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Family health insurance

Get a better understanding of the specific health insurance needs for new parents, single parents and established families.

Whether you are looking to start a family or already have some toddlers or teens, there's a lot to consider when comparing health fund options. This article discusses topics from how maternity services are covered to how government penalties and rebates work.

Compare family health insurance options from 30+ Australian health funds

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Does health insurance cover pregnancy?

Hospital cover can be used to pay benefits towards maternity services, obstetrics and other related costs. However, there are several key points you should know about private health insurance and pregnancy:

  • Cover is expensive. Pregnancy and related services are only fully covered by the highest-level hospital policies. Some mid-range policies may partially cover you for pregnancy as a private patient in a public hospital.
  • Don’t wait until you’re pregnant. Many health funds require you to serve a waiting period of 12 months before you can claim for pregnancy. If you’re already due when you purchase a policy, it may be too late to get the cover you need.
  • Out-of-hospital services. Hospital policies only cover the costs related to hospital admissions for childbirth. They don't cover expenses incurred outside the hospital, such as GP visits and some scans and tests.
  • Take out a family policy. To make sure your new baby receives the same health insurance cover as you, make sure to add them to your family policy.

You can get cover for many of the costs associated with pregnancy in a public hospital. However, only health insurance can cover unexpected costs, give you access to a private room in a private hospital, and allow you to choose your own hospital, obstetrician and specialists.

How long can children remain on a family policy?

Your children can be covered under your policy until they are considered adults by your health fund. While the rules around dependants vary between funds, there are three main classifications that are typically used:

