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Compare prices from 30+ Aussie funds in under 30 seconds.
What does seniors health insurance cover?
Hospital
Hospital cover gives access to treatment in a private hospital as a private patient. You can choose your doctor, get your own hospital room (where one is available) and have more flexibility over scheduling procedures. You can choose from four levels of hospital cover in Australia: basic, bronze, silver and gold. All must cover specific treatments.
Accommodation as a private patient in a private or public hospital
Operating theatre fees
Intensive care costs
The cost of MRIs, X-rays, CAT scans and pathology for in-patients
Eye surgery
An extensive range of other surgeries and procedures (such as hip and knee replacements, back surgery, colonoscopies, dental surgery, hernia repair, renal dialysis and more)
Extras insurance helps pay for out-of-hospital treatments which Medicare doesn't usually cover. This can include dental, physiotherapy, chiro, optical and more. Many policies also cover ambulance fees which the public system does not pay for, unless you live in Queensland or Tasmania.
Preventative tests (such as bowel screening and bone density testing.
What's the best health insurance for seniors?
Our list of top health funds can make finding the best seniors health insurance policy a little easier. Here are some of our top health insurance picks based on best insurer, most popular and waiting periods. For a more detailed breakdown, you can head to our best health insurance page.
We chose Bupa because it won Finder's Best Health Insurance Provider award in 2020 and Finder's Best Gold award in 2020.
Medibank
We chose Medibank because it was the most visited Finder partner on our site between March 2020 and March 2021 and had the highest percentage of members of all Aussie funds, according to the Commonwealth Ombudsman's State of the Health Funds Report.
ahm Lifestyle extras
We chose ahm lifestyle extras because it lets you claim heaps of benefits from day one, general dental, optical and physiotherapy are all included and we couldn't find another policy this generous for common treatments.
What seniors health insurance policy do you need?
Thanks to 2019 government reforms, all health cover in Australia must cover specific treatments. There's usually no specific seniors health insurance policy offered by insurers, but there are certain levels of cover that are more appropriate for seniors than others.
Gold-tier hospital insurance typically costs around $160 per month for a single policy and covers all 38 treatments outlined by the Australian government. This includes joint replacements, insulin pumps and cataracts so are good for seniors with some health issues or those who want total peace of mind.
Silver-tier hospital insurance covers a minimum of 26 treatments but does not include joint replacements, insulin pumps and cataracts cover, so costs a little less than gold – often around $115 per month. You'll still be covered for services such as implantation of hearing devices, podiatric surgery and heart and vascular though.
This is a more basic policy that may be more suited to seniors who want to take advantage of shorter waiting times and some basic cover such as joint reconstructions, kidney and bladder and chemotherapy. Policies start from around $80 per month.
Most seniors probably aren't suited to basic cover as it is only required to provide restricted cover for rehabilitation, hospital psychiatric services and palliative care. It's good if you simply want to avoid an expensive ambulance bill or still work – you don't need to pay the Medicare Levy Surcharge and Lifetime Health Cover Loading if you get a policy. Policies cost around $75 per month.
Plus Policies
Since all health funds are required to offer the same treatments for each tier, keep an eye out for Silver Plus, Bronze Plus and Basic Plus policies. These cover at least one service more than the standard tiered policies and are often tailored to seniors who want top cover that doesn't also include pregnancy services.
Every senior has different health concerns, though there are a few common illnesses among those aged 65 and over. For instance, coronary heart disease is the number one leading cause of death for men aged 65 and over – for women, it's lung cancer. Find out which level of health insurance covers the treatment you need below:
"R" means insurers are allowed to offer cover for this clinical category on a restricted basis or with limited benefits.
Clinical category
Basic
Bronze
Silver
Gold
Rehabilitation
R
R
R
Hospital psychiatric services
R
R
R
Palliative care
R
R
R
Brain and nervous system
Eye (not cataracts)
Ear, nose and throat
Tonsils, adenoids and grommets
Bone, joint and muscle
Joint reconstructions
Kidney and bladder
Male reproductive system
Digestive system
Hernia and appendix
Gastrointestinal endoscopy
Gynaecology
Miscarriage and termination of pregnancy
Chemotherapy, radiotherapy and immunotherapy for cancer
Pain management
Skin
Breast surgery (medically necessary)
Diabetes management (excluding insulin pumps)
Heart and vascular system
Lung and chest
Blood
Back, neck and spine
Plastic and reconstructive surgery (medically necessary)
Dental surgery
Podiatric surgery (provided by a registered podiatric surgeon)
Emergency ambulances are covered with basic policies.
