Health Insurance For Seniors

Originally published by TJ Ryan on January 30, 2017 

Find out what to look for in a seniors health insurance policy.

To get the most out of seniors health insurance, it’s important to choose the cover that best meets your needs now and into the future. Whether you’re an established person at the height of your career or winding down towards retirement, empty nesters or dealing with a house full of young adults, Canstar can help you find the seniors health insurance policy to suit your needs.

Looking for a seniors health insurance policy? The table below displays a snapshot of hospital & extras policies on Canstar’s database for seniors aged 60+, sorted by Star Rating (highest to lowest), with links to providers’ websites. These results are based on a mature couple in NSW.

What is seniors health insurance?

Seniors health insurance is an insurance policy specifically designed to cover the needs of singles or couples who are over 50 or who are at retirement age (over 65 and up). Seniors health insurance can provide peace of mind that you’re covered for the common ageing conditions without having to rely on the public system.

Canstar researches seniors health insurance policies and gives them a Star Rating based on how much value they provide for two different seniors profiles:

Mature Singles This profile caters to mature, single men or women who no longer have or never had dependent children. This profile is more concerned with the cover provided by a policy. Hospital cover should include benefits towards cardiothoracic surgery, hip and knee replacements, or other surgeries.
Mature Couples This profile caters to mature couples who no longer have or never had dependent children. This profile is concerned with Hospital cover such as benefits towards cardio-thoracic surgery, hip and knee replacements, or other surgeries; and Extras cover such as dental cover for crowns and dentures, optical cover for multifocal lenses, chiropractic, and physiotherapy care.

What does seniors health insurance cost?

It depends on whether you choose a Hospital Cover, Hospital and Extras, or Extras Only policy. Seniors health insurance policies are typically less expensive than Family policies or Couples policies for those planning a family because you aren’t paying for benefits such as pregnancy and obstetrics cover.

Here’s what you can expect to pay for Singles and Couples health insurance for seniors, according to the average prices on our database for Hospital and Extras cover at the time of writing:

2017 Health Insurance Premiums – Hospital and Extras Packages

Mature Singles $2,587 $1,851 $2,609 $2,465 $2,522 $2,644 $2,479
Mature Couples $5,162 $3,699 $5,213 $4,937 $5,058 $5,290 $4,959
Based on packaged cover policies considered for 2017 Canstar Health Insurance Star Ratings. Premiums include Base Tier Australian Government Rebate of 25.934%. “Mature” profile only includes products that include cover for cardiac and hip/knee replacements. “Established” profile only includes products that include cover for cardiac.

Compare Seniors Health Insurance

What does seniors health insurance cover?

Health insurance for seniors, like other insurance policies, can include Hospital cover, Hospital and Extras cover, or Extras Only depending on your choice of policy. A good value seniors health insurance policy should cover all the common health conditions that affect seniors, some of which are not usually covered under a standard policy for a younger person.

Confirm what is included in a policy before buying it, by reading the product disclosure statement (PDS) and contacting the insurer if you have any questions about coverage.

Why would you need seniors health insurance?

Here in Australia, we have a great public healthcare system where seniors can get bulk-billed appointments to see a GP, discounted prescription medications on the PBS list, and other concessions. If seniors have the Commonwealth Seniors Health Care Card for over 65s, they have additional public benefits such as an increased Medicare Safety Net.

But the public system is not perfect, and where private health insurance comes in handy as a senior is particularly with surgeries that are not an emergency but are nevertheless vital for maintaining quality of life. Many patients wait for months before there is even a spot for them to be placed on a waiting list – and then they may spend more months on the waiting list, being bumped further down the list as other patients become a more urgent priority.

It’s also worth noting that if you do not have Hospital cover and you are a high-income earner because of investments or the like, the Medicare Levy Surcharge of up to 1.5% will apply as an extra tax on your income. Find out whether a surcharge applies to you.

Seniors health insurance for aged care

At the time of writing, private health insurance does not provide cover for aged care. However, most types of aged care are partly government-funded for eligible seniors, so that the costs are lower than they could be.

There are three main types of aged care support for seniors who need some extra help with daily living tasks:

  • Commonwealth Home Support Program (CHSP) (a.k.a. Home and Community Care Services): Basic support services for those who want to stay in their own home and have minimal care needs such as help with weekly cleaning or shopping trips. To be eligible, the senior will need to have moderate, severe, or profound functional disabilities that make it difficult for them to perform these tasks on their own. Partly funded by the government.
  • Home Care Package: A coordinated package of services for those who want to stay in their own home and have moderate care needs such as help with bathing and dressing, cleaning, washing clothes, home maintenance and gardening, shopping assistance, transport to and from the doctor, and home nursing services. Partly funded by the government.
  • Private Home Care Agencies: A coordinated package of services for those who want to stay in their own home; services available vary from agency to agency. Solely funded by the client (the senior).
  • Residential Care: Accommodation at an aged care home, with meals, laundry services, and electricity costs included. This accommodation can be bought on a respite basis (a few days a month when the senior person’s carer needs a break), or on a permanent basis for high care. Respite care is partly funded by the government, and permanent high care is funded by the client.

Seniors health insurance and Lifetime Health Cover loading

If someone did not have Hospital Cover before they turned 30 years old, and they have not held Hospital Cover for the past 10 years, then Lifetime Health Cover (LHC) loading will apply to their seniors health insurance policy. This makes their insurance premium more expensive.

After 10 years of continuously holding Hospital Cover, the LHC loading charges stop applying. At that point their premiums should become cheaper, reducing to the usual standard. Contact your insurer if your premiums have stayed at the same price after 10 years in a row with Hospital Cover.

Health insurance for seniors over 70

If you’re over 65, some of the positives of having health insurance can include:

  • At home nursing
  • Emergency ambulance transportation
  • Theatre fees
  • Hospital accommodation
  • Intensive care
  • A concession card for reduced medication costs
  • Joint replacements
  • Physiotherapy

Rebates on seniors health insurance

People aged over 65 years old receive a higher government rebate on seniors health insurance than younger people, and when you reach 70 years old, the rebate you receive is even higher. The amount of money you get back from the government on the insurance premiums you pay for your policy will be based on your income from the Age Pension and your super or account-based pension.

Find out what rebate applies to your household.

How to find seniors health insurance

Take the time to compare your options when it comes to choosing seniors health insurance, and make sure you review your coverage at least every five years to be sure that it still meets your changing needs.

Here at Canstar, we compare hundreds of health insurance policies every year so that you can easily perform a search for over 50 health insurance, filter by the inclusions you need, and get quotes from the insurers. We can help you make sure your insurance is affordable and suits your life.

Compare Couples Health Insurance

Find out other things you need to know as a senior in Australia:

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