Elderly couple strolling in the sun

Seniors health insurance

Are you over 65? Make an informed decision when comparing seniors health insurance.

Looking after yourself in later life is about taking charge of your health. You can achieve this through a healthy diet and regular exercise, by accessing all the age benefits you’re entitled to and by having adequate seniors health insurance.

This article provides general advice for warding off common ailments that can affect older Australians, outlines the various government benefits available to seniors and explains how to tailor a health insurance policy to meet your needs as you age.

Compare health insurance for seniors offered by 30+ health funds

Why is health insurance important for seniors?

While exercising regularly and maintaining a healthy diet are key to warding off health issues as you age, it's an unfortunate fact that as you get older you become more prone to certain illnesses and conditions. This is why it might be worth taking out health insurance once you've reached pension age.

On the other hand, if you already have health cover it can still be worth reviewing your existing policy. Here's why:

  • Change in health priorities. As you get older you may want to drop services such as pregnancy from your cover and add treatments such as joint replacement, cardiac surgery and cataract removal.
  • Change in personal circumstances. If you are covered by a family policy and your children are no longer living at home you may wish to switch to a couples or singles policy. These are generally more affordable than family policies.
  • Increased government rebates. People who are over 65 receive a larger government rebate for private health insurance and an even higher rebate when they’re over 70.

What can health insurance offer over 65s

Health insurance typeMain featuresWhat it can cover
  • Hospital cover
  • Access to a private or shared room in a private hospital.
  • Choose the doctor who treats you and the hospital you attend.
  • Ability to avoid lengthy public hospital waiting lists for procedures.
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  • Extras cover
  • Claim for out of hospital services that are largely excluded from Medicare.
  • Huge amount of benefits available ranging from dentistry to exercise classes.
  • Can be combined with hospital cover for dual protection.
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Hospital treatments over 65s might find useful

  • Emergency ambulance transport
  • Theatre fees
  • Intensive care fees
  • Emergency department fees
  • GP visits
  • Cardiothoracic (heart and chest)
  • Hospital pharmacy charges
  • Prostheses
  • Joint replacement
  • Non-cosmetic eye surgery
  • In-hospital psychiatric care
  • Bone marrow transplant
  • Organ transplant
  • X-rays
  • Pathology
  • Palliative care

Extras services over 65s might find useful

  • General dental
  • Major dental
  • Optical
  • Physiotherapy
  • Chiropractic
  • Hearing aids
  • Podiatry
  • Remedial massage
  • Occupational therapy
  • Psychology consultations
  • Blood pressure monitors
  • Non-PBS prescription medicines

Are seniors eligible for a health insurance rebate?

The good news is that all Australians whose income falls below a certain threshold can claim the government's private health insurance rebate. The better news is that if your over 65 the rebate amount you receive increases, providing you're not classified as a high-income earner ($140,001 for singles and $280,001 for families, single parents and couples).

The rebate can be claimed either as a premium reduction through your health fund or as a tax reduction through the Australian Taxation Office (ATO).

What is the rebate for those over 65?

Select the age group you or your partner fall into to find out the rebate percentage that can be claimed based on income. As you can see, the older you are and the lower your income, the higher your rebate for health insurance. Please note that families include single parents, couples and de facto couples.

Learn more about how the health insurance rebate works

How does the Commonwealth Seniors Health Card work?

Once you turn 65 you are considered a senior by the Australian Government which means you may be eligible for a Commonwealth Seniors Health Card. This is a concession card for older Australians which can be used to subsidise the cost of certain medical treatments and services.

The Government introduced the Commonwealth Seniors Health Care Card in 1994 to encourage people to self-fund their retirement. With the income test threshold remaining the same since 2001, the government has now committed to indexing the threshold every year to reflect cost of living increases.

