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Health insurance for seniors
Health insurance for seniors
Written by
Madeline Pettet
Edited by
Andrew Kemp
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 health insurance for seniors?
There are no specific health insurance policies for seniors, however some health cover appeals more to seniors, like comprehensive hospital options, to help manage age-related health issues.
And while you’re only as old as you feel, when we talk about health insurance for seniors, we’re generally referring to people aged 67 and older. This is the magic number the Australian Government uses for the pension age and some related healthcare benefits. If you haven’t quite hit this age, check out health insurance for over 50s instead.
Is health insurance worth it for seniors?
Seniors looking to manage a range of health conditions, like heart conditions, strokes and different types of cancer, find health insurance worthwhile. This includes getting to choose your doctor in hospital, having a shorter wait for elective surgeries and getting money back on services Medicare usually doesn’t cover.
While Medicare and concession cards like the Pensioner Concession Card and Commonwealth Seniors Health Card help cover some common health conditions experienced by many older Australians, health insurance gives you greater coverage, including as a private patient in hospital.
What are the key benefits of health insurance for seniors?
Health insurance’s benefits for seniors include being seen sooner as a private patient, choosing your doctor in hospital, having the chance at a private room to recover in, getting money back on your cover and reducing your tax, if eligible.
Skip the risk of long public waiting times
Private patients in public hospitals were on average seen 21 days sooner for elective surgeries than public patients in 2024–25 financial year, according to the Australian Institute of Health and Welfare (AIHW). Spending less time on the waiting list can improve your quality of life and help you recover sooner.
With people aged 65 and over making up just 17% of the population but accounting for 45% of hospitalisation in 2024–25 financial year, according to AIHW, you’re likely to need to go to hospital at some point in your senior years. Private hospital cover gives you a better chance at a shorter wait for elective surgery, though.
Pick a doctor you trust
With private hospital cover, you can pick your treating doctor and have some or all of their fees covered by your health fund, depending on your insurer’s gap agreements. Being treated by a doctor you trust can give you peace of mind about your procedure.
Ahead of your procedure, check your health fund also has an agreement with the private hospital your chosen doctor practices at to avoid unexpected out-of-pocket costs. Otherwise, you’ll need to cover hospital fees, like accommodation costs.
Recover in a private room
Private patients can request a private room in hospital if you need to stay overnight, helping you get some much-needed rest as you recover from your surgery. Some private health insurers also give money back if you request a private room and none are available.
Along with being a comfortable space to rest in, a private room makes it easier to have friends and family visit without the extra audience.
Get money back on your cover, if eligible
People aged 65 and older can claim a higher private health insurance rebate from the Australian Government to help pay for their private health cover, depending on how much they earn. From 1 July 2026 to 31 March 2027, those aged 65 and over with a single income of less than $164,000 or a combined income of less than $328,000 can get a rebate of 12.058% or more, depending on their eligibility.
You can claim the private health insurance rebate either as a premium reduction through your insurer, so you pay less up-front, or as a tax offset when you lodge at tax time.
Most people, particularly older people, can claim the rebate. In fact, 93% of people aged 67 years or older who used iSelect’s health comparison service in 2025 told us they claimed the rebate.
| 2026–2027 income thresholds | ||||
|---|---|---|---|---|
| Base tier | Tier 1 | Tier 2 | Tier 3 | |
| Singles | ≤$105,000 | $105,001–$123,000 | $123,001–$164,000 | ≥$164,001 |
| Families | ≤$210,000 | $210,001–$246,000 | $246,001–$328,000 | ≥$328,001 |
| Rebate percentage (1 April 2026 to 31 March 2027) | ||||
| Age <65 | 24.118% | 16.079% | 8.038% | 0% |
| Age 65–69 | 28.139% | 20.098% | 12.058% | 0% |
| Age 70+ | 32.158% | 24.118% | 16.079% | 0% |
Note: These figures reflect indicative private health insurance rebates, based on Australian Government data. Data retrieved June 2026.
Save money on your tax, if eligible
Holding appropriate hospital cover makes you exempt from paying Medicare Levy Surcharge (MLS) as part of your tax. This can be as much as 1.5% of your taxable income for the year. Otherwise, you need to have a taxable income of $105,000 or less as an individual or a combined income of $210,000 or less for 2026–27 financial year.
Appropriate cover in this case is a hospital excess of $750 or less for singles or a hospital excess of $1,500 or less for couples and families. Your level of hospital cover, like what services are covered, isn’t considered.
Although you may no longer be working, some superannuation payments and investment incomes, like rent from investment properties, count towards your taxable income for MLS purposes. Therefore, having appropriate cover to avoid the MLS is still important if you’re a senior.
| Base tier | Tier 1 | Tier 2 | Tier 3 | |
|---|---|---|---|---|
| Single threshold | $105,000 or less | $105,001–$123,000 | $123,001–$164,000 | $164,001 or more |
| Couple or family threshold | $210,000 or less | $210,001–$246,000 | $246,001–$328,000 | $328,001 or more |
| MLS rate | 0% | 1% | 1.25% | 1.5% |
Note: These figures reflect income thresholds based on Australian Government data. Data retrieved June 2026.
