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Family Health Insurance
Imagine if the Brady Bunch needed eight different Health Insurance policies – it’d be a nightmare! Thankfully, you can purchase family Private Health Insurance and rest assured, because all your family members are protected under the one Family Policy.
What is a family when it comes to Health Insurance?
When it comes to health insurance, a family means parents (or single parent) and their dependent children. There is no limit as to how many kids you can have covered (although there are limits to how old the kids can be, which we’ll get into later). But keep in mind a family policy won’t cover grandparents, grandkids or other extended family members.
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 actually need: is it Hospital Cover that offers pregnancy and delivery care, or Extras Cover that helps pay for the kids’ glasses? Work out what’s important and what you’ll probably never use. This will help you chose a policy that covers you for the essentials without any unnecessary inclusions.
What types of Family Health Insurance policies are available?
Family Hospital Cover
Hospital Cover can help you pay for in-hospital treatments at a private or public hospital, including theatre fees for surgery and accommodation at a hospital.
You also typically get to choose your preferred doctor and hospital. 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.
Firstly, consider which product tier is suitable for your family: Gold, Silver, Bronze or Basic. This will determine what treatments you’re covered for and how much your premium will be.
Generally, the higher the level of cover, the more expensive your Family Cover will be – for example, a Gold Family Policy will likely cost more than a Silver Family Policy.
Family 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 does not usually pay a rebate for, like dental checkups or glasses.
When choosing an Extras Cover policy there are usually three levels to choose from: basic, medium, and comprehensive.
Remember to check what’s included in your policy before signing up, as not all treatments you need will necessarily be included, and you also don’t want to pay more for services you are unlikely to use. And keep in mind that some family Extras policies have family limits, which refers to the total or combined amount per service that can be claimed by all family members covered under your policy.
Family Combination Cover
Family extras cover and family hospital policies cover very different things, so a lot of people actually get both. This is known as Combined Hospital and Extras Cover.
If you take out both hospital cover and extras cover for your family, you can usually combine them into a single policy with the same insurer.
You should also be able to combine different levels of cover to suit your needs, for example you might want Gold hospital cover and a medium extras policy.
Family Health Insurance Explained
Learn more about how Family Health Insurance works in this short video.
Laura Crowden
ISELECT SPOKESPERSON
‘Since having kids, Private Health Insurance has really paid dividends for our family. My eldest son has had two surgeries (most recently grommets, adenoids & tonsils) and both times we’ve been able to choose our preferred surgeon, skip public waiting lists and have the surgery within just a month or so of being referred. Your kids needing surgery is stressful enough without having to worry about lengthy public hospital waiting times.’
Laura Crowden, Managing Editor, iSelect and mum of two
Frequently Asked Questions
How can Health Insurance help my family?
In Australia, we’re lucky to have access to the public healthcare system. Medicare helps cover part or sometimes even all of the cost of certain medical healthcare services, but there are some services that aren’t included.
If you want your family covered for many common procedures, then a family Health Insurance policy is worth considering.
Having Private Health Insurance also means greater choice when it comes to your healthcare, including the ability to choose your own doctor and hospital. It also helps to give you access to shorter waiting periods for elective surgery in the private system.
It’s a great way to protect your family and give you invaluable peace of mind that you and your loved ones will have greater choice when it comes to your healthcare.
What could Family Health Insurance cost?
The cost will depend on your family’s unique set of needs and circumstances.
Many providers offer a wide range of policies as well as customisable extras, so that you can choose exactly what you need and avoid paying for services or treatments you won’t use.
To get a better understanding of medical specialist service costs in Australia, visit the Australian Government’s Medical Costs Finder.
What types of treatments not covered by Medicare could be covered by Family Health Insurance?
Medicare only covers certain medical procedures.
The good news is that family Extras policies can cover a lot more, including things like dental and orthodontic treatments, physiotherapy, speech therapy, contact lenses and glasses.
See a list of what could be included here and make sure you read your Extras policy document carefully before you sign up to confirm exactly what’s included.
What are some benefits of Family Health Insurance?
- Reduced hospital waiting times
One of the biggest struggles in the public healthcare system is the waiting time for treatments, services and surgery. If you have Private Health Insurance, you can go to a private hospital and this generally means a reduced waiting time for elective surgeries, such as hip replacements, cataract extraction, and ligament repairs. - Choice of doctor and hospital Family Health Insurance can also give you and your family more power to choose when it comes to choosing a doctor and hospital for your treatments and procedures.
- Save money on the services you use most
One of the best things about Private Health Insurance with Extras Cover is that you might be able to get money back on non-Medicare health services, like dental and physiotherapy.
