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Family Health Insurance
Family Health Insurance
Written by
Madeline Pettet
Edited by
Ellie Garran
Reviewed by
Andres GutierrezCheck out our range of private health funds
iSelect does not compare all providers in the market or all policies offered by our partners in your area. Not all policies or special offers are available to all customers and some may only be available over the phone or on the website. Learn more.
What is family health insurance?
Imagine if the Brady Bunch needed eight different health insurance policies – it’d be a nightmare! Thankfully, you (and the Bradys) can purchase just one private health insurance policy to cover your family. Family health cover works just like singles health insurance, but its family sized.
When should I choose a family health insurance policy?
Family health insurance is a great way to keep everyone covered through life’s big (and small) moments. Whether you’re planning for a baby, managing schoolyard scrapes, or helping your teen with braces, the right policy can make life a whole lot easier.
Here are some key life moments when family health insurance makes sense.
Starting a family
If you’re planning to have kids, family health insurance can help cover pregnancy and childbirth. But heads up – there’s often a 12-month waiting period before you can claim. So, it’s smart to get hospital cover well in advance.
Growing your family
As your family expands, a family health insurance policy keeps things simple by covering everyone under one plan. Plus, some funds let you add your second or third child at no extra cost.
When your kids start school
School years bring new challenges – and expenses. Think orthotics, glasses, or braces. These all fall under extras cover, with orthodontics included in more comprehensive policies.
Teenagers and young adults
As your kids hit their teens and early adulthood, family health insurance can still have their back. Most policies cover dependents up to 31 if they’re studying and not married or in a de facto relationship (check your fund’s terms).
What types of health insurance policies are available for families?
Hospital cover
Hospital cover can help you pay for in-hospital treatments as a private patient, including theatre fees for surgery and hospital accommodation.
When deciding on a policy, it’s important to think about what type of procedures or services your family is likely to need in the future. This will help you narrow down your preferred product tier out of basic, bronze, silver, and gold.
Remember, though, the higher the level of cover, the more expensive your family health insurance is likely to be. For example, a gold family hospital policy tends to cost more than a silver one.
Extras cover
Extras cover can provide you and your family with a level of cover for part (or all) of the costs of some allied health services that Medicare doesn’t usually pay a rebate for, like dental check-ups or glasses.
Depending on your policy, the whole family might share a claim limit for services, or you each might have your own.
When comparing policies, think about what services you’d like included. If you want a snug fit for your policy, try to avoid options that have services you’re unlikely to use to avoid paying more than you need to on your premiums.
Combined cover
Combined cover is simply both hospital and extras cover rolled into one policy, assuming you choose the same insurer for both cover types.
Many funds let you combine different levels of cover to suit your needs. For example, you might want bronze hospital cover, and extras cover with general and major dental, physio, and optometry.
Family health cover explained
Learn more about the types of health insurance, choosing suitable cover, and the positives of having a policy.
Laura Crowden
ISELECT SPOKESPERSON
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How much is family health insurance in Australia?
Put simply, the cost of family health insurance varies a lot. Although there’s no hard-and-fast figure, we can share some averages to help you get a sense of what to expect.
Average monthly premiums for combined hospital and extras family policies, September 2025
| NSW | NT | QLD | SA | TAS | VIC | WA | |
| Basic | $415.51 | $334.89 | $424.38 | $407.50 | $418.04 | $421.30 | $386.59 |
| Bronze | $482.59 | $365.20 | $501.47 | $483.86 | $483.26 | $502.55 | $440.88 |
| Silver | $721.53 | $561.06 | $742.36 | $707.49 | $714.60 | $745.10 | $668.71 |
| Gold | $953.90 | $773.17 | $990.01 | $947.79 | $957.62 | $993.77 | $889.04 |
Source: PrivateHealth.gov.au – September 2025
Note: All policies were available in September 2025, and no ‘plus’ tier policies were included. The policies are for both hospital and extras cover for family only, with an excess of $750 per person. Premiums are averaged across the country and do not include any Australian Government rebates or Lifetime Health Cover loading.
How are premiums calculated for family health insurance?
The cost, or premium, for your family health insurance depends on a few different factors.
The main factor is what’s covered by the policy – including the type of cover and how many services are included.
How many people are covered also matters. Typically, kids (dependent children from birth to 17 years old) don’t affect your premium. So, if your policy covers just you, your partner, and your two young kids, you’ll likely only pay the same amount as the equivalent couples policy.
However, a higher number of adults covered, including other types of dependants, may mean a higher premium.
Where you live can change your premium, too, along with whether you’re eligible for the government’s private health insurance rebate.
Helpful tip
Every family is unique and so are their health needs! This means there is no one-size-fits-all solution when it comes to insurance. Think about what you truly need: is it hospital cover that offers pregnancy and delivery care, or extras cover to help pay for the kids’ glasses? Work out what’s important and what you’ll probably never use. This will help you choose a policy that covers the essentials without any unnecessary inclusions.
Dr. Jill Gamberg
GP, Coach, and Lifestyle Medicine Physician
How do I know what type of family health insurance cover to get?
Start by asking yourself the following questions.
Are you planning on having another child?
If you haven’t finished growing your family, and you’d like the option of having your next baby in a private hospital, then you might want to consider getting a hospital policy that includes pregnancy cover. For pregnancy cover, you’ll likely have to limit your search to gold tier hospital cover. This is the only tier that includes obstetrics as a minimum requirement, although some insurers may offer pregnancy cover in silver plus policies.
