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Health Insurance for Seniors

Name: Health Insurance for Seniors
Creator: Savvy
Published: 2021-05-25T14:53:09+09:30

Compare a variety of health insurance options for seniors to help you find the best cover for your needs.

Instant quotes in 2 minutes.

Written by , updated on July 6th, 2023

We’ve partnered with Compare Club to bring you a range of health insurance policies to help you compare them side by side.

Choosing the best health insurance policy is an important consideration, particularly for those Aussies who are seniors or in the later years of their life. Whilst there are many health insurance policies to choose from, not all will be appropriate or a good fit for seniors.

Savvy helps seniors by making the process of finding a great health insurance policy easy. We can help you to explore your private health insurance options by quickly providing a range of quotes for you to compare online. Just by answering a few simple questions about the health insurance you're looking for, you could soon have a number of quotes from some of Australia's leading insurers to compare. Don't delay – start getting your health insurance sorted out with Savvy today!

What is health insurance for seniors?

Private health insurance policies offered in Australia are equally available for people of all ages, as it is illegal to discriminate against anyone based on their age or gender, or to refuse health insurance cover due to a pre-existing health condition. However, there are policies that are geared towards people in the second half of their lives, which offer comprehensive cover for a wide range of treatments, whilst excluding cover for features that are not relevant to seniors, such as pregnancy and childbirth.

What is different for seniors as far as health insurance goes is the level of rebate offered by the government, which increases once a person reaches 65 years of age (based on income.)

The Private Health Insurance Rebate for Seniors

The Australian government assists all citizens with the cost of their private health insurance. The amount of rebate applicable is means tested, with the amount of rebate decreasing as income increases. The basic level of the rebate applies for those who earn under at $90,000 p.a. for a single person, or $180,000 p.a. for a couple.

At 65 years old, the rebate increases from 24.6% to 28.7%.
At the age of 70 years or older, the rebate increases again to 32.8%.

Although the rebate percentage was frozen for a period of eight years up until the 2022/2023 financial year, the amount of the rebate and relevant income levels may change, so be sure to check with the ATO site relating to private health insurance rebates for the very latest information.

How do I compare the best health insurance for seniors?

When comparing your health insurance options as a senior Australian, you will first have to decide whether you want hospital cover, extras only cover or a combination of both.

Hospital cover

The main features of hospital cover are:

You may be able to have access to a private room in a public or private hospital
You may be able to choose the doctor who treats you, and the hospital where you receive your treatment
You may be able to avoid the lengthy delays often associated with public hospital surgery, and choose when to receive your treatment without having to join a waiting list

All of these potential benefits are subject to eligibility and availability, and the terms and conditions of the individual health insurance policy you choose to buy.

Extras cover

The main features associated with extras cover include:

You may be able to claim back some or all of the cost of a variety of outpatient treatments or services that are excluded from Medicare, such as dentistry, optometry and the provision of subsidised hearing aids.

However, the amount you'll be able to claim back, and the range of outpatient services that are covered will depend on the specific policy you choose to buy.

Once you have decided on hospital cover, extras cover, or the benefits of both, you will need to work out what features are most important to you. It may be a good idea to prioritise existing conditions you may have, and make sure these are covered by your policy. Some treatments that are more common later in life, such as heart surgery, eye surgery and joint replacement, may only be available with top-tier policies.

After identifying specific treatments you need cover for, you'll then need to consider what cover you can afford. While more expensive policies may not be within everyone's budget, they will offer the most comprehensive level of cover for senior Australians.

What does health insurance for seniors cover?

The inclusions in your health insurance will depend on the type of cover you choose (hospital cover, extras cover or perhaps a combination of the two.) Furthermore, your inclusions will depend on the tier of cover you choose, ie. basic, bronze, silver or gold. Hospital cover can have many of the inclusions which are popular with seniors including:

Private patients accommodation in private or public hospitals
Operating theatre fees
Fees charged by doctors, surgeons and anaethetists
In-patient MRIs, x-rays, CAT scans and blood pathology
Hip and knee replacements

Cardiothoracic surgery for heart, lungs or chest
Organ transplant
Back surgery
Dental surgery
Hernia repair
Colonoscopies
In-patient pharmaceuticals

Cancer and stroke treatment
Prostheses
Eye surgery
In-patient pshchiatric services
Palliative care
Ambulance cover

Extras cover health insurance can include some or all of the following, depending on the level of cover you choose:

Optical services including glasses and contact lenses
Dental cover, including checkups, root canal treatment, dentures and extractions
Physiotherapy
Chiropractic services
Hearing aids

Podiatry
Occupational therapy
Psychology
Blood pressure monitors
Preventative tests such as bowel cancer screening and bone density testing

What isn't covered by health insurance for seniors?