Saving on the smaller things like this can help pay for some of the bigger expenses in life like schooling, mortgages and loans.
- Private hospital rooms Public patients often share a room with several other patients, but with most Private Health Insurance policies, you or anyone under the same policy in your family can request a private room at the hospital (subject to availability).
- Manage unexpected costs Health Insurance is like a safety net. Having the right policy in place can help you worry less about being caught off-guard with unexpected medical costs like dental care, chronic illness or hospital treatments.
How do I know what type of Family Health Insurance cover to get?
It depends on the size and shape of your family.
When choosing a family Health Insurance policy you should consider the age, lifestyle and medical history of every member in your family.
Start by asking yourself the following questions:
- Are you planning on having another child? If the answer is yes and you would like the option of having your baby in a private hospital, then you might want to consider getting a hospital policy that includes pregnancy cover. As pregnancy and birth has a 12-month waiting period, we suggest you start looking at getting cover about a year before you want to start planning for a new arrival. For pregnancy cover, you will want to look at Gold-tier policies, as this is typically the only tier that includes obstetrics as a minimum requirement, although some insurers also offer pregnancy cover in Silver Plus policies.
- Do you have young children?
If so, you might want to look at a policy that covers a wide range of services.
From little monkey-bar warriors to football superstars, kids are a little more susceptible to accidents and illnesses.
Additionally, procedures for grommets and tonsils can often come with longer waiting lists in the public sector. But with Health Insurance, your child may not have to wait nearly as long to be treated privately.
- Do you have older children?
If your children are hitting their teens, it’s worth looking at your cover and making sure you still have an appropriate level of cover for older kids.
If they need prescription glasses, physiotherapy, or orthodontic work, it might be worth moving from basic to comprehensive extras.
Alternatively, you might find they’re hardly using any of the benefits and it could be more worthwhile going down a tier and paying a lower premium.
- Does anyone in your family have any specific needs?
If you know that someone in your family is going to need regular checkups for things like dental, speech therapy or podiatry, then it might be worthwhile looking at a policy that provides a higher level of benefits for these particular services.
If I have Family Health Insurance, do I have to pay the Medicare Levy Surcharge?
Good news! If you have appropriate level of private hospital Health Insurance, you don’t have to pay the Medicare Levy Surcharge.
Considering your current income, use the table below to work out which rate applies to you and your family. The MLS rate of 1%, 1.25% or 1.5% is levied on your taxable income.1Income thresholds effective 1 July 2024. Source: Australian Taxation Office – Medicare Levy Surcharge Income, Thresholds and Rates
Base Tier | Tier 1 | Tier 2 | Tier 3 | |
Family Threshold | $194,000 or less | $194,001 – $226,000 | $226,001 – $302,000 | $302,001 or more |
Medicare Levy Surcharge | 0% | 1% | 1.25% | 1.5% |
Source: Australian Taxation Office
If you have two or more dependent children, the family income threshold is also increased by $1,500 for each child after the first.
How long can my kids stay on my Family Health Insurance policy?
Until your kids turn 18, they’re automatically covered under your family Health Insurance policy as dependents.
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 still allow them to stay on your policy or they may ask that you pay a higher premium.
Generally, once they hit 31, they’re considered independent and booted off your policy, so they’ll need to decide whether they will choose their own Health Insurance plan or rely on Medicare.
Can Health Insurance Cover vaccination costs?
Some providers 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 Insurance policy?
Yes, providers typically allow newborns to be added onto a family policy, but if you are yet to serve any full waiting periods on your existing policy, then this waiting period may also apply to your newborn.
Some health funds require you to add your baby to your policy before it is born, while others give you a grace period after it is born to add it to your policy without having to serve any waiting periods, although 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 if you currently have a single or couples policy, then you’ll need to upgrade your policy to a family (or single parent) policy for your newborn to be covered.
Does family Health Insurance cost more for families with more children?
Many providers allow you to add kids at no extra cost. Generally, a family policy will cost a similar amount to a couples policy, regardless of how many kids (under the age of 18) you have included on your policy.
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
iSelect does not compare all health insurance providers or policies in the market. The availability of policies will change from time to time. Not all policies available from its providers are compared by iSelect and due to commercial arrangements, your stated needs and circumstances, not all policies compared by iSelect are available to all customers. Some policies and special offers are available only from iSelect’s contact centre or website. Click here to view iSelect’s range of providers
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- 1.Income thresholds effective 1 July 2024. Source: Australian Taxation Office – Medicare Levy Surcharge Income, Thresholds and Rates