The eligibility requirements and benefits you can claim with this card are outlined below:

Commonwealth Seniors Health Card eligibility criteriaConcessions you can claim for
  • Be of pension age (65) or older.
  • Be an Australian resident currently living in Australia.
  • Don't qualify for a Department of Veterans' Affairs pension.
  • Don't qualify for any other Department of Human Services payments.
  • Meet an income test.

There is no asset test for the Commonwealth Seniors Health Card, but there is an adjusted taxable income (ATI) test that has the following eligibility conditions:

Commonwealth Seniors Health Card income testWhat factors define my adjusted taxable income?
  • Single seniors. ATI must be less than $51,500 p.a to qualify.
  • Senior couples. ATI must be less than $82,400 p.a. to qualify.
  • Taxable income
  • Fringe benefits
  • Pension payments or other benefits
  • Foreign income
  • Reportable super contributions
  • Reportable super contributions
  • Investment losses
  • Child support

What options are available for home care?

As you get older, living at home can become increasingly difficult. If you need home care assistance there are two government options and one private option available:

  • Commonwealth Home Support Program. Called Home and Community Care in Western Australia, this offers support services to older people who require help with daily tasks such as home maintenance, home modification and meal delivery. This program is open to people 65 years or older, Aboriginal and Torres Strait Islanders who are 50 years or older and those who are on a low income, homeless or at risk of homelessness who are 50 years or older.
  • Home Care Packages. These provide a package of services plus a case manager or adviser if required. The services offered vary according to your needs and help you stay safe and maintain your independence in your own home. The program is available to older people who require coordinated services to help them stay in their home, and to younger people who suffer from dementia or special care needs not covered by other services.
  • Private home care agencies. The advantage of using a private home care provider is that they have no eligibility requirements for age and can offer support for those suffering from conditions such as Parkinson's Disease. The downside is that they don't receive government funding so you'll have to pay for them yourself. The services differ from one home care agency to the next, so contact the facilities in your local area to find out what level of care is available.

Old couple sitting by the lake

How to stay healthy in your golden years

As well as having seniors health cover, another way to insure yourself against ill health in later life is to improve your diet

Healthy eating for over 60s

  • Eat fewer calories. If you're over 65 you may not need to consume as many calories as you did when you were 20 as you won't be as active. However, regardless of age, the requirements for vitamins and minerals remain the same.
  • Eat a balanced diet. Fruit and vegetables should form a large part of your diet (5 portions per day is recommended). You also need to eat plenty of foods rich in starch and fibre, as well as some milk, dairy foods, meat and fish.
  • Reduce your salt intake. Consuming too much salt increases your blood pressure, which could lead to complications such as heart disease and stroke. Read food labels carefully and try to limit your intake to a maximum of six grams of salt a day.
  • Vitamins. If you find you spend a lot of time indoors consider buying some Vitamin D supplements. While young people primarily obtain Vitamin D naturally from sunlight, getting outside may not be as easy as you age.
  • Antioxidants. Did you know that a diet high in antioxidants (commonly found in fresh fruit and veggies) can help defend against Alzheimer’s? Moderate consumption of wine is another method of getting the antioxidants your body needs.
  • Calcium. Calcium helps prevent osteoporosis, so eating lower-fat versions of milk, cheese and yoghurt is a good idea. Sardines and green leafy vegetables are also excellent sources of calcium.
  • Iron. Iron is an essential nutrient for health and wellbeing, and the Department of Health recommends one daily serving of lean red meat to ensure that you have enough iron in your diet.

