Now that your children are older and can (for the most part!) take care of themselves, you might think that your job as a parent is done. And for the most part, you’d be right. After all, when your children are all grown up and are working or studying (or both), you don’t necessarily need to chase them up on everything.

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However, there is one aspect of your children’s lives that you’re always likely to worry over, no matter what their age: their overall wellbeing. Everyone wants their loved ones to be happy and healthy, but the unfortunate truth is that no-one can predict when an unexpected injury or illness might crop up.

If your children are trying to save for the future, or if you and your partner are attempting to build up your retirement fund at the same time, the possibility forking out hefty healthcare expenses is definitely not ideal. Having private health insurance will allow your family to take care of each other during these difficult times without having to worry over medical and pharmaceutical bills.

Private Health Insurance For Families with Older Kids

When it comes to private health insurance, a family policy is both pragmatic and convenient. After all, it only makes sense to have all the health needs and priorities under one roof accounted for! The great thing about health insurance is that it’s highly versatile – you have plenty of choices when it comes to tailoring your hospital and extras cover to suit your whole family’s priorities. Because health insurance is such a wide and varied market, it’s easy to shop around and find the right health fund for your family.

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When it comes to private health cover for the whole family, it’s a good idea to opt for a higher level of coverage. While Medicare helps you cover a range of healthcare costs, private health insurance can go one step further to helping ensure that you and your family have the best healthcare possible for all your present and future needs.

Your health and wellbeing should always be your top priority, no matter what your life stage or situation is. You definitely want to be in good hands should anything should go awry health-wise for you or any one of your family members.

Hospital cover isn’t something you’ll need to rely on day in and day out, but it can be extremely useful during those rare occasions when someone in the family falls seriously ill or suffers a major injury. Forking out for any necessary surgeries or procedures would undoubtedly be a heavy financial burden for any family. While Medicare can help by allowing your family members to be treated at a public hospital, unfortunately there are several important services it doesn’t cover, including private patient hospital costs and ambulance services. Additionally, only having Medicare means you’ll be on a waiting list for any treatment you require, which is clearly not conducive to a speedy recovery!

So while it might seem easier to skimp on hospital cover, the truth is that if someone in your family experiences a serious setback in their health, the best way to quickly and effectively bounce back from this is to have great medical care and attention. Depending on your level of cover, this is what private health cover can ensure by giving you access to different private hospitals and allowing you to choose your own doctor.

The same goes for extras cover. Medicare offers Australian residents some fantastic benefits for various health-related services and treatments under the Medicare Benefits Schedule (MBS) and the Pharmaceutical Benefits Scheme (PBS). However, private health insurance can help you out with the costs of necessary medical services that Medicare doesn’t cover and that your family will likely be utilising again and again. This can include, but is not limited to:

  • Dental and orthodontic treatment;
  • Optical services;
  • Physiotherapy;
  • Podiatry; and
  • Chiropractic treatment.

The bills and expenses for these can definitely add up over the years and end up costing you a fortune, which is why the extras cover on your private health insurance policy offers you such value for money. That way, you and your family can concentrate on putting your hard-earned savings towards more important life expenses, be they a bigger home, a family holiday or a nest egg for the future.

Hospital cover

Having a solid safety net in case your health ever fails is always a good idea, and that’s exactly what hospital cover provides. Having private healthcare means that you and your family can choose whether to be treated at a public or private hospital Depending on your policy, you may also be able to choose your own doctor.

In addition, hospital cover could foot some or all treatment costs at either a public or private hospital. This includes in-hospital treatment by your doctor and any additional costs, such as accommodation and theatre fees.

Private health insurance generally covers all services listed on the MBS, depending on the specific policy. Medicare will cover you for 75% of the costs of these medical services, and your health fund will ostensibly cover the remaining 25% – provided that you have the right private health insurance policy. If your doctor chooses to charge above the MBS fee for the service, you will be required to pay the additional cost, which is known as “the gap.”