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What types of health insurance policies for seniors are available?
Seniors can choose from 4 types of health insurance: hospital cover, extras cover, combined hospital and extras cover, and ambulance cover. When choosing policy types, consider what type of cover you want now and in the future to suit your health and lifestyle needs.
Hospital cover
A hospital policy in your senior years helps cover the costs of being a private patient in hospital, like for a joint replacement or chemotherapy. This includes both your treatment and accommodation costs, meaning less out-of-pocket expenses for you as a private patient. As a private patient, you can choose your doctor, skip long public hospital waiting lists and can request a private room.
Hospital cover comes in four tiers – basic, bronze, silver and gold – with each successive tier covering more services (called ‘clinical categories’) than the last. There are also plus tiers including the standard clinical categories with a little extra. For instance, a silver plus policy covers all silver tier clinical categories plus one or more from gold, like joint replacements.
As the highest tier, gold covers all clinical categories, including expensive and complex procedures like:
- joint replacements, including hip and knee replacements, and rehabilitation afterwards
- cataract surgery
- dialysis for chronic kidney failure
- sleep studies
- insulin pumps
- medically necessary weight loss surgery.
If you have any pre-existing conditions, they won’t exclude you from cover. However, it usually means a waiting period of 12 months before you can claim on that treatment.
Although gold includes everything, you might be happy with a lower level of cover, depending on your budget and health. Lower tiers, like bronze and silver, cover many treatments seniors can need, like:
- heart surgery
- endoscopies, including colonoscopies
- cystoscopies
- joint reconstructions (but not replacements)
- lung operations
- diabetes management (excluding insulin pumps)
- implantation of hearing devices.
iSelect customers in 2025 aged 67 or older tended to think this way, with the majority opting for bronze plus, silver or silver plus tier policies. With a silver plus policy, for instance, you could have cover for cataract surgery and/or joint replacements, depending on the policy.
Extras cover
An extras policy in your senior years means that you can get money back on out-of-hospital treatments not usually covered by Medicare, like physio, general dental and chiro. This cover makes it easier to address health issues before you need to go to hospital, manage ongoing conditions like poor eyesight and stick with post-surgery rehabilitation plans once you’ve left hospital, like following a joint replacement.
Extras cover options vary widely with different levels of cover and services included, like:
- general dental treatment, like dental check-ups and cleans
- major dental procedures, like crowns, root canals and dentures
- physiotherapy
- podiatry
- occupational therapy
- remedial massage
- optical
- medical devices, such as hearing aids
- chiropractic
- prescription medication not covered by the Pharmaceutical Benefits Scheme (PBS).
When comparing extras cover, take a look at the benefit percentages and annual limits. These determine how much you get back for each appointment and how much you can claim on a service in a 12-month period. Typically, higher benefit percentages and annual limits mean more expensive premiums, so it’s important to consider if you’ll get your money’s worth out of a policy.
Combined cover
Combined cover is a comprehensive health insurance option for seniors with cover for in-hospital private patient health care costs and out-of-hospital costs Medicare usually doesn’t cover. This way you can have cover to manage ongoing or unexpected health concerns with varying intervention needs, whether that’s a quick visit with an allied health professional or a few days in hospital.
You can tailor your combined cover to suit you by choosing policies from different health funds or take advantage of convenient bundled options with a combined hospital and extras policy.
Think about your needs now and in the future to decide on the cover you’d like to have, including if your partner or family will also be members. Then it’s simply a matter of finding policies that work for you.
Ambulance cover
Ambulance cover covers the costs of emergency ambulance transport and paramedic treatment for seniors who aren’t eligible for subsidies. For instance, a Commonwealth Seniors Health Card doesn’t qualify you for free ambulance transport in Victoria.
Additionally, even if you’re covered through a concession card, other members of your family may not be eligible. Taking out ambulance cover on a shared policy, like couples or family health insurance, would then provide them with emergency transport cover.
Often ambulance cover is included as part of hospital and extras policies.
Helpful tip
Some extras policies include home care benefits, covering services not typically part of hospital policies, such as wound care and administering medication. These benefits are often found in more comprehensive extras policies, though the exact inclusions can vary. Give your policy of choice careful consideration and decide which benefits matter most to you.
Dr. Jill Gamberg
GP, Coach, and Lifestyle Medicine Physician
How much is health insurance for seniors in Australia?
The average monthly combined health insurance premium was $355.56 for iSelect customers aged 67 years and older in 2025.