Lowering your blood pressure

  • Maintain a healthy weight. Obesity is a contributing factor to high blood pressure, so eat the right diet and get regular exercise to ensure that you stay in a healthy weight range.
  • Get regular exercise. Regular exercise helps reduce your blood pressure, and health authorities recommend that Australians get a minimum of 30 minutes of moderate-intensity exercise five times a week.
  • Eat right. Make sure you consume plenty of fresh fruit and veg along with grain foods, lean meat, poultry and dairy products and drink plenty of water. Try and avoid alcohol, added salt, added sugar and saturated fat as much as possible
  • Eat less salt. Eating too much salt causes your blood pressure to rise, so try to eat less than four grams of salt, which is equivalent to 1,600mg of sodium, a day (the maximum upper limit is six grams).
  • Quit smoking. Smoking won't necessarily increase your blood pressure but it does increase your risk of heart disease, so now is the perfect time to give up this nasty habit.
  • Meditate. Meditation, yoga and tai chi all promote slow, relaxed breathing, which can decrease levels of stress hormones and help lower your blood pressure.
  • Medication might help. Depending on your situation, you may be able to take medication in addition to the healthy lifestyle measures listed above to lower your blood pressure. Ask your doctor for advice on medications and their side effects.

Keeping your eyes healthy

      • Get regular check-ups. Have regular eye exams to ensure your eyes are healthy and if you wear glasses, make sure you have an up-to-date prescription.
      • Eat healthy. A balanced diet can help protect against cataracts and macular degeneration.
      • Protect your eyes. Wear sunglasses with UV filters to shield your eyes from the sun’s harmful rays.
      • Keep fit. Exercise regularly, as good circulation and oxygen intake are important for eye health.
      • Quit smoking. Cigarettes increase your risk of developing cataracts and macular degeneration.
      • Stay within a healthy weight range. Obesity can cause you to become diabetic, which can lead to vision loss.
      • Don't stress your eyes. Use good lighting to avoid eye strain, particularly for reading and close work.
      • Stay well rested. Getting a healthy amount of sleep helps clean and lubricate your eyes.

How is rheumatoid arthritis treated?

  • What is it? Rheumatoid arthritis is an autoimmune disease that leads to pain and swelling in the joints. While the white blood cells and antibody proteins in your blood are supposed to fight off infection, when you have rheumatoid arthritis they attack your joints instead. Swelling and tenderness result from the associated inflammation in affected joints.
  • Which joints does it affect? Typically the body’s smaller joints, such as those in the hands, wrists and feet. However, larger joints in the knee and hip can also be affected. Over time, this inflammation of the joints can lead to thinning of the cartilage that covers the end of your bones, which can then lead to them being eroded away.
  • What causes it? While doctors still don’t know what causes rheumatoid arthritis, it occurs more commonly in people who are smokers or who have a family history of the disease. Following a physical examination to diagnose the condition, your doctor may also conduct x-rays and blood tests to determine how much damage has been caused to your joints.
  • How is it treated? The treatment of rheumatoid arthritis varies depending on the specific nature of your condition, so your doctor may tailor a management plan that can include medications (to relieve pain or slow the disease), heat treatment, cold treatment, surgery, physiotherapy and complementary therapies such as massage or acupuncture.

What are the symptoms of Alzheimer's disease?

  • What is Alzheimer's disease? It is currently the most common form of dementia, accounting for 70% of all dementia suffers. The disease attacks brain cells, nerves and the neurotransmitters that transmit information to and from the brain, affecting the way your brain functions. This leads to impaired memory and thinking processes as well as behavioural issues.
  • How do you contract it? Doctors are still unsure of the exact cause of Alzheimer’s disease, although your chances of developing the disease may be increased by factors including age, a family history of the condition, lifestyle factors, suffering previous severe head injuries and vascular disease.
  • What are the effects of Alzheimer's? Symptoms can include frequent memory difficulties (especially involving recent events), speech problems, difficulty understanding questions or instructions, mood swings, sudden personality changes, forgetting people or places and losing the ability to perform everyday activities.
  • Can you cure or slow it's progress? There is currently no cure for Alzheimer's, although you can do several things that may delay the onset of the disease. Eating a balanced diet, not smoking and reducing alcohol intake can help, while regular health tests from your doctor are a must. Keeping as active as possible, both mentally and physically, is also beneficial.
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17 Responses

  1. Default Gravatar
    RosemaryMarch 27, 2017

    am aged 86 and am insured with Australian Unity for hospital cover
    Is this a good choice or should I be looking at another health fund.
    I keep in good health

    • Staff
      ZubairMarch 28, 2017Staff

      Hi Rosemary,

      Thank you for your question.

      finder.com.au is a comparison and information service and we are not permitted to provide our users with personalised financial advice or product recommendations.

