Family health insurance is health insurance for adults and dependents that covers a range of in-hospital services and services Medicare typically doesn’t cover, depending on the policy you choose.

With hospital cover, your policy takes care of hospital-related costs like admissions, treatments and ambulance cover (although depending on the health 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, like silver, you’ll also get cover for dental surgery, implantation of hearing devices, and even heart and vascular treatments. Some policies even waive the hospital excess for kids under 21 – how good’s that?

Since extras cover is for those out-of-hospital services, think dental (including check-ups, wisdom teeth removal and 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 value for your money.

The pros of family health insurance include choosing your treating doctor as a private patient and getting money back on services Medicare usually doesn’t cover, which can outweigh cons like sharing annual limits and paying for more cover than you’d need as an individual, depending on your policy.

The pros of family health insurance 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, the downsides of family health insurance 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.

Many of these cons, however, can be managed by considering what is the best fit for your family (and if a family policy works for you), regularly reviewing your cover and comparing policies to find a policy that offers you value for money.

Depending on your situation, some pros and cons may matter more to you than others. It’s up to you to make the call on whether family health insurance is worth it for your family or if another kind of health insurance is the way to go.

If your family has had hospital cover with an excess of $1,500 or less for the whole financial year, you won’t have to pay the MLS. Families with a combined income of $210,000 or less for the 2026–27 financial year don’t need to pay the MLS, either. This income threshold increases by $1,500 for each dependent child after your first.

If you earn more than $210,000 and don’t have appropriate hospital cover, you’ll likely have to pay the MLS, which can be up to 1.5% of your taxable annual income.

Note: These figures are indicative MLS income thresholds for combined family incomes in the 2026–27 financial year, based on Australian Government data. Actual costs may vary depending on your income. Data retrieved on June 2026.

Typically, children can stay as dependents on your family health insurance policy until they turn 18, after which they can often still be covered up to the age of 31, depending on your circumstances and health insurer.

Once they turn 18, it’s up to your insurer to decide whether they’ll still offer them cover as dependents. For instance, if your child is 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. Then they’ll need to decide whether they take out their own health insurance or rely on Medicare.

You can encourage your older children to take out their own health insurance before they turn 31 to make the most of age-based discounts and to avoid Lifetime Health Cover (LHC) loading. Age-based discounts can be as much as 10% off their hospital insurance up until they turn 41. Meanwhile, LHC loading is an additional 2% added to their premium for every year after they turn 31 that they don’t have hospital cover. The loading only maxes out at 70% and doesn’t disappear until your adult child has had consistent hospital cover for 10 years.

Some extras policies cover the cost of travel vaccinations and some other vaccinations, but this depends on your policy and the specifics of your extras cover. For instance, your extras could cover you for vaccinations for shingles, hepatitis B and rabies. You don’t need extras cover for vaccinations delivered through the National Immunisation Program, as these are delivered free of charge (although they may have consultation or service fees).

Yes, providers typically allow newborns to be added onto a family policy. However, you’ll need to add your baby to your policy before they’re born, or shortly after, if you want them to avoid any waiting periods (assuming you’ve served all of yours). The deadline for when you need to add your newborn to a family policy depends on your health insurer.

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.