Adding kids to your health insurance policy

Private health insurance can ensure that your kids get the care they need, when they need it. It can also provide cover for expenses like trips to the dentist or glasses and contact lenses.

What do you need to do to include your children on your health insurance policy? Read on to find out.

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What rules do health funds have about adding children?

Got existing private health insurance cover and want to add your kids to your membership? The good news is that it’s very easy to upgrade your cover to a family policy, but you do need to be aware of a few rules, restrictions and waiting periods that apply.

One of the big traps that many expecting parents are unaware of is that many funds impose a waiting period on pregnancy and childbirth. This means you will need to take out cover well in advance of when you plan to fall pregnant if you want to receive maternity cover and cover for your child if there are any complications during labour.

Pregnancy benefits from funds in the finder.com.au panel

Health fund	Policies that include pregnancy cover	Benefit waiting period	Find out more
	Hospital only policies Top Hospital Gold	12 months	More info
	Hospital only policies High Hospital (silver plus) Entry Hospital	12 months	More info
	Combined hospital + extras policies My Family Silver Plus My Family Advanced Silver Plus Hospital only policies Hospital Gold	12 months	Go to Site
	Hospital only policies Gold Top Hospital	12 months
	Hospital only policies Gold Hospital	12 months	Go to Site
	Hospital only policies Gold Star Hospital	12 months	More info
	Combined Hospital + extras policies Gold Ultimate Hospital and Core Extras (With AIA Vitality) Basic Plus Hospital and Mid Extras 65% (restricted benefit) Basic Plus Hospital and Mid Extras Set Benefits (restricted benefit) Hospital only policies Gold Ultimate Hospital Basic Plus Hospital (Restricted benefit)	12 months	More info
	Combined hospital + extras policies Gold Top Hospital & Top Extras Silver Plus Select Hospital with Excess & Healthy Choice Extras Silver Plus Select Hospital with Daily Excess & Top Extras Silver Plus Select Hospital with Excess & Top Extras Silver Plus Select Hospital with Daily Excess & Healthy Choice Extras Basic Plus Public Hospital & Healthy Choice Extras (restricted benefit) Hospital only policies: Basic Plus Public Hospital (restricted benefit) Gold Top Hospital Silver Plus Select Hospital with Excess Silver Plus Select Hospital with Daily Excess	12 months	More info

^{*Data last confirmed as correct 9 Oct 2020.}

How to add a child to your health insurance

If you plan to add a child to your policy after they have been born, be aware that your fund may impose specific time limits on when you can do this. For example, HIF members who already hold a couple or family membership have two years from the date of birth to add their baby to their policy. This can be done for no additional charge.

However, HIF members who hold a single policy have a maximum of two months from the baby’s date of birth to upgrade to a family policy and they must also pay the increased premium that applies to a family policy.

Once again, the exact process for adding a baby to your membership differs between funds, so contact your health fund for specific details.

Will I have to pay to add my child to my policy?

It’s possible for many Australians to take out free private health insurance for their kids. The cost of a couple’s private health insurance policy is the same as a family policy with most Australian health funds, so adding your children to your policy effectively doesn’t cost a cent. Some funds will also waive any hospital excess that applies when your child is admitted to hospital, making it possible to enjoy even further savings on cover.

However, you may end up paying more for cover if you’re a single parent who has a single membership in place. To add children to your membership, you will usually have to upgrade to a family or single-parent family membership, which will cost you more.

What services and treatments are useful at this stage of life?

There are several important services that you should look for in a family health insurance policy. These benefits will help give your kids the best possible medical care.

• Pre-birth
• Post-birth

How long will your kid be covered by your policy?

In most cases, Australian private health funds allow you to cover your children for free under the same membership until they reach the age of 18. However, this can be extended to include cover for an older child in the following circumstances:

• As a child dependant. Your child will need to be under the age of 21, unmarried and financially dependent on you.
• As a student dependant. Your child will need to be under the age of 25, unmarried and studying full-time.

In addition, some funds allow cover for non-student adult dependants up to 25 years of age, but an additional premium will usually apply. Once your child reaches the relevant age they will need to apply for their own health insurance cover.

If you have adopted children, foster children or stepchildren, rest assured that they will be covered in the same way as biological children.

Does Medicare offer any child specific benefits?

To help make essential dental services more affordable for Australian families, Medicare offers the Child Dental Benefits Schedule. This schedule provides access to basic dental services for around three million eligible children aged 2-17.

Under this program, each eligible child receives up to $1,000 in benefits to cover a range of basic dental treatments and services. These include dental examinations, x-rays, cleaning, fissure sealing, fillings, root canals, extractions and partial dentures and can be provided in a public or private setting.

However, the Child Dental Benefits Schedule is set to close from 1 January 2017 and will be replaced by the Child and Adult Public Dental Scheme. This new scheme began in July 2016 and provides financial assistance for dental services for Australian children as well as adults on concession cards.

Other health insurance hints and tips

There are a few other factors you should be aware of when adding children to your health insurance policy. These include:

• Check extras benefit limits. Keep an eye out for low extras benefit limits or situations where a fund imposes a total policy limit rather than a per-person limit. Make sure the policy you choose has generous enough benefit limits to suit your family.
• Mix and match. You don’t have to purchase your hospital cover and your extras cover from the same health fund; you can mix and match to tailor cover to suit your unique requirements.
• Remember other costs. Not only will you need to pay a health insurance premium, but some policies also feature excesses or co-payments when a family member is hospitalised. Also, be wary of any hospital cover policy that features an excess and a co-payment.
• Take advantage of government initiatives. The Australian Government has a range of initiatives in place to encourage you to take out health insurance. The Medicare Levy Surcharge applies to high-income earners that don’t have private health insurance, there’s a private health insurance rebate to help cover the cost of premiums and the Lifetime Health Cover Scheme means health insurance is more expensive for those who don’t take out cover until after their 31st birthday.
• Review your cover regularly. As your children grow, your health insurance needs change. Make sure to check your cover every year or so to determine whether it still suits your requirements.
• Switch cover. If you find a health fund that offers better cover for you and your family, don’t be afraid to switch – it’s quick and easy to do.

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