Do you have young children?
From playground gymnasts to the dreaded daycare germs, kids are a little more susceptible to accidents and illnesses. Also, common childhood procedures can often come with longer waiting lists in the public sector. For instance, in 2023–24, the median wait time for a tonsillectomy was 189 days for public patients, but only 93 days for private patients in public hospitals.1Australian Institute of Health and Wellbeing – Admitted patient care 2023–24: What procedures were performed? Therefore, you might want hospital cover for younger kids (and for the sake of your patience).
Do you have older children?
The teen years are tough on everyone, with raging hormones and changing bodies leaving teens and parents alike catching their breath. It’s also a time when your kids might need different cover, whether it’s orthodontic work like braces or physiotherapy to recover from a sporting (or videogaming) injury. So, you might want to expand your extras coverage if you have older kids.
Does anyone in your family have any specific needs?
Everyone has their own health journey, and sometimes that can mean regular appointments with specialists and allied health professionals, or even visits to hospital. If you know that someone in your family is going to need regular healthcare services, like seeing a speech therapist or visiting the dentist, you might want to tailor your family’s cover around these needs.
Frequently asked questions
What does family health insurance cover?
Family health insurance can cover a range of hospital services and extras to support the needs of your entire family. Here’s what coverage could look like:
- Hospital cover: This takes care of hospital-related costs like admissions, treatments, and ambulance cover (although depending on the fund, this could sometimes go under extras). In the bronze tier and above, you’ll find cover for things like tonsils, adenoids, grommets, joint reconstructions, and diabetes management. If you go for a higher-tier policy, you might also get cover for dental surgery, sleep studies, pregnancy and birth, and even heart and vascular treatments. Some policies even waive the hospital excess for kids under 21 – how good’s that?
- Extras: Extras are the cherry on top, covering out-of-hospital services. Think dental (check-ups, wisdom teeth removal, root canals), physio, remedial massage, optical, and mental health support. If glasses, braces, or even a bit of physio are on the cards for you or the kids, extras cover could be handy.
Your family’s needs change, so it’s worth giving your policy a regular once-over. Check what’s included, compare with other options, and make sure you’re getting a good bang for your buck.
What are the pros and cons of family health insurance?
The pros include:
- choosing your doctor in a private hospital
- the chance of a private room in a private hospital
- possibly having a shorter wait for private hospital inpatient treatments
- getting money back on services usually not covered by Medicare
- having a safety net to manage unexpected costs and give you peace of mind about your family’s health.
Meanwhile, cons can be things like:
- possibly sharing annual limits with other family members
- needing to choose cover that works for everyone in your family, rather than just what you need
- not all providers having an agreement with your insurer
- paying higher premiums if certain types of dependants are on your policy.
Some pros and cons may matter more to you than others. And which pros and cons apply to you can depend on your policy and your needs. It’s up to you to make the call on whether health insurance is worth it or not for your family.
If I have family health insurance, do I have to pay the Medicare Levy Surcharge (MLS)?
Good news! If, for the whole financial year, you have an appropriate level of hospital cover – that’s an excess of $1,500 or less for couples and families – you don’t have to pay the Medicare Levy Surcharge (MLS).
Otherwise, to avoid paying the MLS, you’ll need to earn under the income threshold. For couples and families, the threshold is $202,000 or less, as of 1 July 2025. However, if you have dependent children, that threshold is increased by $1,500 for each child after your first.
If you earn more than $202,000 and don’t have appropriate hospital cover, then you’ll likely have to pay the MLS.
| Family income threshold | Medicare Levy Surcharge |
| $202,000 or less | 0% |
| $202,001–$236,000 | 1% |
| $236,001–$316,000 | 1.25% |
| $316,001 or more | 1.5% |
Source: PrivateHealth.gov.au – Medicare Levy Surcharge
How long can my kids stay on my family health insurance policy?
Until your kids turn 18, they’re usually automatically covered under your family health insurance as dependants.
Once they turn 18, it’s up to your insurer whether or not they still qualify. If they’re a full-time student or financially dependent on you, some insurers will allow them to stay on your policy, but you might need to pay a higher premium.
Generally, once your kids hit 31, they’re considered independent and booted off your policy. It’s not much of a fun turning-30 task, but they’ll need to decide whether they take out their own health insurance or rely on Medicare.
Can family health insurance cover vaccination costs?
Some extras policies do cover the cost of vaccinations, but this depends on your policy and the specifics of your extras cover.
Can families add their newborn to an existing family health insurance policy?
Yes, providers typically allow newborns to be added onto a family policy. However, if you are yet to serve any full waiting periods on your existing policy, then these waiting periods may also apply to your newborn.
Some health funds require you to add your baby to your policy before they’re born, while others give you a grace period after bub is born to add them to your policy without having to serve any waiting periods. How quickly you need to do this varies between insurers.
It’s a good idea to confirm directly with your health fund about their rules around adding newborns.
Keep in mind that if you currently have a single or couples policy, then you’ll need to upgrade to a family (or single parent) policy for your newborn to be covered.
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Health Insurance & Tax
Tax Implications on Health Insurance
How to save on Health Insurance
About the Medicare Levy Surcharge
About the Life Time Health Cover Loading
Government Rebate & Means Testing
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