When you hit 65, you're entitled to a higher rebate.
Cons
It may be too expensive for you – policies start from around $80 per month.
You may be happy to wait longer on the public health system.
If you've never had health insurance, you will have to pay the lifetime health cover loading – a 70% additional charge on top of your premiums.
Public vs private waiting times for procedures
Why you can trust Finder's health insurance experts
We're free
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Unlike other comparison sites, we're not owned by an insurer. That means our opinions are our own and you can compare nearly every health fund in Australia on the site (and find a better deal).
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Since 2014, we've helped 350,000+ people find health insurance by explaining your options simply. We'll never ask for your number or email to see prices. We're here to help you make a decision.
FAQs about seniors health insurance
Yes. You will usually have to serve a 2-month waiting period for most treatments or 12 months for pre-existing conditions. The good news is you won't have to re-serve any waiting periods for items if you held a previous policy that also covered that treatment. However, if the policy you're switching to has higher benefit limits or cover for treatments not covered by your original policy, you will have to serve those waiting periods.
Private health insurance can provide access to more services and treatments, including private hospital rooms, elective surgeries and some treatments not covered by Medicare. It also provides more choices of doctors and hospitals and can help avoid waiting lists for non-urgent procedures.
In general, it is recommended that seniors evaluate their needs, budget, and existing coverage through Medicare before deciding to purchase private health insurance and compare various plans and policies offered by different insurance providers before making a final decision.
Once you turn 65, the Australian government officially considers you a senior and you may be eligible for a Commonwealth Seniors Health Card (CSHC). This is a concession card for older Australians that allows you to access cheaper pharmaceuticals and government-funded medical services. The eligibility requirements and benefits you can claim with this card are outlined below:
Eligibility criteria
Benefits
To qualify for the CSHC, you must meet the following criteria:
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
CSHC holders can access the following:
Bulk-billed visits to your GP (depending on your doctor).
Other benefits that vary depending on where you live. These may include discounted utilities bills and property rates, cheaper health care costs (including ambulance, dental and eye care) and discounted public transport.
Health insurance is community rated, which means whether you're 18 or 88, you're going to pay the same amount for the same level of cover. On average, a single hospital + extras policy can cost from $67.15 per month to $277.41 per month for a female living in NSW.
All health insurers are required to cover pre-existing conditions. However, you'll generally need to serve a 12-month waiting period starting when you take out a policy before you can submit a claim.
As with any health insurance policy, there are a number of common exclusions. Typically, this includes treatments such as laser eye surgery and specialist appointments outside of the hospital. Another common exclusion is non-medically necessary surgery. Examples include surgical face-lifts or tattoo removal.
Yes and if you're over the age of 65, your private health insurance rebate increases, provided you're not classified as a high-income earner ($144,001 or more for singles and $288,001 and over for families, single parents and couples).
You can claim the rebate either as a premium reduction through your health fund or as a tax offset when you lodge your tax return with the Australian Taxation Office (ATO).
Singles
≤$93,000
$93,001-108,000
$108,001-144,000
≥$144,001
Families
≤$186,000
$186,001-216,000
$216,001-288,000
≥$288,001
Base Tier
Tier 1
Tier 2
Tier 3
Up to 65
24.608%
16.405%
8.202%
0%
Age 65-69
28.710%
20.507%
12.303%
0%
Age 70+
32.812%
24.608%
16.405%
0%
Thresholds above are based on new tiers brought in by the government from 1 July 2023. Source: Private Healthcare Australia.
In most cases, yes. There are some exceptions where seniors won't have to pay the LHC – for example, if you were born on or before 1 July 1934.
If you've never had health insurance before, you will likely have a Lifetime Health Cover (LHC) of 70% applied to your premium, unless you were born before 1 July 1934. This is the maximum LHC loading that can be applied. You'll also need to hold cover for 10 continuous years before the fee is removed. For example, if the normal annual premium for your seniors health insurance policy was $1,800, you'd need to pay an extra $1,260 per year, not counting any rebates you might be eligible for.
This article was reviewed on 30 June by James Martin. James is the insurance editor at Finder and he's written on a range of insurance and finance topics for over 7 years.
Gary Ross Hunter is an editor at Finder, specialising in insurance. He’s been writing about life, travel, home, car, pet and health insurance for over 6 years and regularly appears as an insurance expert in publications including The Sydney Morning Herald, news.com.au, The Telegraph, Explore Travel and Escape. Gary holds a Kaplan Tier 1 General Insurance (General Advice) certification and a Kaplan Tier 1 Generic Knowledge certification which meets the requirements of ASIC Regulatory Guide 146 (RG146).
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