Family Health Insurance

Reviewed and updated 3 April 2024

What is Family Health Insurance?

In Australia, Family Health Insurance is private health cover for you, your partner and your children.

You have the option of taking out:

Hospital Cover
Extras Cover
Combined Hospital and Extras Cover
Ambulance Only Cover.

Many couples with children take out a family policy because:

Your children are covered for the same treatments as you.
You have the convenience of:
- one account
- one policy
- one payment.

Some insurers will cover your children until the age of 31 if they are classified as dependants.

Is Family Health Insurance more expensive than couples or singles health insurance?

Family Health Insurance can be more expensive than couples and singles, but it is often the same price as a couples policy.

Your insurer may even let you upgrade from a couples to a family policy at no extra cost.

How much does Family Health Insurance cost?

Prices

For families:

Hospital Cover starts at around $200 per month
Extras Cover starts at around $35 per month
Combined Hospital and Extras Cover starts at around $235 per month.

Key factors affecting the cost of Family Health Insurance

The cost of Family Health Insurance depends on your tier of Hospital Cover, extent of Extras Cover, you and your partner’s age, combined income, where you live, chosen excess and any co-payments:

Tier of Hospital Cover:
- Basic Cover
- Bronze Cover
- Silver Cover
- Gold Cover.
Extent of Extras Cover.
You and your partner’s age:
- If you are 18-29 and eligible for the Age-based Discount, you can save up to 10% per year on Hospital Cover.
- if you have not taken out Hospital Cover before the age of 31, you have to pay the Lifetime Health Cover Loading, which means you pay 2% per year for every year you have not taken out cover.
Your combined income: if your combined income is $186,000 or less, you may be eligible for the Private Health Insurance Rebate, which gives you a discount on:
- Hospital Cover
- Extras Cover
- Ambulance Cover.

If your combined income is over $186,000 per year and you do not have Hospital Cover, you may have to pay the Medicare Levy Surcharge.

Where you live: you pay more if:
- you live in an area where there is a higher rate of claims
- your state or territory charges more for hospital services.
Higher excess: if you choose this in exchange for a lower premium.
Co-payment: if you pay a contribution for every day you are in hospital in exchange for a lower premium.

How the Private Health Insurance Rebate may make health insurance cheaper for your family

The Private Health Insurance Rebate is a discount you may receive on your health insurance depending on your income and age.

The means-tested threshold is $288,000 for couples and families.

If you have family or couples cover and depending on your financial situation and age, you may be able to claim a larger rebate from the Australian Government than if you had singles cover. Moreover, your children are covered for free.

Do my partner and I have to be married to get Family Health Insurance?

No. You do not have to be married to take out a family policy.

However, you have to be married, a registered couple or in a de-facto relationship (living together but not married).

Each of your children can be:

your child, whether or not born in marriage
your adopted child
a stepchild
a foster child.

If we are divorced, can we get family health insurance?

No. Once you are legally separated from your spouse or divorced, you can no longer have a couples or family policy.

Instead, you need to take out Single Parent Health Insurance. This type of policy is designed to provide you with the same level of protection without the cost.

Can I get Family Health Insurance if I am a single parent?

No. You cannot get Family Health Insurance if you are a single parent.

You need to tell your insurer if you are going through a separation or divorce to ensure it will pay any claims you make.

Instead of staying on a family policy, you have to take out Single Parent Health Insurance.

Your children need to be on your policy or your partner’s policy, not on both.

What is the best health insurance for a family?

To find the best Family Health Insurance for your family, ask these 10 questions:

Q1: What are your family’s circumstances?

What are your health needs?
What are your lifestyle habits?
Does anyone have a pre-existing condition?
Do you both want health insurance to reduce your tax bill only?
What is your family history of health conditions?

Q2: How old are your children?

Are you about to start a family?
- If you are thinking of having children, you will need Gold Cover, which has a waiting period of 12 months before you can make a claim.
- If you want your baby to be covered under your policy when they are born, most health insurers require you to take out a family policy 12 months before the baby is born but some require up to 12 months.
Do you have young children, school age children or teenage children?
- Consider whether, if your children develop health issues, you want the choice of having them treated in the private hospital system.
- Consider whether you want help paying for expenses that Medicare does not cover like Dental, Optical, Speech Therapy and Orthodontics.
Do you have adult children who are dependent on you?
- The Australian Government:
  - allows dependent children, such as students, to remain on a family policy until the age of 31
  - has removed the age limit for dependants living with disability.
- Check whether the insurer has extended their family cover to dependants because it is optional for them to do this.
- Check whether your insurer charges you a loading for covering adult dependants.
Have your children moved out of home?
- Consider whether you need to change your policy because your health needs may have changed or it makes more sense to transfer from a family policy to a couples policy or 2 singles policies.

Q3: What type of health insurance does your family need?

Hospital Cover
Extras Cover
Combined Hospital and Extras Cover
Ambulance Cover Only.

Q4: If you want Hospital Cover, what tier of Hospital Cover does your family need?

Hospital Cover tiers:

Basic
Bronze
Silver
Gold.

Q5: If you want Extras Cover, what treatments do your family need and are likely to use?

There is no point taking out Extras Cover if you are not going to use it.

Check whether the policy offers free or discounted extras for children.

Q6: For Extras Cover, what are the limits on the policy?

Check the policy for:

claim limits: how many claims you can make for a particular treatment?
annual limits: how much you can claim each year?
lifetime limits: how many claims you can make for a particular treatment over the life of the policy?

Q7: What is your family’s budget for health insurance?

Does the cover you have selected fit within your budget?
Are you eligible for the Private Health Insurance Rebate?
Are you eligible for the Age-based Discount?
Will you have to pay the Lifetime Health Cover Loading?

Q8: Will you have to pay an excess if you make a claim on Hospital Cover?

How much is the excess?
Will you be able to afford the excess or co-payment if you make a claim?
Look for a policy that does not charge an excess or co-payment if your children go to hospital.

Q9: Will you have to make a co-payment if you make a claim on your Hospital Cover?

How much is the co-payment?
Will you be able to afford the co-payment if you make a claim?
Look for a policy that does not charge a co-payment if your children go to hospital.

Q10: Does the policy have waiting periods?

Check the policy to find out:

What is the waiting period before you can make a claim for a particular Hospital Cover clinical category?
What is the waiting period before you can make a claim for a particular Extras Cover treatment?

For example:

If you are thinking of having children, you need Gold Cover, which has a waiting period of 12 months before you can make a claim.
If you want your baby to be covered under your policy when they are born, most health insurers require you take out a family policy 12 months before the baby is born but some health funds require up to 12 months.

Can my children get their own health insurance?

Yes. It is possible for a child to take out health insurance but it is not very common.

Generally, you cannot take out private health insurance until you turn 16, but some insurers cover younger children.

Since most Family Health Insurance policies cover dependants, it may make more financial sense to take out a family policy because it covers your children at no extra cost.

If you don’t have a partner, you may want to take out Single Parent Health Insurance to cover your children.

How can I compare Family Health Insurance?

Use our Calculator to find the best and cheapest family health insurance for you.

We compare every insurer and policy.

We can also give you a personalised price on your Family Health Insurance because you can calculate whether you:

can save on your health insurance because you are eligible for the Private Health Insurance Rebate and/or the Age-based Discount
have to pay the Lifetime Health Cover Loading.