Health insurance for over 50yr olds

For many Australians, life truly begins in your 50s. Maybe you’ve reached the pinnacle of your career, raised a family and seen them start off on their own journeys, and now you’re now financially stable enough to enjoy all the things you wanted to in previous years. 

That’s why it’s more important than ever to stay fit and healthy. According to the Australian Bureau of Statistics , by the age of 50, 18.8% of people had at least one long-term health condition such as arthritis (10.9%), diabetes (6.8%), heart disease (3.7%), or cancer (3.5% ).  A good over 50s health insurance policy can help you get the health care you need when you need it, and support you to access preventative treatments. 

Information on long-term health conditions, ABS

• To get the most value from your over 50s health insurance, consider any chronic conditions or specialist care you might require. And think about potential future health issues that could arise as you age.

• If you’re healthy and don’t expect to need hospitalisation often, opting to pay a higher excess might be a cost-effective way to reduce your premiums.

• Pre-existing conditions typically won’t affect the cost of your cover, but you may need to serve a waiting period of up to 12 months on them before you can make a claim… unless you’re switching from an equivalent cover.

What are the benefits of health insurance for 50 and over?

Health insurance offers financial protection against unexpected medical costs, which can be especially important if you're on a fixed income or approaching retirement. Policies for over 50s often provide extensive coverage for various services, including hospital care and elective surgeries. Extras policies generally cover dental, optical, and hearing services, which may become more necessary with age.

Key benefits of over 50s health insurance may include:

• Reduced waiting times for elective surgeries: People with appropriate private health insurance typically get faster access to elective surgeries through the private hospital system. This is particularly beneficial for procedures like hip replacements, cataract surgery, or knee reconstructions that are more common among older adults.

• Choice of doctors and hospitals: Health insurance policyholders can typically choose their preferred doctors and hospitals. This can be important for ensuring continuity of care when dealing with more complex age-related health issues or for chronic disease management such as arthritis.

• Proactive preventive care: Private health insurance isn’t just about treating disease – it can also help you stay well into and beyond your 50s. The best health insurance for over 50s in Australia often includes coverage for preventive health measures, like regular health checks and screenings.

How much does health insurance for over 50 year olds in Australia cost? 

There’s no one-size-fits-all approach to health insurance. So it’s up to you to choose your insurer, your level of hospital cover (Gold, Silver, Bronze or Basic), and any extras you want.

The price will depend on what type of cover you select, as well as the state you live in.

For example, a person aged 65 to 69 living in New South Wales with a taxable income of $97,000 or under could expect to pay from about $175 to $305 per month for a singles Silver tier hospital and extras policy with $750 hospital excess.

How can you get the most value from over 50s health insurance?

You can choose from multiple levels of cover and hospital excess, and a range of extras. That means you could see large price gaps between the different policies. 

This is where you can be very savvy with your budget. The type of cover you choose obviously depends on your own health needs and that of your family, but there are some smart ways to stay covered for what you need without overpaying. 

For example, Bronze and Basic hospital cover will likely end up being much cheaper than Silver or Gold cover, but you may not be covered for some of the more common medical procedures, such as heart disease.

But that doesn’t necessarily mean you need to rush out and buy top-tier Gold cover.

Ultimately, you’ve got to weigh up what treatments you need or might need in the future. The savings you could get from paying lower premiums might not be worth it if you have to pay for an expensive procedure out of pocket down the road.

Here are some tips to get the most value from over 50s health insurance: 

1. Assess your health needs

Consider any chronic conditions or specialist care you might require. And think about potential future health issues that could arise as you age, such as joint replacements, eye surgeries, or cardiovascular treatments. 

2. Choose the right level of coverage

Decide if you need hospital cover, extras cover, or both. Hospital cover is essential for surgeries and inpatient care, while extras cover helps with out-of-hospital services like dental, optical, and physiotherapy. 

3. Maximise your extras cover

Regularly use your dental and optical benefits. These can cover routine check-ups, cleanings, new glasses, or contact lenses. And if your policy covers services like physiotherapy, podiatry, or massage, use them to manage any age-related aches, pains, or mobility issues.

4. Manage your costs effectively

It’s vital to choose the right excess to maximise the value of health insurance according to your needs. For example, choosing to pay a higher hospital excess can reduce your premium. So if you’re healthy and don’t expect to need hospitalisation often, opting for a higher excess might be cost-effective.

5. Take advantage of discounts and rewards

Some insurers offer discounts for long-term members or those who bundle multiple policies (like health and home insurance). Health insurers may also offer discounts or rewards for participating in fitness programs, reaching your health goals, or attending preventive health workshops.

6. Review your health insurance policy regularly

Reviewing your health insurance policy every year is a great way to make sure you’re still getting the best value for your money. The experts at Compare Club make it fast and easy to compare health insurer policies to help you find great value health insurance for over 50s in Australia. 

