Private Health Insurance For Families

Whether you have kids or you're thinking about starting a family, chances are you've got a lot on your plate – and health insurance might not be at the top of your to-do list.

But choosing the right health cover is important. 

You can often get better value by opting for a policy that covers your whole family.

If you already have private health cover, it's worth comparing your options, as switching to a new family health policy could save you money.

Knowing what to look for when choosing a policy, and how you can get better value from your health fund, can make a big difference to your family budget. Your family is worth a lot more than dollars, but having kids still costs plenty of them.

Family health cover is a type of private health insurance policy designed to provide healthcare coverage for an entire family. These policies typically include the primary policyholder, their spouse or partner, and their dependent children. Family health cover offers a wide range of benefits, including hospital cover and extras (ancillary) cover.

Here is what you should consider when looking for family health cover:

What types of health insurance are available to families?

Family health insurance policies are designed to provide cover for you, your partner (if you have one) and your children. It’s usually for medical or therapeutic treatments received outside the public healthcare system. There are two main types of family health cover:

Family hospital cover

This covers you and your family if you're treated as a private patient in a public or private hospital. The tier of cover you choose, along with your specific policy, determines which treatments you're covered for and the cost of your health cover premiums. Usually higher tiers cover more treatments than lower tiers. They also tend to be more expensive.

Expert Note: Basic cover tends to have more restrictions than Bronze Cover (above).

The tier of cover you choose, along with your specific policy, determines which treatments you're covered for and the cost of your premiums.

Usually higher tiers cover more treatments than lower tiers, but they also tend to be more expensive.

Family extras cover

This provides cover for the cost of non-hospital services that aren't covered by Medicare.

These can include:

• Dental and orthodontic treatment

• Optical treatment

• Physiotherapy

• Pharmaceutical costs

• Podiatry

• Speech therapy

• Chiropractic treatment

• Professional diet and nutrition services

• Pre- and post-natal treatment

Most insurers tend to offer three tiers of extras cover:

• Basic

• Medium

• Top or comprehensive

Extras cover can be especially beneficial if you have children who are likely to need dental treatment, braces or glasses in future, or if you want additional cover for pregnancy-related treatment (which is covered in more detail below).

If you want both hospital and extras cover for your family, you can also choose a combined family health insurance policy.

Combined hospital and extras cover for families

Some health funds let you mix and match different levels of cover to suit your needs.

For example, you could choose silver hospital cover with top extras, or gold hospital cover with medium extras. If you're a single parent, and not sure what health cover you need, we’ve got you covered here.

What are the benefits of a family health insurance policy?

There are several advantages to choosing family health cover:

• Better value for money: It's usually cheaper to take out a policy that covers your whole family rather than having a separate policy for each family member.

• Kids are covered from birth: If you're planning to start your family, ensure your baby is covered from birth by adding them to your family health insurance policy. Most health insurance policies come with a 12 month waiting period, so it's a good idea to get cover well in advance.

• Avoiding the Medicare Levy Surcharge: If your household income is over $180,000 a year (or $90,000 for single parents) you can avoid paying the Medicare Levy Surcharge by taking out appropriate private health cover.

• Get money back on common health expenses: If you're going for an annual family dental check-up or your child needs glasses, then you can get a percentage of the costs back in rebates from your health fund. These rebates help offset the overall cost of your family's health cover and reduce your out-of-pocket expenses. Remember that dental care (and glasses/contacts) are not covered by Medicare. Without private cover, you’ll pay for 100% of these costs yourself.

• Choice of your treatment provider: With private hospital cover you can choose your doctor or surgeon, even when you or your family member is being treated as a private patient in a public hospital.

• Get a private hospital room: If you or a family member needs a hospital stay for any reason (such as giving birth), you may be able to request a private room, depending on your policy.

• Avoid public hospital waiting lists: In 2021-2022, 50% of patients waited at least 41 days for elective surgeries -- such as tonsil removal and orthopaedic surgery* -- in a public hospital. With private health insurance, you and your family may be able to skip or reduce your wait for elective surgeries by seeking treatment in a private hospital.

How much does family health insurance cost?

