Couples health insurance

Like other health insurance policies, couples health insurance can include hospital cover, hospital and extras cover, or extras only depending on your choice of policy.

There are also different levels of cover to suit your needs. Policy tiers range from Basic cover through to Bronze, Silver and Gold for hospital cover. For extras cover, the categories are not as clearly defined but most providers offer a range of different levels of extras cover with varying inclusions and exclusions for each.

It’s important to carefully consider the level of cover you get based on your and your partners’ needs. For example, the level of cover you need as a young couple would be different to a couple planning a family or a mature couple who may need cover for conditions that can arise with age.

Some of the benefits of couple health insurance may include:

• You only have one premium to pay and one account to manage.
• You may be able to claim a higher private health insurance rebate from the government (more on this below).
• You may be able to tailor your cover to suit both your needs.
• It may be cheaper than having two singles policies.

If you’re a young couple you may decide that a more basic level of hospital cover is sufficient to suit your budget, plus extras cover if you need benefits such as optical and dental.

To keep the cost of your health insurance down, you could think about choosing a policy that only covers what you need at this life stage. For example, if you’re in good health you’re unlikely to need cover for cataracts or joint replacements.

Likewise, you may not need pregnancy cover if you don’t plan to have children in the near future. If you’re a young couple who spends a lot of time at the gym, some health funds also offer a discount on gym memberships with participating gyms, or you might want to consider a policy that includes physio as an extra option if you lead an active lifestyle.

→ Related story: Who offers dental health insurance with no waiting period?

If you’re a couple planning a family in the near future, you may want to consider cover that includes pregnancy and birth services. All Gold tier hospital policies must include pregnancy and birth cover, as well as assisted reproductive services such as IVF.

You may also be interested in extras cover that includes antenatal and postnatal services.

Health funds usually have a 12-month waiting period before they allow you to claim benefits for obstetrics (pregnancy and birth related services). So, to get the benefit of these services, you generally need to take out private health insurance at least three months before you or your partner plan to get pregnant.

Bear in mind that you and your partner will have the same cover under a couples policy. You might want to check to see if you would be better to get one singles health insurance with pregnancy and birth cover, and another singles policy without this. There could be a potential cost saving.

Read more: Singles health insurance: How much does it cost and should you get it?

If you choose to have a baby, you may wish to transition to a family policy. Most insurers charge similar premiums for family health insurance and couples health insurance. It’s a good idea to talk to your insurer to see what impact adding any kids will have on your policy and premium.

If you’re thinking of changing your health insurer for family cover, consider looking closely at your options before deciding which one is best suited to your needs.

If you’re an established and mature couple with no dependent children you may benefit from having a high level of hospital cover and a wide range of extras, depending on your needs.

If you and your partner are senior citizens, you may wish to consider seniors health insurance options that are available to you.

Some of the potential drawbacks of couple health insurance may include:

• You and your partner may have different health needs and in ensuring you are each covered adequately by a couples policy, you could end up paying more than you would for two separate singles policies.
• In the event of a relationship separation, you would likely need to end the couples policy and each find new insurance of your own should you both choose to remain covered.

A big question for many couples will be what can you expect to pay for couples health insurance?

Canstar has calculated the average annual premiums for couples at different life stages. This is based on the policies on our database as at the date indicated below.

Average annual health insurance premiums for couples

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Prepared by Canstar.com.au on 23/09/2022. Based on all combined hospital and extras, standalone hospital, and standalone extras insurance policies on Canstar’s database for couples. The Australian Government Private Health Insurance Rebate, Base Tier for under 65s, of 24.608% has been applied to premiums. National average premiums based on state averages weighted by state population of insured persons, as per Australian Prudential Regulation Authority (APRA) quarterly private health insurance statistics. Overseas Student Health Cover (OSHC), visitor and corporate policies, as well as policies from restricted funds, are excluded.

There is not much difference on average in price between a couples health insurance policy compared to two singles policies with the same level of cover, according to Canstar’s research.

For example, the average annual cost for a hospital and extras policy for an established single person was $2,542 or $5,084 for two singles policies. For a couple in the same profile, the average annual cost was $4,900. That’s a saving of $184, or less than a 4% difference in price on average.

This calculation is based on an established profile for singles and couples with hospital cover for the heart and vascular system, based on premiums at the time of writing.

If you’re interested in taking out singles health insurance, we’ve also looked at how much singles health insurance costs on average.

If you and your partner have agreed that couples health insurance is the way to go, you need to take the time to compare your options.

Canstar’s comparison tables (above) can be a good place to start. Canstar compares thousands of health insurance policy variations based on price and features.

You may also want to check out the national, and state and territory award-winning providers of hospital and extras policies in Canstar’s latest Health Insurance Star Ratings and Awards and which provider had the most satisfied customers according to Canstar’s annual survey.

If you don’t take out any private hospital cover before you turn 31, the government’s Lifetime Health Cover (LHC) loading will apply.

This means that if you do decide to take out any hospital cover later in life you’ll have to pay a 2% loading on top of your health insurance premium for every year you are over 30 years old for a maximum of 10 years.

For example, The Australian Taxation Office (ATO) says if you take out private hospital cover when you are 40, you could pay an extra 20% (10 × 2%) on the cost of this cover per year for 10 years.

For couples, the LHC loading will be an average of your loadings. For example, if you had a 2% loading and your partner had a 4% loading, you would have a total average loading of 3% on your couples policy.

This applies even if one partner took out hospital cover before turning 31 years old and has no LHC loading. For example, if you had a 0% loading and your partner had a 10% loading, the LHC loading on your couples policy would be 5%. Therefore, it may be cheaper for the partner with no LHC loading to take out a singles health insurance policy.

Depending on how much you and your partner earn, you may be able to claim a higher private health insurance rebate from the government with a couples policy than you would with individual singles cover.

For example, under the private health insurance rebate, singles with an income of $90,000 a year or less are eligible to receive the maximum rebate. For couples or families, this threshold is based on a combined earnings of $180,000 or less for the maximum rebate.

The Australian Taxation Office (ATO) confirmed that the maximum rebate would apply even if one partner earned more than the singles threshold so long as the combined earnings were less than the families threshold of $180,000.

The rebate is tiered and reduces in stages with no rebate available for singles earning more than $140,000 a year and $280,000 for couples and families.

Check the rebate tiers at the federal government’s PrivateHealth website to see whether you could get a better rebate as a couple or a single.

If you want to add your partner to your health insurance policy you will need to talk to your provider to see what type of cover is available and what conditions may apply, such as any waiting period.

For example, Bupa says: “If your partner has been without cover for more than 60 days before they’re added to your policy, we won’t be able to recognise the waiting periods they served on their previous policy.”

You will also need to find out what will happen to your premium.