How does Lifetime Health Cover Loading affect health insurance for 50 and over?

Lifetime Health Cover Loading (LHC)  is a government initiative in Australia designed to encourage people to take out private hospital insurance earlier in life and maintain it over the long term. 

It has a significant impact on health insurance for people over 50  who are considering taking out private health insurance for the first time or who have had a lapse in coverage. 

The standard rule is that if you do not have hospital cover by 1 July following your 31st birthday, you will pay a 2% loading on top of your premium for every year you are over 30 when you first take out cover.

If you are over 50 and taking out private health insurance for the first time, you will likely incur a higher LHC Loading. For example, if you take out hospital cover at age 50, you would face a 40% loading. This means you’ll pay 40% more on your premiums than someone who took out health insurance at age 30.

The loading remains in place for 10 continuous years of maintaining private hospital cover. After 10 years, the loading is removed, and you pay the standard premium.

On the other hand, if you took out private health insurance before your 31st birthday, and maintained it continuously, the LHC Loading does not apply – even if you switch insurers.

What is the best health insurance for singles over 50?  

Again, there’s not a one-size-fits-all solution to finding the ‘best’ health insurance for singles over 50. It’s all about finding health cover that’s the best fit for your needs. 

However, the good news is that as a single you can focus on finding coverage that is solely based on your health requirements. 

Premiums are also generally lower for singles policies than for couples’ coverage. And, for singles, the Medicare Levy Surcharge (MLS) and private health insurance rebate are calculated based on your individual income, not on your combined household income. 

What pre-existing conditions impact the cost of health insurance for over 50 year olds in Australia?

Pre-existing conditions don't affect the cost of your premiums, but they can add an additional waiting period of 12 months onto your cover for a pre-existing condition, if you haven’t had cover before.

This means you won’t be able to claim on any procedures or treatments until after that waiting period has been served… unless you’re switching from an equivalent cover.

Some common pre-existing conditions for over 50s in Australia include:

• Diabetes

• Heart disease

• Hypertension (high blood pressure)

• Stroke

If you’ve got a pre-existing condition, speak to our specialists. They’ll find a fund on our panel that offers a waiver for waiting periods already served.

Should I keep my adult children on my health insurance?

Extended Family Cover may allow you to keep your adult children on your health insurance policy until they turn 31. 

However, health insurers impose different terms and conditions, and some may increase your premium by as much as 30% to cover a non-student adult child on your policy. 

The experts at Compare Club can help you find and compare Extended Family Cover policies that deliver good value for you. 

Frequently Asked Questions

Are there specific health funds for over 50s?

Some funds offer tailored plans for over 50 that may focus on services like joint replacements, cataracts, and chronic disease management.

What types of extras cover are most important for people over 50?

As you age, extras cover may become more relevant for services like dental care, optical services (glasses and contact lenses), physiotherapy, podiatry, and hearing aids. Physiotherapy can also be essential for managing joint pain or mobility issues.

How does health insurance work for chronic conditions?

Chronic Disease Management Programs (CDMPs) may be included in some health insurance policies and are particularly valuable for over 50s. These programs typically provide support and services for managing long-term conditions like diabetes, heart disease, and arthritis. 

Can I reduce my health insurance premiums? You can typically choose to pay a higher hospital excess or reduce your extras cover to decrease your health insurance premiums. Or you can compare health insurers to find a better value health insurance policy for you#. 

What are waiting periods, and do they apply to me if I switch health funds?

Waiting periods are the time you must wait after joining a health fund before you can claim certain benefits. If you switch insurers but maintain equivalent cover, you generally won’t have to re-serve waiting periods for services you were already covered for. 

Can I get health insurance that covers pre-existing conditions?

Yes, but there’s typically a 12-month waiting period before you can claim for treatment of pre-existing conditions after you join or upgrade your cover. This is defined as any condition for which signs or symptoms were present in the six months before you joined the fund. After the waiting period, your insurance will usually cover these conditions.

Sources

Long-term health conditions, Australian Bureau of Statistics, 2022 https://www.abs.gov.au/articles/long-term-health-conditions

 Lifetime health cover, Australian Taxation Office, https://www.ato.gov.au/individuals-and-families/medicare-and-private-health-insurance/private-health-insurance-rebate/lifetime-health-cover

*Pricing based on a Gold Hospital Cover + Medium Extras AHM policy and a Gold Hospital Cover + High Extras AHM policy with no excess for a 55 year old couple with a combined annual income of $180,000 or less with the government rebate of 24.608% applied.

**Pricing based on a Silver Plus Hospital Cover + Medium Extras HCF policy and a Silver Plus Hospital Cover + High (Top) Extras with $250 excess for a 55 year old couple with a combined annual income of $180,000 or less with the government rebate of 24.608% applied.

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).