The following table gives you a rough idea of the cost of family health insurance from some popular funds.

Source: The costs below are based on a family of 4 in NSW with the primary & partner ages, an income tier of 1 & pre-existing health insurance

The actual cost will depend on your health fund, your situation and the level of cover you choose.

What's the best health insurance for my family?

The short answer is it depends on your circumstances.

If, for example, you plan on starting a family soon, you might want to choose a family health insurance policy that includes pregnancy cover and cover for your baby once they're born (remember, there are waiting periods).

If you have older children, it could make sense to choose a policy with extras cover for treatments like orthodontics and optical.

There are a lot of options out there and every family's needs are different.

That's why it makes sense to compare policies from multiple health funds to find one that's right for you.

And whatever your situation, keep in mind most family health insurance policies have a waiting period (ranging from 2 months to 12 months or more) that you'll need to serve before you can make a claim.

So if you think you or a family member might benefit from cover for a particular treatment down the track, it's best to get family health insurance sooner rather than later -- otherwise you could be hit with out-of-pocket costs.

If you already have family cover, you can usually switch to a more competitive equivalent cover with a different insurer without serving any new waiting periods.

What options are available if I've split from my partner or have step-children?

Most family health insurance policies offer flexible cover for different family arrangements including parents, biological children, step-children, adopted children and foster children.

If you're separating from a partner and already have health insurance, your options will depend on your health fund.

Some funds will allow you to stay on the one policy (which could be cheaper than buying separate policies) or remove one person from an existing policy.

Others will require you to take out a new policy if your marital status changes, and most allow a grace period (usually up to 30 days) to take out a new policy before you have to re-serve waiting periods.

Some health funds also offer lower premiums for single parents on family health insurance policies.

This means you could potentially save by switching health funds.

As a single parent, you could also be eligible for a family private health insurance rebate (which is covered in more detail below).

How can I make sure my kids are covered?

The most important thing to look out for is a family health insurance policy.

Often health funds will allow you to 'upgrade' your individual or couples policy to add children, or you can switch to an entirely new family health insurance policy.

This can help with costs associated with treatments for your kids like tonsils & adenoid removal & hospital visits. Different family policies include different levels of cover, so it's worth shopping around to find a policy that suits your family's needs.

If you're pregnant or planning on starting a family, keep in mind you'll need to add your child to your policy to make sure they're covered from birth.

How long can children remain on a family policy?

In Australia, children can stay on a family health policy until the age of 21 as long as they're dependent, or until the age of 25 if they're dependent and studying full-time.

Some health funds increase premiums once a child is over the age of 18 and not studying full-time.

If this is the case for you, it's worth reviewing your policy and seeing if there's another option that better suits your family's situation and saves you money.

Does family health insurance cover pregnancy and IVF?

Sometimes. Pregnancy cover is typically included as part of a health fund's Gold hospital cover policy, although some insurers offer specific Silver Plus pregnancy packages.

It's also worth noting if psychiatric services are included -- while it's not a pleasant thing to think about, it could be a useful service for parents suffering from postnatal depression.

Both Gold and Silver Plus are generally the most expensive policies, which means you're probably going to need to choose a top-tier family health insurance policy to get cover for pregnancy-related treatment and services such as:

• Hospital accommodation

• Theatre/labour ward fees

• Birth-related intensive care treatment

• Medication provided in hospital

• Doctor's fees

Some private health funds also offer additional cover options for treatments such as:

• In-vitro fertilisation (IVF)

• Care by a private midwife or doula (pregnancy support professional)

• Prenatal and postnatal classes

• Lactation consultancy

• Pregnancy massage and physiotherapy

What rebates and tax breaks are available for families who hold private health insurance?

If you have family private health insurance, you may be eligible for a rebate on premiums.

If you haven't claimed the rebate through reduced premiums throughout the year, you may be able to claim it as a tax offset.

In these cases, the rebate is calculated as a percentage of the cost of your premiums and claimed as a tax offset by reducing the amount of tax payable on your taxable income.

The rebate amount is calculated based on your age and household income.

What % of your family health cover premium can you get back as a rebate?

