Family Health Insurance

What is Family health insurance?

In Australia, Family health insurance is private health cover for 2 adults and one or more dependants.

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 beMany couples with dependants take out a Family policy because: 

• Your dependants are covered for the same treatments as you. 

• You have the convenience of: 

• one account 

• one policy 

• one payment. 

Some insurers will cover your dependants until the age of 31. 

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Is Family health insurance more expensive than Couples or Singles health insurance?

Family health insurance can be more expensive than policies that cover just one adult, 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. 

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How much does Family health insurance cost?

For families (per month): 

• The cheapest Hospital Cover starts at around $76 in the NT ranging up to $206 in TAS. 

• Extras Cover starts at around $23.10 in the NT ranging up to $31.10 in most other states and territories for the lowest level of cover.  

• Basic Combined Hospital and Extras Cover ranges from $165.78 in the NT up to $253.05 in QLD. 

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, 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.
• Where you live. You pay more if:
  • you live in a state or territory 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.

Other factors that could impact your premium 

If government incentives and penalties apply to you, these will impact how much you pay for your policy. These are partly determined by: 

• 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 did not take 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 $302,000 or less, you may be eligible for the Private Health Insurance Rebate, which gives you a premium reduction on: 
  • Hospital Cover 
  • Extras Cover 
  • Ambulance Only Cover. 

If your combined income is more than $194,000 per year plus $1,500 for each dependent child per year after the first child, and you do not have Hospital Cover, you may have to pay the Medicare Levy Surcharge. 

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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, if you are not married, you must be a registered couple or in a de-facto relationship (living together but not married). 

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

No. Once you are legally separated from your spouse or divorced, insurers typically require you to take out Singles health insurance or Single Parent health insurance. This type of policy is designed to provide you with the same level of protection. 

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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. Instead of staying on a Family policy, you have to take out Single Parent health insurance (one adult plus dependants) or a Singles policy just for you (if your children are covered on your co-parenting partner’s policy). You need to tell your insurer if you are going through a separation or divorce to ensure it will pay any claims you make. 

Your dependants need to be on your policy or your co-parenting partner’s policy, not on both. 

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What is the best health insurance for a family?

To find the best Family health insurance for your family, ask these 10 questions:

Q 1:	What are your family’s circumstances? What are your family’s health needs?  What are your family’s lifestyle habits?  Does anyone have a pre-existing condition?  Do you want health insurance to reduce your tax bill?  What are your families’ histories of health conditions?
Q 2:	How old are your dependants? Are you about to start a family? If you are thinking of having children in a private hospital, you will need Gold Cover, which has a waiting period of 12 months before you can make a claim.  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 adult dependants to remain on a Family policy until the age of 31, however each insurer has different conditions for this. A higher premium may apply. has removed the age limit for dependants living with disability.  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 to a policy for 2 adults only (you and your partner) or 2 separate policies for each of you.
Q 3:	What type of health insurance does your family need? Hospital Cover Extras Cover Combined Hospital and Extras Cover Ambulance Only Cover
Q 4:	If you want Hospital Cover, what level of Hospital Cover does your family need? Basic Bronze Silver Gold
Q 5:	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.
Q 6:	For Extras Cover, what are the claim limits, annual limits or lifetime limits on the policy?
Q 7:	What is your family’s budget for health insurance? Does the cover you 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?
Q 8:	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 if you make a claim?  Look for a policy that does not charge an excess or co-payment if your dependants go to hospital.  Will you have to pay out-of-pocket fees, such as Medical and Hospital Gaps?
Q 9:	Will you have to make a co-payment if you make a claim on your Hospital Cover and, if so, can you afford it? 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 dependants go to hospital.
Q 10:	Check what are the waiting periods before you can make a claim for any policy you are considering. For example:  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, check with your insurer about their requirements and whether waiting periods will apply.

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Can my children get their own health insurance?

Yes. It is possible for a child to take out health insurance but currently only 2 insurers offer child-only policies: Navy Health and Defence Health. These are both restricted insurers which means you must meet certain criteria to be eligible for cover.  

Can my children stay on my Family policy when they become adults?

Yes. Private health insurers allow you to include adult dependants on your Family policy, provided they meet certain conditions. Here are the government’s definitions of ‘dependants’ for health insurance purposes: 

• Child dependant – aged up to 18, and single 

• Student dependant – aged 18 to 31, single and enrolled in full-time study 

• Non-student dependant – aged 18 to 31, single and not in full-time study 

• Dependant with a disability – aged 18 and over, and participating in the National Disability Insurance Scheme (or fitting the health insurer’s definition of a dependant with a disability). 

Each insurer may have its own criteria for these categories, so it is important to check. 

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How can I compare Family health insurance?

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

You can also compare your existing policy against other relevant policies currently in the market. 

We compare every insurer and every policy, with no commercial bias, and guarantee you the cheapest policy. 

You can also 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.