Interestingly, it was those aged 84 and older who had the lowest average monthly combined health insurance premium at $370.51, while those aged 73–78 had the highest at $416.26. This could be down to people typically becoming frailer as we age, making older seniors less of a good candidate for surgeries. Therefore, seniors in their 80s and above might not be able to make the most out of higher levels of hospital cover, so drop their cover level somewhat compared to what they held in their 70s.
Your health insurance premium may be more or less than these averages; it depends on lots of factors, like your chosen policy and if you have other people on your cover. For instance, if you share a gold hospital couples policy with your partner, your premium is likely to be higher than if you only had a singles silver hospital policy.
| Age | Average monthly combined premium |
|---|---|
| 67–72 | $405.62 |
| 73–78 | $416.26 |
| 79–84 | $399.16 |
| 84 and older | $370.51 |
| All seniors | $355.36 |
Note: These figures reflect indicative monthly health insurance premiums, based on internal iSelect data that resulted in a sale and rounded where appropriate. Actual costs may vary depending on your chosen policy. Based on data from January 2025 to December 2025.
Frequently asked questions
If I have health insurance for seniors, do I still have to pay Medicare Levy Surcharge (MLS)?
Regardless of your age, if you have appropriate hospital insurance you don’t need to pay MLS. Appropriate hospital insurance in this instance is an excess of $750 or less for singles and $1,500 or less for couples and families. Your chosen hospital tier doesn’t matter.
If you don’t have hospital insurance, your annual income might disqualify you from paying MLS. For 2026–27 financial year, the single income threshold is $105,000 or less and the combined income threshold is $210,000. If you earn over these thresholds, you need to pay a surcharge of up to 1.5% of your taxable income, unless your otherwise exempt from MLS.
| Base tier | Tier 1 | Tier 2 | Tier 3 | |
|---|---|---|---|---|
| Single threshold | $105,000 or less | $105,001–$123,000 | $123,001–$164,000 | $164,001 or more |
| Couple or family threshold | $210,000 or less | $210,001–$246,000 | $246,001–$328,000 | $328,001 or more |
| MLS rate | 0% | 1% | 1.25% | 1.5% |
Note: These figures reflect income thresholds based on Australian Government data. Data retrieved June 2026.
How does Lifetime Health Cover (LHC) loading affect health insurance for seniors?
You’ll have an additional loading added to your hospital insurance premium for 10 years, unless you have had consistent hospital cover since your LHC base date or are otherwise exempt from LHC. Your base day is the latest of either 1 July 2000 or 1 July after your 31st birthday.
For each year from your base day you don’t have hospital insurance, your LHC loading increases by 2% to a maximum of 70%.
LHC loading is often talked about as a consideration for young people and private health insurance, but it’s only the very elderly who can ignore it. You are only exempt from LHC loading through age if you were born before 1 July 1934.
Does health insurance for seniors cover pre-existing conditions?
Health insurance does cover pre-existing conditions, however your pre-existing conditions affect your waiting periods (how long you need to hold the cover before you can start claiming on it). For hospital cover, pre-existing conditions have a 12-month maximum waiting period. This is why it’s worthwhile considering what your health needs could be soon to pre-emptively serve waiting periods before you need specific cover.
The Australian Government sets maximum waiting periods for hospital cover, but health funds can choose their own waiting periods for extras cover. You can see what these are in the relevant policy documents.
If you’re switching from one health fund to another and have already served your 12 months for hospital cover, you won’t need to serve them again.
Do seniors get a discount on private health insurance in Australia?
Eligible seniors get a discount on their private health insurance through a government rebate. People aged 65 to 69 can receive a private health insurance rebate of up to 28.139% for 1 July 2026 to 31 March 2027, while those aged 70 or older get a rebate of up to 32.158%, depending on your income. The base tier threshold is $105,000 for a single income and $210,000 for combined incomes.
You can claim the rebate as a discount off your health insurance premium or as a reduction on your tax.
Many seniors claim the private health insurance rebate, with 93% of people aged 67 or older who used iSelect’s health comparison services in 2025 telling us they intended to claim it.
If you qualify for the aged pension, your income falls within the base tier for the private health insurance rebate.
| 2026–2027 income thresholds | ||||
|---|---|---|---|---|
| Base tier | Tier 1 | Tier 2 | Tier 3 | |
| Singles | ≤$105,000 | $105,001–$123,000 | $123,001–$164,000 | ≥$164,001 |
| Families | ≤$210,000 | $210,001–$246,000 | $246,001–$328,000 | ≥$328,001 |
| Rebate percentage (1 April 2026 to 31 March 2027) | ||||
| Age <65 | 24.118% | 16.079% | 8.038% | 0% |
| Age 65–69 | 28.139% | 20.098% | 12.058% | 0% |
| Age 70+ | 32.158% | 24.118% | 16.079% | 0% |
Note: These figures reflect indicative private health insurance rebates, based on Australian Government data. Data retrieved June 2026.
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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
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