Health Insurance for Seniors

As you get older, there are a couple of things to consider when it comes to Health Insurance.

Firstly, your health needs may become more complex.

As a result of that, you may also need more frequent trips to the doctor or various specialists, which can take up a lot more of your time and resources.

If you haven’t thought about Health Insurance or you haven’t checked your cover in a while, now could be the time to look into it.

What are the different kinds of Health Insurance policies that may be suitable for seniors?

Almost all private Health Insurance policies fall into three different categories – hospital cover, extras cover, or a combination of both.

While there’s no insurance product called ‘seniors’ health insurance’, Private Health Insurance policies for seniors are no different. What is different, however, is the stage of life that you’re in.

Singles in their early 20s, families, and people heading into retirement all have different health and lifestyle needs. That’s why it’s important to consider what type of cover you want now and in the future.

Once you have an idea of your needs, iSelect can try and help you find a suitable health insurance policy for your lifestyle and requirements from our range of policies and providers*.

Hospital cover

There are four general tiers when it comes to hospital cover – Gold, Silver, Bronze and Basic.

Depending on the level of cover, hospital cover can offer choice of doctor/surgeon and potentially help cover you for a wide range of private in-hospital treatments, such as¹:

• Rehabilitation
• Hospital psychiatric services
• Palliative care
• Hospital accommodation
• Fees for the operating theatre
• Medication (related to in-hospital treatment)
• Treatments for the brain and nervous system
• Eye surgery (non-cosmetic)
• Prosthetics (hip, limb and joint replacements etc.)

Bear in mind that, as a senior, a basic level of hospital cover might not be adequate for people who have complex or ongoing health needs.

For example, if you require treatments for joints and muscles, or the ears, nose and throat, then a Bronze level of cover may be suitable for you.

However, if you require ongoing treatment for issues such as dialysis for chronic kidney failure or weight loss surgery, then a higher level of cover might be a better option for you.

Extras cover

Extras cover, on the other hand, can help cover services that take place outside of the hospital and are not covered by Medicare. Depending on your policy, these might include: 

• Dental treatment 
• Visits to the chiropractor or physiotherapist 
• Podiatry 
• Medical devices such as hearing aids 
• Occupational therapy 
• Optical 
• Prescription medication not covered by the Pharmaceutical Benefits Scheme (PBS)

What isn’t covered by Health Insurance?

As with any type of insurance policy, it’s just as important to check what you are covered for as it is to check what you’re not covered for.

Hospital cover can help out when it comes to in-hospital treatments, while extras cover may help subsidise treatments not covered by Medicare.

Private hospital policies, however, don’t offer support when it comes to services that aren’t listed under the Medicare Benefits Schedule (MBS). Policies will have different limits and exclusions and every policy is different, so make sure you read through your policy brochure before you sign up.

How can seniors save on Health Insurance?

Here are a few ways you can make the most of and potentially save on your Health Insurance.

Rebates

The Australian Government offers a Private Health Insurance Rebate to help cover some of the costs of their insurance premiums.

The Private Health Insurance Rebate is income tested, and generally, eligible policyholders over the age of 65 will receive a higher rebate.

Source: PrivateHealth.gov.au - Australian Government Private Health Insurance Rebate

For more information on the Private Health Insurance Rebate, visit the ATO website. 

Public waiting times

When it comes to elective surgery, waiting times can be long in the public system.

According to the Australian Institute for Health and Welfare, in 2021-22, 90% of patients admitted to hospital from public hospital elective surgery waiting lists waited for 323 days or less, while 50% of patients waited for 40 days or less².

One possible benefit seniors may value from Private Health Insurance could be potentially shorter waiting times for elective surgeries.

Depending on your policy, hospital cover could help you schedule a procedure as early as possible, and help you avoid lengthy waiting times.

Taking control of your treatment time could also put the cost of Health Insurance in perspective.

What if I have a pre-existing condition?

The good news is that pre-existing conditions shouldn’t increase the price of your premium.

In Australia, you can generally elect to cover yourself for what procedures are important to you even if you already have a pre-existing condition. However, note that there will usually be a 12-month waiting period on pre-existing conditions before you can claim³.

A pre-existing condition consists of any ailment, illness or condition where the signs or symptoms of the condition are apparent for 6 months prior to the date you purchase your Health Insurance Policy⁴. It’s also important to note that, that an opinion about whether an illness or injury is pre-existing will be formed by the health insurer’s appointed medical practitioner who will take into account information provided by the member’s treating doctor⁵.

Where can I compare options?

At iSelect, we compare a range of different policies and providers to help people find a policy that’s suitable for their lifestyle and budget*. Just give us a call on 1800 784 772 and someone from our team will take you through your options today.

^{Sources:
1 Australian Government Department of Health and Aged Care - Private Health Insurance Reforms - Hospital Treatment Product Tiers, pg 2 
2 Australian Institute for Health and Welfare - Access to Hospitals 
3 Australian Government Department of Health and Aged Care - Waiting Periods and Exemptions 
4 Commonwealth Ombudsman Private Health Insurance - The Pre-existing Conditions Rule 
5 As above.}