Are there free health programs for kids in the public system?

The Australian Government does subsidise the cost of some health services for children, and also provides free medical treatments. For example:

  • Medicare covers the cost of basic dental services under the Child Dental Benefits Schedule, up to a certain limit and within a set time frame. The parent or child must be receiving payments from the Government to be eligible. Individual states also have their own dental programs for children.
  • The National Immunisation Program provides free vaccines for certain diseases or conditions for children and youths from zero to 19 years old.
  • Treatment for cleft lip and cleft palate is covered by Medicare.
  • Medicare covers treatment as a public patient in a public hospital.

On top of these, some optometrists bulk-bill their eye tests through Medicare, which applies to children as well as adults. The cost of the glasses themselves aren’t covered by Medicare but might be under an extras policy.

General Practitioner (GP) visits are subsidised by Medicare, and you’ll get a rebate for some of the cost back when taking your family to see the doctor. Some GPs may bulk-bill, which means you will not be out of pocket for the consultation.

Utilising these free or subsidised services can help reduce the cost of medical treatment. Between the public system and private health insurance, you could have well-rounded cover for your child’s healthcare needs.

Can I just get cover for my child, and not for me?

There are some health insurers who can provide a private health policy for a child alone, and not for parents or other family members. This is rare, however, and typically family policies let you cover your dependents at no additional cost.

What if I have adopted children or foster children?

If you have adopted or foster children in your care, you’ll typically be able to add them to your family policy. You might be required to provide additional info about them and when they came into your care. This also applies to any step-children in your care.

Compare health cover for your family

Comparing policies and health funds can help you see what rules apply to your dependents; such as age limits, relationship status and study or employment criteria.

Are you looking to take out a policy or switch? Try our easy-to-use free comparison tool today to find cover for your family. Comparing policies with us could help you save time and money on your insurance, and makes it easy to see what’s covered under policies available through our service.

So, what are you waiting for?

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