  • Student dependant. A single person aged 21 to 25 who is studying full time can be covered by a family policy.
  • Adult dependant. A single person aged 21 to 25 who is not studying full time may be covered for an additional fee.
  • Independent adult. A single person aged over 25 can no longer be covered by a family policy and needs to take out their own cover. This can often be done without serving an additional waiting period if they choose the same fund.
TitleDependant conditions
ACA Health Benefits Fund
  • Child dependant. ACA considers children dependent until the age of 21.
  • Student dependant. If your child is unmarried, or in a non-de facto relationship while a full-time student earning less than $20,000 per year, they can remain covered on your family policy until they reach 25 years of age, at no extra cost.
  • Adult dependant. If your child is between 21 and 25 years of age, not studying full-time and is unmarried, they can be covered for an additIonal 30% loading.
ahm Health Insurance
  • Child dependant. A child of the policy member who is not married or living in a de facto relationship and is under the age of 21.
  • Student dependant. Someone who is unmarried, is over 21 but is under the age of 25, and is engaged in full-time education.
  • Adult dependant. A dependant who is unmarried, is over 21 but under 25, and is not undertaking full-time study.
Australian Unity Health
  • Child dependant. A child aged up to 23 years old who is unmarried.
  • Student dependant. A student dependant can be covered on your family policy until the age of 25, provided they are single and are enrolled in an approved course.
Bupa Australia
  • Child dependant. A person who does not have a partner and is under 21, or who is engaged in full-time study and is under 25.
  • Adult dependant. A child of the policyholder aged between 18 and 24, who is not studying in a full-time capacity.
CBHS Health Fund
  • Child dependant. A dependant who is unmarried, aged under 18 and is a child, stepchild or foster-child who lives with the policyholder.
  • Student dependant. A student who is at least 18 but under 25 years of age, unmarried and participating in full-time study.
  • Adult dependant. A child of the policyholder who is unmarried, over the age of 18 but under the age of 25, and is not a student.
CDH Benefits Fund
  • Child dependant. Children or dependants under 21 years of age.
  • Student dependant. A child under the age of 25 who is studying full-time.
CUA Health
  • Child dependant. Any dependant children or young adults are covered on a family policy until their 23rd birthday.
  • Student dependant. Full-time student dependants are covered until they turn 25. They must be registered each year from 23 years of age.
Defence Health
  • Dependant child. Someone who is unmarried and under the age of 21.
  • Student dependant. Someone between 21 and 24 years of age and is enrolled in full-time study.
  • Adult dependant. A dependant who is unmarried, is not enrolled in full-time study, and is between 21 and 24 years of age.
Doctors Health Fund
  • Child dependant. Children can be covered by your family membership up to the age of 21.
  • Student dependant. Dependants are covered by the family's membership until the age of 24 .
Frank Health Insurance
  • Child dependant. Children are covered until they turn 21 years of age.
  • Student dependant. Dependants are covered until they turn 25 years of age, provided they are in full-time study.
GMF Health
  • Child dependant. Someone who is unmarried and under the age of 21.
  • Student dependant. A dependant who is aged between 18 and 25, is enrolled in full-time studies, and does not have a taxable income in excess of what is stipulated by HBF.
  • Adult dependant. Children of the policyholder who are under 25, unmarried, fully dependent on their parents, and do not have a taxable income in excess of what is stipulated by HBF.
GMHBA
  • Child dependant. A child under the age of 21 who is no longer a student.
  • Student dependant. Refers to dependants who are engaged in full-time study and are under 25 years of age.
HBF Health
  • Child dependant. Children are covered at no extra cost until the end of the year they turn 18, unless they are married or in a de facto relationship.
  • Student dependant. A dependant who is unmarried, is not earning in excess of the amount specified by HBF, is under 25 years of age and is studying full-time.
HCF
  • Child dependant. Children are automatically covered under family policies until the day before they turn 22.
  • Student dependant. If your child is enrolled in full-time study, they are covered at no extra cost until the day before they turn 25 or until they cease full-time study, whichever comes first.
Health Care Insurance
  • Child dependant. Children are covered until they reach the age of 23, as long as they remain unmarried.
  • Student dependant. Financially dependant on the policyholder, aged between 23 and 25, and enrolled in full-time study.
  • Adult dependant. Children between 23 and 25 can be covered on the Family Dependant Plus policy if they are unmarried and are not in a de facto relationship.
Health Insurance Fund of Australia
  • Child dependant. Child dependants are covered until 21 years of age.
  • Student dependant. Your child can be covered as a student until 24 years of age if they are engaged in full-time study.
Health Partners
  • Child dependant. A child dependant can be covered until they reach the age of 21.
  • Student dependant. Your children can be covered at no extra cost if they are aged between 21 and 25 and enrolled in full-time study.
health.com.au
  • Child dependant. Children are covered until they reach 21 years of age.
  • Student dependant. A child who is enrolled in full-time study and aged between 21 and 25.
Latrobe Health Services
  • Child dependant. A child can stay on a policyholder's membership until they are 18 years of age, as long as they are unmarried.
  • Student dependant. A child who is unmarried, is under 25 years of age and studying full-time.
Medibank Private
  • Child dependant. A child can be covered at no extra cost until they turn 21.
  • Student dependant. A child who is under 25 years of age, is unmarried and studying full-time.
  • Adult dependant. If your child isn't studying full-time, is unmarried and aged between 21 and 24, you are able to cover your children for an additional premium with the families with adult children option.
Mildura Health Fund
  • Child dependant. Children who are unmarried remain covered until they reach 21 years of age.
  • Student dependant. Full-time students under 25 years of age.
National Health Benefits Australia (onemedifund)
  • Child dependant. Children remain covered as long as they are under 21 years of age.
  • Student dependant. Your child is covered until 25 years of age if they are enrolled in full-time study.
Navy Health
  • Child dependant. A child is covered if they are unmarried and under 22 years of age.
  • Student dependant. Students are covered if they are in full-time study, aged between 22 and 25 and are unmarried.
NIB Health Funds
  • Child dependant. Children under the age of 21.
  • Student dependant. Unmarried, enrolled in full-time study and between 21 and 25 years of age.
  • Adult dependant. If your child is unmarried, aged between 21 and 25 and not enrolled in full-time study, you can cover them for an additional premium with the Extended Family policy.
Peoplecare Health Insurance
  • Child dependant. Someone who is under 21 years of age and unmarried.
  • Student dependant. Under 25 years of age, unmarried and enrolled in full-time studies.
Phoenix Health Fund
  • Child dependant. Children are automatically covered until the day before they turn 21.
  • Student dependant. Students in full-time study are covered until they reach 25 years of age or cease full-time study, whichever comes first.
Police Health
  • Child dependant. Someone who is unmarried and is under the age of 21.
  • Student dependant. A child who is unmarried, is studying full-time and is aged between 21 and 25.
  • Adult dependant. Children can be covered until the age of 25 under the Platinum Plus policy.
Queensland Country Health Fund
  • Child dependant. A child can remain covered under your family policy up to the age of 21.
  • Student dependant. Under 25 years of age, unmarried and enrolled in full-time study.
  • Adult dependant. Dependants aged between 21 and 25 can be covered under the Family Plus policy if they are unmarried.
Railway and Transport Health Fund
  • Child dependant. A child can remain covered under your family policy up to age 21.
  • Student dependant. Under 25 years of age, unmarried and enrolled in full-time study.
  • Adult dependant. Dependants aged between 21 and 25 can be included with Premium Hospital cover.
Reserve Bank Health Society
  • Child dependant. Dependent children can be covered if they are unmarried and under the age of 21.
  • Student dependant. Under 25 years of age and enrolled in full-time study.
St.LukesHealth
  • Child dependant. Children can remain on their parent’s policy if they are under 23 and unmarried.
  • Student dependant. Enrolled in full-time study, fully dependant on their parents and under 25 years of age.
Teachers Health Fund
  • Child dependant. Children can be covered under your policy if they are under 23 and not married.
  • Student dependant. Studying full-time, fully dependent on their parents and under 25 years of age.
  • Adult dependant. You are able to get cover for children who are not studying full time, and who are aged between 21 and 25, if you take out Extended Family Cover insurance.
Transport Health
  • Child dependant. Someone under the age of 21.
  • Student dependant. Aged between 21 and 25 and enrolled in full-time study.
TUH
  • Child dependant. Your children can be included in a family policy if they are unmarried and under 21 years of age.
  • Student dependant. A child under 25 years of age who is unmarried, earns less than $50,000 per year and is enrolled in full-time study.
Westfund Limited
  • Child dependant. Children are covered until they reach 18 years of age.
  • Student dependant. Someone enrolled in full-time study and under the age of 25.