      If you would like to compare policies from health insurance brands in our panel, please enter your details into thequote form on the top of the page.


  2. Default Gravatar
    barryFebruary 10, 2017


    • Staff
      RichardFebruary 10, 2017Staff

      Hi Barry,

      Sorry to hear you’re having issues with the price rise. Unfortunately, increasing health costs due to the ageing population, improved medical testing and other factors have forced health funds to increase their premiums.

      If you would like to compare your options in hopes of finding a more affordable option, you can do so by entering your details into the comparison tool at the top of the page.

      All the best,

  3. Default Gravatar
    DeniseJanuary 15, 2017

    I am not a member of a health fund but would like to get cover for my 74 year old husband and myself at 69 years old is it possible to get it.

    • Staff
      RichardJanuary 16, 2017Staff

      Hi Denise,

      Thanks for getting in touch. While you will be able to get cover, as you’ve not held a policy before you may be subject to the lifetime health cover loading.

      To speak with an adviser about your cover options, please click the enquire now button in the table above. Once you’ve completed the contact form, an adviser will be in touch.

      All the best,

  4. Default Gravatar
    WendyNovember 12, 2016

    I would like to enquire about seniors hospital cover with no extras

    • Staff
      RichardNovember 14, 2016Staff

      Hi Wendy,

      Thanks for getting in touch. You can enquire either directly or with help from an adviser, by using the table at the top of this article.

      All the best,

  5. Default Gravatar
    JeanSeptember 11, 2016

    I have no health insurance I just want to have a first idea of how much it would cost approximately.
    I am 66 years old and am still working full time

    • Staff
      RichardSeptember 12, 2016Staff

      Hi Jean,

      Thanks for your question. finder.com.au is a comparison service and we are unable to provide our users with personalised financial advice. Since you’ve not had health insurance before, you may have to pay the Lifetime Health Cover loading. If you would like to speak with an adviser about your options and to get a quote, please complete the contact form at the top of this article.

      All the best,

  6. Default Gravatar
    ChandlerJune 4, 2016

    I am currently a member of a health fund but since I am a senior I am attempting to compare it with senior’s funds in an attempt to find one offering what I need and hopefully, at less cost.
    Is there a table I can use to compare specific funds?
    Thank you

    • Default Gravatar
      Robyn.September 6, 2016

      Is there a table I can use to compare the health fund that I’m already with . I am a senior looking for a fund at a lower cost

      Thank you

    • Staff
      RichardSeptember 6, 2016Staff

      Hi Robyn,

      Thanks for your question. We don’t currently have the facilities in place to compare health policies online. If you would like to speak with an adviser who will be able to give you a price comparison, please complete the contact form at the top of the page and they will give you a call.

      All the best,

    • Staff
      RichardJune 6, 2016Staff

      Hi Chandler,

      Thanks for your question. finder.com.au doesn’t currently have the facilities in place to provide you with a personalised quote. However, if you complete the contact form at the top of the page, an advisor will be give you a call to discuss your options with you.

      I hope this was helpful,

  7. Default Gravatar
    marieMarch 1, 2016

    are all hospitals covered by health funds

    • Staff
      RichardMarch 1, 2016Staff

      Hi Marie,

      thanks for your question. Most funds will have their own network or member private hospitals. If you choose to be treated in a private hospital, you can generally eliminate the majority of your out-of-pocket expenses. You can also elect to be treated as a private patient in a public hospital. All of this will depend on your level of cover and the fund you’re with. You should contact your insurer directly for more information about their cover network.

      I hope this was helpful,

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