Common exclusions to health insurance policies include:

Laser eye surgery
Acupuncture
Appointments with specialists outside of hospital
Surgery not considered medically necessary, such as tattoo removal or face lifts

Self-inflicted injuries
In-home nursing care (which is frequently provided by Medicare if considered necessary)
Chinese medicine
Some alternative medicines and therapies

It is vital to get a thorough understanding of a policy’s inclusions and exclusions, so you understand exactly what you are covered for. Savvy makes this easy by helping you to compare a number of policies side-by-side so you can cleary see the differences. Start comparing health insurance policies here with Savvy today.

How much does health insurance for seniors cost?

It’s a common misconception that health insurance for seniors costs more than for younger Australians. Health insurance is community rated, which means that everyone pays the same for their insurance no matter your age, health status or claims history.

The amount you'll pay for your health insurance will be impacted by several factors, including:

The level of cover you choose. Top-tier cover is going to be significantly more expensive than basic level cover.
Whether you opt for hospital only, extras only or a combination type of cover.
The insurance company you choose
Your location and the state you live in

What are the benefits of seniors’ health insurance?

Choose your doctor – if you have private health insurance, you may have a choice about which doctor you see and which surgeon performs your surgery
Skip public hospital waiting lists – having private health insurance can help you skip lengthy public hospital waiting lists
Have your own room whilst in hospital – it is possible (but not guaranteed) that you may be able to be accommodated in a single room in a public or private hospital if you are a private patient. This will depend on the terms and conditions of the policy you buy, and the availability of single rooms.
Decide which hospital you wish to receive treatment in – you may be able to choose which hospital you receive your treatment in, although this will depend on which hospitals the surgeon of your choice operates out of
Save thousands on treatments not offered by Medicare – some of the Medicare exclusions can end up costing thousands – for example, hearing aids and complex dental treatment. Rather than pay the full cost of such treatments, having health insurance may mean you're covered for all or part of these costs
Avoid the Medicare Levy surcharge – the Medicare Levy Surcharge (MLS) is an additional levy imposed on Australian taxpayers who don’t have private health insurance (and who earn over $90,000 p.a. for a single person, or $180,000 for a couple.) It starts at 1% of your income and goes up to 1.5% on a sliding scale.
Receive an Australian Government rebate – all Aussies are assisted with the cost of private health insurance by the Australian Government, However, when you reach 65 years old, you will be eligible for higher rebates from the government to reduce your premiums. If you’re a single earning up to $90,000 or a couple/family earning up to $180,000, your rebate will also increase again once you reach 70.

Types of health insurance

Hospital cover

This can help you pay for medical treatment if you need to be admitted to hospital. It can help cover the cost of your admission or accommodation and the fees charged by doctors, surgeons and anaesthetists. It can also cover other costs associated with a stay in a private hospital.

Extras cover

This helps cover the costs of health care treatments outside a hospital setting which aren’t covered by Medicare. This can include major and minor dental treatment, orthodontics, hearing aids, physiotherapy, glasses, contact lenses and podiatry (in most cases with annual limits).

Cover for singles

This is a standard health insurance policy designed for a single person, rather than being tailored to cater to the needs of a couple or family. It may include hospital cover plus extras, or either of these types of insurance on their own, depending on what you're after for your health cover.

Cover for families

A family health insurance policy is designed for a family unit including dependent children who may reach up to 31 years of age with some insurers. It offers private health insurance suitable for the whole family and may include shared limits for all members included in your policy.

Cover for seniors

A health insurance policy aimed at seniors is designed to appeal to people who are in the second half of their life. These are often specific Silver Plus policies that offer the same cover as other health insurance policies, with the exception that pregnancy and childbirth cover may not be included.

OVHC

Visitors who are in Australia on a temporary basis for travel, work or study may be able to take out Overseas Visitors Health Cover (OVHC). Many visas issued in Australia come with a requirement to take out this type of insurance, which covers visitors who may not be covered by Medicare.