How do family types affect the kind of cover you need?

Just welcomed your first bundle of joy?

  • Hospital cover. While top cover may be too expensive, not to mention unnecessary, at this stage, you can opt for a mid-range policy to get private hospital accommodation and avoid waiting lists. If cost is the biggest issue, a basic policy might be a better option, but make sure that emergency ambulance transport and treatment for accidents are covered.
  • Extras cover. This affordable health insurance is a must for young families as it covers you for Medicare-excluded services that children commonly need such as dental and optical. In addition, the healthy lifestyle benefits offered by many extras policies, which include services such as nutrition consultations, may be very attractive to new parents.
  • Health insurance deals. To save money and get maximum value from your cover, keep an eye out for promotions offered by health funds. These are especially common around March and May due to health insurance premium adjustments, which are made in April and at the end of the financial year in June.
  • Government rebate. The government provides a financial incentive for taking out private health in the form of a rebate, the size of which is dependent on your family income.
  • Lifetime Health Cover loading. If you and your partner are approaching 31 years of age, it's in your interest to take out private health cover now to avoid a 2% increase to your premiums for every year you don't have cover.

Expanding your family?

  • Hospital cover. If you're trying for another child and want full pregnancy cover, then purchasing or upgrading to a top policy might be your only option. Alternatively, you can take out a cheaper mid-range policy for partial cover. Just make sure whichever policy you choose provides ample protection for your other children as well.
  • Extras cover. The ideal extras services depend largely on the ages of your children. Dental is always useful, although a more costly extras policy is required for major dental or orthodontic benefits. Older children who are starting to play sport can benefit from physical therapies, and optometry is worthwhile for anyone whose vision may be deteriorating.
  • Cover for stepchildren. Family policies allow you to cover children under the age of 21. This includes stepchildren, adopted children and permanent foster children.
  • No-gap dental and optical. A number of health funds allow you to access free preventative dental procedures, optical items such as frames and lenses, and eye tests. This is always beneficial but even more so if you have several children who require these services.
  • Medicare levy surcharge. If your family income is more than $180,000 p.a., you pay between 1% and 1.5% more tax than everyone else if you don’t have private hospital cover.

