Looking after your family’s health now could pay dividends to your future. There’s no way to predict when you or your kids might get sick or suffer an injury, both of which can be costly scenarios. However, you can take some steps to prepare for such circumstances. This is where private health insurance comes in.
Typically, insuring family members under a family health insurance policy means they’re covered for the same treatments and services you are.
Thanks to reforms introduced by the Australian Government in 2019, health insurance policies fall into one of three categories:
Note: health insurance can also cover emergency trips in an ambulance – see below for more information on this.
When considering treatment, it’s important to ask your insurer how you can use your policy to cover the bill. You might need to fill out a claims form and submit it to your health insurer either online or by post. However, you may be able to use a Health Industry Claims & Payment Service (HICAPS) and simply swipe your health fund card through the machine right there at your appointment.
It makes sense to have all the health needs and priorities of a family under the one policy, where it’s neatly and collectively accounted for. Even though Medicare in Australia is quite comprehensive, there are still some things it doesn’t cover.
There are many reasons to consider taking out family health insurance:
One of the great things about family private health insurance policies is that you can generally upgrade your couples policy to cover your dependent children at no extra cost. This is true regardless of whether you’re a family of three, four or even more! Depending on your insurer, children up to the age of 18 – 25 may also be covered. All you need to do is provide some details about your child to add them to your policy.
When it comes to finding cover to suit your family’s priorities, it’s simple enough to find cover that fits the bill.
Each family has unique health needs, so it’s important to consider the life stage you and your family are at when it comes to health insurance and the medical treatments you might need. Here are some scenarios when you should consider taking out a family policy.
Having your first child is something special, but it also means it’s time to start preparing. Anyone hoping to start a family should consider taking out insurance early on. That way, you won’t miss out on private obstetrics cover or assisted reproductive treatment should you need it, because both of these have a 12-month waiting period.
If you’re pregnant, you’ll need to contact your insurer a few months before your due date to see which waiting periods apply to your newborn (if any).
We outline the particulars for couples starting a family in greater detail here. Don’t worry if you’re a single parent, as the advice applies to everyone!
Maybe now that you’ve had one or two children and they’re out of nappies, you aren’t thinking about having any more at the moment. Even if this is the case, you’ve still got to look out for the health of the kids you already have!
Combined Hospital and Extras cover for the family ensures you have access to benefits like:
While the above features are all subject to annual limits and what’s available with your particular insurer, there are plenty of products out there that offer cover for young children.
When the kids hit school, prepare for some new and unexpected expenses! Maybe they turn out to have flat feet and require orthotics from a podiatrist, or perhaps their eyesight isn’t perfect and they require glasses. And of course, the dreaded braces loom on the horizon, which is when cover for orthodontic work can be a life saver.
Extras cover in particular becomes quite important at this age as all these additional expenses begin to pile up, so make sure you review your cover every year to be certain you’re getting the best value possible.
If your child is involved in sports, an extras policy with physiotherapy might come in handy if they’re injured. Other extras policies might include cover for counselling and psychology to help look after their mental health.
Your kids can stay on your family health insurance policy until their 20s depending on your health fund; After that, they’re on their own!
Until then, they can generally be covered under your policy at no extra cost.Or maybe they’re planning a big trip overseas for schoolies, in which case their travel vaccinations may be covered (in part) by your policy too (depending on your coverage).
Just because the kids grow up doesn’t mean they don’t need looking after. Once they’re old enough though, point them towards paying for their own policy.
If the price of premiums is making you a tad hesitant to invest in private health insurance, you’ll be happy to hear that the government can give you a helping hand.
The private health insurance rebate is based on your household’s taxable income and applies to hospital, extras and standalone ambulance policies. If eligible, you can claim your rebate on your tax return or as a discount on your health insurance premium.
Having a family private hospital insurance policy can also save you paying a surcharge on the Medicare Levy. If you and or your partner have a combined income that triggers that Medicare Level Surcharge (MLS), you may pay between 1% – 1.5% extra at tax time.
Note: health insurance rebates, taxes and levies are generally based on income thresholds and are not applicable to everyone.
If you live in a state or territory where you are not entitled to free ambulance services (Queensland and Tasmania cover ambulance costs), you can buy ambulance cover as a standalone policy, or it can fall under hospital cover, extras cover or combined health insurance. However, this varies between policies and health funds.
Discover why you might need ambulance cover here.
There is no particular health insurance policy that’s best for all families, as everyone’s needs are different. Comparing policies based on their coverage and price against the medical needs you think your family will face can help you find a policy with great value.
One extra thing to look for is whether a particular health fund has a no-gap or known gap agreement with a hospital or doctor. Going to that doctor or hospital for treatment can help you avoid out of pocket costs, or at least know what they’ll be beforehand.
When it comes to dependants, age limits on family health insurance policies can range from 18 to 25 years old. Depending on whether they’re studying, in a de-facto relationship, married or employed full time, you might have to pay a little extra to cover them on your policy.
Once they leave the nest and are no longer covered by your private health insurance, it’s time to contact your insurer to discuss moving to a singles or couples policy, depending on your situation.
Discover more about insuring dependents with a family health policy.
If your child is injured at school, it’s important to note that while the school should have liability insurance, it might not have accident insurance to cover the cost of healthcare. Schools have a duty of care and will provide first aid, call an ambulance if needed and notify parents.
Any expenses relating to care, including emergency ambulance trips (except if you’re a resident of QLD or TAS) are borne by you. In situations like these, ambulance cover and private health insurance can help cover expenses and provide peace of mind.
You generally can’t add your parents to your family health insurance policy, only your spouse or de facto partner and dependent children.
Depending on how old your parents are, they might want to consider health insurance for seniors.
Some health insurers do provide cover for children only, though these policies are rare. Most family health insurances cover nearly all immediate family members (bar your parents), including birth children, stepchildren, adopted children and foster children. In some of these instances, you might need to provide additional information about when your dependents entered your care.
Whether you haven’t held a family policy before or you’re considering upgrading your current cover, you can compare a number of insurance policies from our partners through our health insurance comparison service. It’ll help you compare prices and coverage from any available policies side-by-side, all in one place. Plus, it only takes a few minutes to get started!
