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Health Insurance Options in Australia for Seniors

Health Insurance Options Available in Australia for Seniors

It’s not always easy finding a private health insurance in Australia, that suits your current and future needs. When looking for a policy that’s best suited, ageing Australians could take out combined hospital and extras cover. By having a combined cover you’re ensuring that you’re covered for both in hospital and everyday health costs towards your healthcare. Hospital cover will cover you for in-hospital treatment. Extras will cover you for everyday health care costs such as dental, optical and physiotherapy.

Whether you decide to take out a combined policy or not, there are many policies out there to suit your budget and circumstances. Actually, there are policies that cover common ageing conditions too.

As people age, their risks of developing chronic health conditions increases. Consequently, they’re more likely to access both in-hospital care and out of hospital care. By having private health cover, older people avoid lengthy hospital waiting periods. They also gain access to some complementary therapies and allied health services too.

When Aged Care Prepare asked the experts at nib what health insurance options were available for seniors, they had an extensive list. What they did say that was important though was that “everyone is different, so you should always consider your individual personal circumstances when selecting your cover and we strongly recommend contacting our consultants to discuss your personal needs and budget.”  They make a great point. It doesn’t matter which insurance company you’re considering taking out a policy with, opting to speak with one of their consultants first is a great idea.

Health Insurance Premiums

When people discuss health insurance costs in Australia, the monthly premiums often appear high. But it’s important to consider that as you age, your risk of developing health conditions increases. Consequently, the likelihood of having several treatments and several hospital stays increases. This can be very costly. So although the premiums might seem excessive, it’s important to consider how much a hospital stay would cost if you didn’t have cover. Or how much a regular allied health service would cost without cover. And nowadays there are ways that you can reduce your health insurance premiums.

With the implementation of the new health insurance reforms, people have the option now to pay a higher excess if the time arises that they need admission to a hospital. By paying a higher excess, their health insurance premiums reduce, making it more affordable to manage.

Which is the Most Popular Health Insurance Cover for Seniors?

Under most circumstances, people will tend to take out a combined cover with the same private health insurance fund. Aged Care Prepare recently spoke with nib and asked them what health insurance options they have available for seniors? While they have several options available, they said they have a policy that seems to be most popular among seniors: “Our Silver Advantage Hospital Plus is the most popular product we sell to those aged 55+ because this is our most comprehensive product for seniors covering all services except pregnancy, assisted reproductive surgery, weight loss surgery and in-hospital psychiatric treatment.

Keep in mind that health insurance cover for seniors doesn’t need to include fertility treatment or obstetrics. When looking for a cover be sure to choose a policy that best meets your needs now and what you think you might need in the future.

man being examined by dentist

What Are the Benefits of Including Extras to Your Seniors Health Insurance?

A combined private health insurance policy covers people for both hospital and extras. Extras cover varies between insurers and it’s always a good idea to search for the right coverage to meet your needs. Many health insurance funds offer options suitable for seniors. For example, at nib, they offer Core & Young at Heart extras that provides coverage for age-related services such as hearing aids, pharmaceutical prescriptions, podiatry, and a variety of health aids (i.e. walking frame, compression garments, etc.). When searching for an extras cover, really look at what your coverage is. Make sure that your greatest healthcare needs get covered.


Are Seniors Eligible for a Health Insurance Rebate?

The answer is yes. The Australian Government Rebate (AGR) is an amount that the Government puts towards your health cover to make it more affordable. You can either receive this rebate as a percentage reduction on their private health cover premiums. Alternatively, you are able to receive it as a refundable tax offset when you lodge a tax return.

Furthermore, the private health insurance rebate is income tested, therefore seniors will also receive the AGR if they are eligible. The level of AGR a person receives is dependent on the age of the oldest person on the policy and the taxable income (or combined family income for couples and families).

Once the oldest person in the house reaches 65 years, the rebates go up to as high as 29.236%. And then once the oldest person in the house reaches 70 years, the rebates go up to as high as 33.413%. These are the current percentages at this time. The Government reviews the AGR every year and adjusts it annually on April 1. Be sure to keep an eye out for these adjustments.

How to Save Money on Your Private Health Insurance Policy?

For many over 50s, managing your finances and minimising unnecessary expenses is important. And, nobody wants to pay more for private health insurance than you should be. There are a couple of very simple ways to make sure you’re not paying more than you need to for health insurance.

Firstly, make sure that you’re utilising the discounts on offer. For example, some health funds offer discounts for people who pay via direct debit. At nib, they offer discounts of up to 4% to members who set up direct debits from their bank accounts.

As previously mentioned, you can usually opt for a higher hospital excess, which will make your monthly premiums lower.

Finally, be sure to apply for the Australian Government Rebate if you are eligible.

Remember, that all health funds must follow and abide by the principle of Community Rating. Community rating requires health insurance providers to offer health insurance policies to all individuals at the same price. This is regardless of their age, race, or health status.

Why Get Private Health Insurance When There’s Medicare?

Australia has a public healthcare system (Medicare). It provides all Australian citizens access to free or low-cost care for certain health issues. If your health condition isn’t life-threatening, however, it’s possibly considered elective treatment/ surgery. If this is the case, you may experience long waiting periods in the public system. Additionally, you won’t be able to choose your doctor or hospital.

By having private health insurance, you’re able to receive treatment as a private patient, avoid public hospital waiting periods and choose your hospital and treating doctor. Private hospital cover also pays some or all of the costs for your hospital accommodation, theatre, doctor and specialist fees. If you have Extras cover, it aids in covering the costs of everyday services such as physiotherapy, dental, and other allied health and complementary health services.

Seniors With Pre-existing Health Conditions

For those who have pre-existing health conditions, health insurance companies aren’t allowed to deny you coverage on the basis of your condition. This is because Private Health Insurance is community rated. This means that insurance providers offer health insurance policies to all individuals at the same price, regardless of their age, race, or health status.

On the other side, usually pre-existing conditions have a 12-month waiting period that applies before any benefits are available for hospital cover. Extras cover often have a shorter waiting period. When you join a fund, be mindful of the waiting periods. Furthermore, have a chat with a consultant about your current situation. In some cases, waiting periods might be reduced.

Considerations for Seniors When Deciding on a Health Insurance Policy

Experts at nib explained, “the first consideration for anyone when it comes to private health insurance is whether you’ve got an appropriate level of cover for your current circumstances”. They went on to explain that one must “take into account what may come as you age, remembering that peoples’ health status changes over time”.

Many seniors are on a tight budget. Looking at saving money is important. You can do this by checking that you’re not paying for things you don’t need, like obstetrics.

Finally, give your private health fund a call from time to time. Check, and make sure that your cover still meets your needs.


Author: Renae Diggles/ Editorial Director/ Aged Care Prepare
Expert Contributor: nib Team

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