Health insurance tips for good value family cover

Review your cover regularly

As your children grow up and your circumstances change, so do your health insurance needs. Reviewing your policy each year ensures that you're being covered for the things that matter most to your family.

Avoid combined limits

When considering an extras policy, try and find one that offers individual benefit limits for each service rather than overall combined limits. Your family may exceed individual limits if they aren't high enough.

Don't be afraid to switch

If you find a better policy offered by a different health fund then consider changing. Your benefits and any served waiting periods must be honoured by your new fund.

Split your cover 

If one health fund has your ideal hospital policy, and another has the extras policy that suits your family’s lifestyle, there’s no law that says you can't have a separate policy for each.

Get full ambulance cover

Look for policies that offer full ambulance cover, which pays benefits towards ambulance fees for non-life threatening journeys as well as emergency transport.

Conclusion

Everybody's needs are different and what's right for one family might not be right for another. But whatever your situation, it's important to review your health cover regularly to make sure you're getting good value for your money as your family grows up.

If you're thinking about switching funds or taking out a new family health insurance policy, you can quickly and easily compare policies by clicking the button below.

Frequently Asked Questions

Are there waiting periods for family cover?

Most private health insurance policies, including family cover, have waiting periods before you’re able to make a claim. Hospital cover typically has a two-month waiting period, but certain treatments and pre-existing conditions have longer waiting periods. Extras cover may also have waiting periods for specific services. Pregnancy-related cover usually has a waiting period of 12 months.

Can I add a new child to my family cover?

If you have a new child, such as a newborn or a newly adopted child, you can generally add them to your family health cover without additional waiting periods, providing you notify your insurer within a specific timeframe.

Newborns: Most insurers allow you to add newborns to your policy without additional waiting periods, so long as you inform them within 30 days of the child’s birth.

Stepchildren or adopted children: Stepchildren and adopted children can typically be included under your family cover. You’ll need to show any necessary documentation to your insurer.

Will having family cover make me eligible for the health insurance rebate?

The private health insurance rebate is essentially a partial refund  the government gives you on your health insurance premiums. Think of it as a reward for having private health cover. 

If you’re eligible, you can get the private health insurance rebate on hospital cover, extras cover, or both. The rebate is age and income-tested, which means the amount you get back depends on how much you earn.

Do I have to pay the Medicare Levy Surcharge if I have a family policy?

The Medicare Levy Surcharge is a percentage of your income payable to the ATO when you lodge your tax return, if you don’t have eligible health insurance. It was introduced by the Australian Government to encourage high income earners to get private health insurance.

You’ll need to pay the MLS if you don’t have eligible private health cover and earn more than $93,000 as a single person (this includes single parents), or $186,000 as a family (including couples and single-parent households).

Can I remove family from my policy if I need to?

Yes, you can remove family members from your policy if your family circumstances change. Changing your policy may affect your premium.

How do I choose the best extras family cover for my family?

It's important to understand exactly what your extras limits are and how much you get back on dental, optical, physio and psychology. If your extras policy isn't a good fit for your family anymore, you’ll still be hit with a lot of out-of-pocket expenses.

What's more, if your dentist or physio doesn't have an agreement with your health fund, you could end up trekking across town to get the care you need.

Chris Stanley is the sales & operations manager of health insurance at Compare Club. With extensive experience and expertise, Chris is a trusted leader known for his deep understanding of health insurance markets, policies, and coverage options. As the sales & operations manager of health insurance, Chris leads a team of dedicated professionals committed to helping individuals and families make informed decisions about their health insurance needs.

Meet our health insurance expert, Chris Stanley

Chris's top health insurance tips

• 1

  Australia’s public health system is world-class, but wait times for public hospitals can be long, inconvenient - and leave you living in constant pain while you wait.

• 2

  An appropriate private health insurance policy can speed up your surgery, relieving your pain sooner.

• 3

  Family health cover means your children are covered under the same policy as you.

• 4

  Many health insurance policies come with a 12-month waiting period for pregnancy-related cover, so it’s a good idea to get a family policy organized well before starting your family. This means your child will be covered from birth until at least their early twenties (depending on which health fund you select).