There are four general levels of hospital cover:

  • Top private hospital cover: covers all services where Medicare pays a benefit.
  • Medium private hospital cover: may exclude or restrict one or more of the following, but covers any basic service– pregnancy and birth-related services, assisted reproductive services, cataract and eye-lens procedures, joint replacements, hip replacements, dialysis for chronic renal failure and sterilisation.
  • Basic private hospital cover: may exclude or restrict one or more of the following – cardiac and cardiac-related services, non-cosmetic plastic surgery, rehabilitation, psychiatric services, and palliative care.
  • Public hospital cover: covers default benefits for treatment in public hospitals only.

There are certain exclusions and restrictions when it comes to hospital cover. These vary depending on the individual policy. For instance, most hospital policies won’t insure you for any medical procedures or surgeries that don’t necessarily maintain your health, such as elective cosmetic surgery.

For more detailed information on what is and isn’t covered, read the Policy Brochure carefully, and if you’re still looking for answers, contact the insurer directly.

Extras cover

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While hospital cover insures you for when you might need serious medical attention, extras cover (also known as general treatment cover or ancillary cover) is more suitable as a financial safety net for your family’s everyday health needs. This is why it continues to be useful for people of all ages over the course of their lifetime. That way, you, your partner and your children will be able to take advantage of your extras cover for a multitude of health purposes. Whatever health-related services and treatments your family is after, extras cover can cater to you.

The best way to get the most value out of your extras cover is to pick a policy that suits your family’s lifestyle and your collective health needs. For example, if you’re a highly physically active family, you’ll probably want to find a more comprehensive policy that covers the costs of services such as physiotherapy and podiatry in case any physical injuries crop up in the future. General Dental is always a popular option, as children and parents alike will definitely make use of it over the years. And should you have someone with poor eyesight in your family, Optical will come in handy!

It’s all about figuring out exactly what your family needs from your healthcare, and because there is such a great variety of policies on the market these days, you won’t have a problem finding the right extras cover to suit all of you.

There are three general categories of extras cover. We’ve listed them below.

  • Comprehensive cover: has a more extensive range of services and higher benefits for claiming. Services include cover towards general dental, major dental, endodontic, orthodontic, optical, non-PBS pharmaceuticals, physiotherapy, podiatry, psychology, naturopathy and acupuncture.
  • Medium cover: includes cover towards general dental, major dental, and endodontic, as well as five of the following – orthodontic, optical, non-PBS pharmaceuticals, physiotherapy, podiatry, psychology, and hearing aids.
  • Basic cover: includes minimum services that may vary from fund to fund.

Extras cover is highly versatile. It can be purchased separately or combined with hospital cover. If you decide to opt for combined cover, many insurers let you mix and match different hospital policies and extras policies at your convenience.

It’s a great idea to have a family discussion about the kinds of cover you want to invest in. For example, you might choose to purchase medium level hospital cover as a safety precaution, but opt for comprehensive extras cover to suit the everyday health needs of the whole family. Be sure to ask your insurer for further information regarding combined packages.

Ambulance cover

Medicare does not cover the costs of emergency transport or ambulance services, so it’s important to arrange for ambulance cover through your private health insurance. Generally, you can purchase ambulance cover as part of your hospital cover or extras cover, or even as a stand-alone cover.

However, depending on which state you live in, you might not even need ambulance cover, or you may be eligible for a discount. Check the Private Health Insurance Ombudsman website for further information.

