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Over 50s Health Insurance

Name: Over 50s Health Insurance
Creator: Savvy
Published: 2023-03-27T16:08:19+10:30

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Written by , updated on July 6th, 2023

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For many Australians, reaching 50 is a significant milestone which brings major changes to life. Perhaps your children have now left home or are starting families of their own? You may have settled into your chosen career and you may just begin to notice your body has slowed down a little compared to when you were younger. For this reason, it’s crucial to ensure you have the most suitable health insurance to cover you in your older years.

Savvy can help you find and compare a range of health insurance policies that offer a wide choice of cover for adults over 50. Our free online comparison service can help you consider policies side-by-side from a panel of leading insurers with no obligation to help you see what's available and determine whether you need to switch or upgrade your health insurance policy. Start comparing here through Savvy today.

What health insurance options are there for over 50s?

There are two main types of health insurance available in Australia, which can offer cover for certain treatments received both inside and outside of hospital. Having both types of insurance will provide you with the most comprehensive cover if you require different types of health services and treatments as an adult over 50.

Hospital cover

Hospital cover can help you with the cost of treatment if you’re admitted to hospital. It can cover:

Consultations with doctors, anaesthetists and other specialists once you’re admitted to hospital
Costs associated with being admitted to a private hospital or public hospital as a private patient (if private beds are available)
Costs associated with receiving surgery (such as theatre and recovery ward fees)
Cost of tests administered as part of your treatment while an inpatient (such as blood tests, CT scans and x-rays)
Allied health services such as pain management or psychology services received after your treatment while still an inpatient
Ambulance cover*

*Not included under all hospital insurance policies. Ambulance cover differs between states and territories, with some states affording residents free cover either within their state or nationally.

Hospital cover is available in four different tiers: basic, bronze, silver and gold. The Australian Government regulates which services must be provided at each level, making it easier to compare similar policies side-by-side. A basic hospital cover policy will be the cheapest, but will only offer very limited cover if you’re admitted to hospital. On the other hand, a gold policy offers the top level of cover for all clinical categories at the greatest cost.

Extras cover

Extras cover is health insurance which will assist you with the cost of treatments and services received out of a hospital setting which aren’t covered by Medicare. It can cover areas such as:

Dental (both preventative, minor and major treatments)
Optical (glasses, contact lenses)
Physiotherapy and chiropractic treatments
Podiatry
Speech pathology
Hearing tests and hearing aids
Remedial massage
Psychology
Dietetics
Non-PBS medications
Wellness and lifestyle programs

It’s also available at different levels of cover, although these aren’t as strictly regulated by the government as hospital coverage is. Therefore, extras cover tends to vary more between health funds.

The cheapest policies will offer fewer benefits, so you’ll likely have more out-of-pocket expenses. For example, you may only be able to claim 50% of the cost of seeing a dentist.
More expensive extras policies may reimburse you up to 85% or more of the cost of seeing a dentist, physio or chiropractor.

Savvy can help you compare these different types and levels of health insurance all in one place. If you require assistance, you can request a call back from a health insurance specialist, who can talk you through the process and make sure your policy purchase goes smoothly.

How do I compare health insurance policies for over 50s?

In Australia, health insurance policies for seniors are no different than those offered to any other age group. When comparing policies, it’s important to consider several factors which may help you decide which type of cover is the most appropriate for your health needs as someone aged over 50. Ask yourself the following questions to help narrow down your choice:

What are my current health needs?

Think about all the health care services you’ve received in the past year and any treatments you’ve required. For instance, if you regularly visit a chiropractor or a physiotherapist, an extras policy may well be worth considering if it provides sufficient cover in these areas.

What health services may I need in the future?

Although none of us have a crystal ball to see into the future, it's possible to anticipate to a certain extent what health services you may need in the future. Think about your dental, optical, physio and chiropractic needs, as well as how much hospital treatment you may require in the future.

What private health facilities are available in my area?

Think about the health facilities available in your region. Those living in metropolitan areas may have ample choice when it comes to private hospitals, whereas Aussies living in remote areas may not have as many options. Consider whether it’s worth having the type of private health cover you’re after if there are very few relevant facilities in your local area.

Your choice of health cover should reflect your current and potential future health needs, prioritising those areas of cover which you'll use. For example, a gold tier hospital policy offers cover for pregnancy and fertility treatments, which you may not need, but it also provides cover for sleep studies and cataracts, which may be of more relevance to someone aged over 50.

How much does private health insurance cost for over 50s?

The cost of your health insurance may depend on several factors, including:

What level of cover you choose to buy, both for hospital and extras cover
How much you’ve selected as your excess and/or co-payment (higher payments in these areas may lead to cheaper premiums)
Whether you buy a singles policy, a couples policy or family cover (if you still have dependents living at home)
How much private health insurance rebate you’re entitled to (which is based on your income)
Whether you have to pay the Lifetime Health Cover loading (which applies to those who didn't have private health insurance for a period after turning 31)

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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Frequently asked questions about health insurance for over 50s

Will I have to serve additional waiting periods if I increase my level of cover now that I’m over 50?

Yes – you may have to serve additional waiting periods if you increase the tier of your hospital cover, such as from bronze to silver or silver to gold. However, you’ll only have to serve waiting periods for those additional clinical categories that you’ve previously not had cover for, so you won’t have to repeat a waiting period.

Do I have to have hospital and extras cover with the same health fund?

No – you can choose to take out health insurance with different health funds for your hospital and extras policies. However, it may be cheaper in some cases to buy with the same provider, as you may be able to take advantage of special offers on a combined hospital and extras policy offered as a package.

Do pre-existing conditions impact the cost of my over 50s private health insurance?

No – unlike life insurance, the cost of health insurance isn't affected by any pre-existing conditions you may have, such as diabetes, a heart condition or cancer. This is because it’s community-rated, meaning everyone is entitled to buy the same health cover regardless of their age, gender or health status. However, coverage for treatment relating to your pre-existing condition will still be subject to waiting periods.

If I don’t have health insurance and I’m over 50, will I have to pay the Medicare Levy Surcharge?

If you don’t have private health insurance, you may be required to pay more on top of the income tax you normally pay. This additional tax is called the Medicare Levy Surcharge, which applies to those who have no private health insurance and earn over $90,000 p.a. (or $180,000 for couples). It ranges from 1% to 1.5% of your income, depending on how much you earn above $90,000*.

*Information correct as of March 2023, but subject to change.

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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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