Health Insurance Age Limits

The basic cost of a health insurance policy doesn’t change according to the age of the customer under Australia’s community rating legislation. However, you will be entitled to a higher percentage Health Insurance Rebate once you turn 65 years old, so your health insurance will likely end up costing you less once you reach 65.  

There is no legal definition of a dependent as defined by the Australian Government. Who is classified as a dependent will depend on the health fund you choose. However, generally, a dependent is classified as someone who: 

• Lives in the same household as the main provider 
• Is provided with food and basic living essentials by the household provider 
• Is single and not married 
• A disabled dependent is a person who lives at home with their parents and is in receipt of NDIS funding or equivalent support 

You’ll need to have a minimum of a basic hospital cover policy as defined by the government to avoid the Medicare Levy Surcharge (MLS). The policy must have an excess of no more than $750 for a single or $1,500 for a couple or family policy. The MLS is an additional health tax of between 1% and 1.5% (depending on your income) which Aussies have to pay if they don’t have private health insurance and earn over $90,000 p.a. for a single and $180,000 for a couple. 

There’s no legislation that says you must have private health insurance. In fact, more than 55% of Aussies don’t have private hospital cover, while around 45% don’t have extras cover (as of March 2023). However, if you do suffer a serious accident or illness which requires extensive out-of-hospital healthcare to assist with your recovery, you may find yourself with thousands of dollars of out-of-pocket expenses.  

You’ll also have to join public hospital waiting lists for any non-emergency in-hospital treatments and surgeries if you don’t have private health insurance. As such, it’s worth considering your priorities when determining whether you need private health insurance.