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Participating Health Funds

Seniors' health insurance

Tradition states that wisdom comes with age, and one way to start flexing the newfound wisdom muscle is to make sure your health insurance plan offers all the medical protection you need for the price you're willing to pay.

Changes in health insurance for seniors

Health changes

As your circumstances change, so too do your health insurance needs. Now is the time to review your health insurance to make sure you're covered for the things you might need to claim on later. Because health risks can often increase with age, some features you should consider for your health insurance include:

  • cardiac cover
  • cataract cover
  • hip and knee joint replacement
  • shoulder and elbow join replacement
  • rehabilitation

If you have pre-existing medical conditions, there may be a 12 month wait for some of these features if you don't have cover for them already, so take action now to be covered later when you need them.

It might be a good idea to see your family doctor and get a health check, to see what health insurance features are indispensable for your level of health.

Family changes

Another major change to your health insurance is that your kids may no longer eligible for health cover under your private health insurance policy. Most health funds allow you to cover your kids under your family health insurance until they reach 21, unless they're single and studying full-time, in which case they can be covered until the age of 25. Read our article on dependant children and check the threshold age and specific details with your health fund.

If your child is no longer eligible to be covered by your health insurance policy, then it's time to change your status and review your cover. Switching to a couples or singles cover can save you hundreds, especially if you're downgrading from the adult children family cover. However in many cases, couples and family cover can often cost the same. Encourage your child to review their own situation and decide whether health insurance is a good idea for them to take out independently. Medicare Levy Surcharge and Lifetime Health Cover rules may now apply to them.

Lifestyle changes

If you're an empty-nester or a retiree, you can finally do those things you've wanted to do for ages but didn't, for the sake of the kids. Will it be an exotic overseas holiday? Those home renovations you've been itching to make? A new car? When your children cease to be reliant on you, you'll have more cash, more time and more freedom.

Empty-nesters and retirees are known to travel further now than previous generations. If you plan to travel around Australia, make sure your health cover protects you across the multiple states you plan to travel to. Most major Australian health funds cover nationally, but smaller health funds may be limited in the extent of their coverage and the number of agreement private hospitals outside the state you live in. 

If you plan to travel overseas, contact your health fund to arrange a suspension period so you're not paying health insurance premiums for the time that you are away. For prolonged stays overseas, you are able to be without health insurance for a period totalling 1094 days (one day less than three years) without affecting your Lifetime Health Cover. You may, however, need to check with your health fund to see if your waiting periods will be affected when you return to Australia.

Save on health insurance

Shop around for health insurance

The best way to find a great deal and get the health insurance cover you need is to shop around. moneytime helps you search, save and join health insurance from a number of leading Australian health funds, allowing you to compare them side by side so you can see exactly what benefits you receive from the health funds for the price you pay.

Save with the Government Rebate

One of the advantages of ageing is that it's recognised and rewarded by the Government, which increases your health insurance rebate depending on the age of the oldest person covered by the health insurance policy:

30% rebate for people aged up to 65

35% rebate for those aged between 65-69

40% rebate for those aged 60 years old and up

Other ideas to save on health insurance

  • Pay a year's health insurance premium in advance at the beginning of the year to lock in the previous year's rate before the annual rate rise. The annual rate rise occurs around March/April each year, when the health funds increase their health insurance premiums with the approval of the Health Minister to cover the cost of rising medical inflation. In previous years, the rate rise has generally been around 5% of the previous year's health insurance premium.
  • Pay by direct debit – a number of funds offer up to 5% discount on the cost of your health insurance when you choose to pay by direct debit.
  • Before you go to hospital for a medical procedure, check first to see if you'll be liable for a gap payment (this is when the specialist charges a higher fee than the Medical Benefits Schedule). If your doctor has an agreement with your health fund, you can often avoid the gap, so it pays to check in advance.
  • Get a health insurance plan that covers you for the things you need. You can recoup the cost of your health insurance premium if you use the full benefits you're entitled to. Know the maximum benefits for features like dental, optical, physio, etc under your plan, and use them to improve your health and wellbeing.

For more ideas, check out our tips to save on health insurance.

If you're joining health insurance for the first time...

If you're thinking of joining a health fund for the first time, it's important to be aware of Lifetime Health Cover regulations, which may detrimentally affect the cost of your health insurance premium. Lifetime Health Cover is a Government initiative designed to encourage people to take out private hospital cover earlier in life, and maintain their cover throughout their lifetime. Those who take out hospital cover by 1 July following their 31st birthday can lock in the lowest base health insurance premium for as long as they keep continuous hospital cover. If you didn't take out health insurance by that date, a 2% loading is added to the base health insurance premium for each year above the age of 30 that you were without hospital cover. The Lifetime Health Cover loading applies to hospital cover only, and does not affect the cost of your extras cover.

The exception to this is people who were born before 1 July 1934. If you were born before this date, then you are exempt from Lifetime Health Cover and can pay the lowest base health insurance premium regardless of when you join a health fund. Read more about Lifetime Health Cover.

However the good news is that if you're a single person with an income above $77,000 or a couple with an income above $153,000 p/a (current for the 2010-2011 financial year), you will avoid the Medicare Levy Surcharge, which is an extra 1% tax imposed on those without hospital cover. You can put the savings from the Medicare Levy Surcharge towards the cost of your health cover instead, and also save with the increased Federal Government Rebate. After ten years of continuous hospital cover, the loading will be dropped and you'll be able to pay the base health insurance premium from that point onward.

For further questions on choosing private health insurance or navigating our website, don't hesitate to call the moneytime help desk on 1300 88 26 36 (Monday-Friday 8.30am to 5.30pm EST).

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