Children becoming adults?

  • Hospital cover. Until they leave home and take out their own health insurance, it is wise to keep your children on your family policy. What you can do is begin lowering your premium costs by dropping cover for services you may not need anymore, such as pregnancy if no more children are planned.
  • Extras cover. The kind of extras services your children need change as they become young adults. Orthodontics may be less important as the braces come off, while alternative therapies and psychology benefits may become of use. Your children may also find healthy lifestyle benefits attractive, as they allow you to claim for gym membership and fitness classes.
  • Remember to switch. Once your children become ineligible for cover under your family policy, be sure to switch to a couples policy, which is less expensive.
  • Government rebate. You still receive financial assistance with your private health cover in the form of the government rebate. The threshold rises by $1,500 per child.
  • Medicare levy surcharge. You won't be penalised if your adult children remain at home, as their income is not included in your overall family income.

Raising children on your own?

  • Hospital cover. This insurance remains important to single parents, allowing you to choose your own doctor for you and your child, avoid waiting lists, and enjoy private hospital accommodation if it is covered by your policy. Remember to drop any services you don't need, to keep your premium costs as low as possible.
  • Extras cover. Be sure to maintain only the level of cover you need and drop any unnecessary services. Some health funds allow you to build your own extras policy and add only the services you want, so take your time to shop around and get the best* policy for your family.
  • Discounts for single parents. Health funds are now able to offer single parents reduced premiums on cover. The discount amount is decided by the fund, so compare policies to make sure you're getting the largest reduction possible.
  • Getting divorced. If you’re getting divorced remember to keep your health insurance policy in place. If you allow your cover to lapse you may need to serve waiting periods again when you reapply.
  • Government penalties and incentives. As a single parent who is possibly on a single income, maximising the value of your cover is critical. Make sure you take advantage of the government rebate and avoid the Medicare levy surcharge and Lifetime Health Cover loading so you don't pay any more than you have to.

Health insurance tips for families

  • Review your cover. 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 best* extras policy, there is 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.

Paper cutout of a family with medical items

Rebates, tax and health insurance for families

  • Private health insurance rebate. This was introduced by the Australian government to help more people access health insurance. The rebate amount varies depending on your combined family income and your age. It can be claimed either as a premium reduction through your fund or as part of your tax return.
  • Medicare levy surcharge (MLS). The Australian government introduced the MLS to encourage more people to take out health insurance and reduce the strain on the public health system. If you don't have cover you pay an additional surcharge on top of the standard 2% Medicare levy once your combined family income reaches certain thresholds.

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4 Responses

  1. Default Gravatar
    StephenMarch 13, 2017

    Hi, I am currently with HIF and my premiums are sky high ,i have been putting my details into your comparison finder without any luck ,My cover with HIF is gold Hospital 100/200 and Super options is the ancillary benefits.I have been in this fund for 17 years with a family membership,is there any way you can do a real cost analysis for me.

    Reply
    • Staff
      RichardMarch 14, 2017Staff

      Hi Stephen,

      Thanks for getting in touch. finder.com.au is a comparison service and we are not permitted to provide personalised financial advice. When using the comparison tool have you tried using any of the advanced filtering tools? The default results displayed represent the policies that offer the best value based on the price of the policy and services covered from the funds in our panel. You can choose to sort the results by price and also include the policies from funds not in our panel.

      I hope this was helpful,
      Richard

      Reply
  2. Default Gravatar
    gladysFebruary 3, 2016

    Requesting for the best family health insurance, comparing to Medibank quote

    Reply
    • Staff
      RichardFebruary 4, 2016Staff

      Hi Gladys,

      Thanks for your question. If you enter your details into the form at the top of the page, an advisor will be in touch to help you find the right policy for you.

      I hope this was helpful,
      Richard

      Reply
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