Ambulance cover

Ambulance cover is generally available either packaged into your private health insurance or on its own as a separate policy or subscription. By having this protection, you could be covered for all eligible ambulance travel in Australia (subject to your insurer's terms and conditions).

Basic hospital cover

The cheapest and most barebones form of private hospital insurance, this can include cover for rehab, in-hospital psychiatric services and palliative care. Having this policy will enable you to avoid paying the Medicare Levy Surcharge (MLS) and Lifetime Health Cover (LHC) loading.

Bronze hospital cover

Bronze hospital cover is a step up from basic insurance, including 18 further clinical categories such as ear, nose and throat, bone, joint and muscle, digestive system, joint reconstructions, gynaecology and chemotherapy, radiotherapy and immunotherapy for cancer.

Silver hospital cover

Silver hospital cover is the second-most expensive type of policy and offers the second-most clinical categories. On top of what's offered by basic and bronze cover, it also includes heart and vascular system, lung and chest, blood, hearing device implantation and dental surgery.

Gold hospital cover

The highest level of private hospital insurance available in Australia, gold policies can offer cover for pregnancy and birth, weight loss surgery, assisted reproductive services and insulin pumps on top of all the categories provided by silver, bronze and basic hospital insurance.

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Top tips for choosing health insurance as a senior

Write a priority list

By writing a list of what types of treatment you need (or have used in the past two years) you'll get a better idea of which areas to prioritise when choosing between insurance policies

Determine your health cover budget

Many people pay their health insurance premiums on a monthly basis, so work out what you can afford based on your whole household income per month, minus the essential costs of paying your rent or mortgage and buying food.

Review your insurance needs regularly

You may be surprised at how health insurance policies have changed recently. Regularly review your level of cover to make sure you’re still getting the best deal for your health budget.

Compare policies through Savvy

By comparing health insurance policies you'll gain an understanding of whether your current policy offers you a great deal or not. By giving your health insurance a free check-up through Savvy, you'll get a range of no-obligation quotes almost immediately to help get you a realistic idea of how good your current policy fits your needs as a senior Australian.

Frequently asked questions about health insurance for seniors

Do pensioners get a discount on their seniors’ health insurance?

No, all health insurance policies cost the same regardless of the age of the person wishing to purchase the policy. However, those aged over 65 may receive a higher private health insurance rebate from the Australian Government (if they qualify under the income means test).

Why are there waiting periods on health insurance?

Waiting periods are in place to stop customers from claiming on a particular part of their health insurance within a certain period of time. If there wasn’t waiting periods, customers could sign up, make a claim for an expensive treatment or service, and then cancel their insurance immediately upon receiving the benefit. This would impact others and result in an increase in the cost of health cover across the fund’s membership.

How long are standard waiting periods for health insurance?

Waiting periods for hospital cover are usually:

12 months for any pre-existing conditions
12 months for pregnancy or other birth services
2 months for rehab, psychiatric or palliative care (no matter if it’s a pre-existing condition)
2 months for most other benefits

What is a health cover excess?

A health cover excess, like a car insurance excess, is a contribution you must make towards a health-related claim you make on your insurance policy. It only applies to hospital cover, not extras cover. This excess is typically paid directly to the relevant hospital before or after treatment.

Should I choose a higher excess to reduce the overall cost of my seniors’ health insurance?

This decision depends on your individual financial situation and general health. If you expect that you will require surgery at some point in the near future, you may think about considering a a policy with an excess that is more affordable. While paying more overall for a lower excess, you could potentially save money in the event that you do need a stay in hospital.

Is it possible to transfer my seniors’ health insurance cover between funds without being left uninsured?

Yes. If you do decide to switch to a new insurer, your new fund can contact your previous insurer and cancel your cover the same day you buy a new policy. This can ensure a seamless transition without any breaks in coverage.

Is there any upper age limit for seniors taking out private health insurance?

No, there is no upper age limit on when you can take out a private health insurance policy in Australia. Under Australia's community rating health insurance system, it is illegal to discriminate against anyone based on their age, gender or pre-existing health conditions.

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Helpful health insurance guides

Looking for health insurance to cover your condition or treatment?

Read one of our helpful guides on a range of different ailments and potential hospital or extras treatments to help you find out if they're covered.

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