Other important information

1. The Australian Government Private Health Insurance Rebate

If it’s the premium costs that make you a tad hesitant to invest in private health insurance, you’ll be happy to hear that the government can help you out. The private health insurance rebate is income-tested and applies to hospital, extras, and ambulance policies. Most Australians are eligible for the rebate, based on the following three conditions:

  • You must be eligible for Medicare.
  • You must have complying health insurance product (CHIP) that provides hospital cover, extras cover, or both.
  • You must have an income for Medicare levy surcharge purposes below Tier 3, as shown in the table below:

Health insurance income thresholds

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* Less than $180,000 $180,001-$210,000 $210,001-$280,000 $280,001 and over
Age Base Tier Tier 1 Tier 2 Tier 3
Under 65 25.934% 17.289% 8.644% 0.00%
65-69 30.256% 21.612% 12.966% 0.00%
70 and over 34.579% 25.934% 17.289% 0.00%
* 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. Table information from the Department of Health current as of 24/02/2017

You can claim your private health insurance in one of two ways: as a premium reduction through your health fund, or as a tax offset when you lodge your annual tax return. If you want to use the former method, contact your insurer to discuss the matter, and if you prefer to do the latter, your insurer can provide you with the right paperwork for your tax return. More information can be found at the Australian Taxation Office website.

2. Medicare Levy Surcharge (MLS)

The Medicare Levy Surcharge (MLS) is another great reason to purchase health insurance sooner rather than later. This surcharge is levied on Australian residents who do not have private health cover and who earn above a certain income threshold – currently, $90,001+ for singles and $180,001+ for families (refer to the table below). The MLS was devised by the government in an effort to prompt more people to invest in the private healthcare system, so as to ease the demand on the Medicare system.

The surcharge is calculated at the rate of 1% – 1.5% of your income, in addition to the Medicare Levy of 2% which is paid by most Australian taxpayers. The surcharge is indexed annually, and the levels applicable for the year 1 July 2017 – 30 June 2018 are as follows:

Medicare Levy Surcharge – Income Thresholds
Singles Under $90,000 $90,001 – $105,000 $105,001 – $140,000 $140,001+
Families ^ Under $180,000 $180,001 – $210,000 $210,001 – $280,000 $280,001+
Surcharge 0% 1% 1.25% 1.5%
Retrieved from Privatehealth.gov.au | Information current as of 03/04/2017
^ For families with children, thresholds increase by $1,500 for each child after the first.
Families include couples, de facto couples, and single parents.

3. Switch it up

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In the midst of our lives, nothing seems to be changing very dramatically, and it’s only when we look back through the years that we realise the sheer multitude of life-changing experiences we’ve had. Our routines, circumstances and habits are constantly in the process of developing and evolving, even when we’re not aware of them. It makes sense that as these things change, so do other aspects of our lives – and that includes our health needs!

This is why it’s important to check that your private health cover meets your (and your family’s) current healthcare demands. Chances are, the first health insurance policy you purchase won’t suit your family forever. It’s a good idea to keep re-evaluating your private health cover as time goes on. That way you can ensure that you’re getting the most out of your policy. The health needs of your children when they were younger will most likely differ to their health needs as young adults. For example, if you no longer have the need for Orthodontia as an extras option, you could consider changing up your cover.

Many people think that switching from one health insurance provider to another is complicated, but it’s actually a very simple process. We let you compare a range of policies from Australia’s health insurance providers. Once you’ve found a policy that’s right for you, your new health fund will take care of the switch, including talking to your old health fund.

The great news is that there are no penalties or surcharges involved when you switch providers. Your Lifetime Health Cover (LHC) status will remain the same, with any age loading or absence of loading transferred to your new policy. You will still be eligible for any rebates you’re receiving on your current cover and best of all, waiting periods will be waived (provided you have observed the full waiting period for your previous policy and you don’t have any new or upgraded benefits).

The final word: Looking out for the family

When it comes to looking after your children’s health, having a helping hand can really be a lifesaver. This is why private health insurance can be so beneficial if you’re looking for all-inclusive protection for the whole family. Having both hospital and extras cover means you can rest in the knowledge you and your loved ones will always be in the best of hands health-wise. Don’t forget that you’ll also be able to take advantage of benefits such as the government’s private health insurance rebate!

When you and your children are still living under the same roof, it’s always a good idea to have a financial safety net in place for any eventualities. Start considering private health insurance as soon as you can. That way, you can make a head start on shopping around for health insurance policies to suit your family’s lifestyle.

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