Seniors Health Insurance for over 65

Seniors Health Insurance

Are you over 65 and wanting to review your current health insurance? Find out what you need to know about seniors health insurance.

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

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Details Features
Premier Package
Premier Package
  • Policy type: Hospital + extras
  • Excess: Nil, $250, $500 or $1,000
  • Emergency ambulance cover: Yes
  • 100% back on hospital and day surgery theatre fees
  • 100% back on surgically implanted prostheses
  • $1,000 annual benefit for pharmaceuticals
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Prestige
Prestige
  • Restricted fund, see "More info" for details
  • Policy type: Hospital + extras
  • Excess: None
  • Emergency ambulance cover: Yes
  • Cover for cardiothoracic services
  • Cover for accidental injury
  • $2,200 annual benefit for hearing aids
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High 65 / 75 / 85%
High 65 / 75 / 85%
  • Policy type: Hospital + extras
  • Excess: Nil, $250 or $500
  • Emergency ambulance cover: Yes
  • Cover for cardiothoracic services
  • Cover hip, knee and other joint replacements
  • $300 annual benefit for healthcare appliances
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GoldStar Hospital
GoldStar Hospital
  • Policy type: Hospital only
  • Excess: Nil, $200, $400 or $500
  • Emergency ambulance: Yes (NSW & ACT only)
  • Cover for heart and chest procedures
  • Cover for joint replacement
  • Cover for palliative care
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Deluxe Flexi
Deluxe Flexi
  • Policy type: Hospital + extras
  • Excess: $500
  • Emergency ambulance cover: Yes
  • Cover for all joint replacements
  • Cover for spinal fusion surgery
  • $300 annual benefit for optical
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Smart Combination
Smart Combination
  • Policy type: Hospital + extras
  • Excess: $250 or $500
  • Emergency ambulance cover: Yes
  • Cover for heart-related services
  • Cover for hip and knee replacements
  • $200 annual benefit for optical
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Gold Hospital
Gold Hospital
  • Policy type: Hospital only
  • Excess: Nil, $250 or $500
  • Emergency ambulance cover: No
  • Cover for cardiac treatment and coronary care
  • Cover for cataract and corneal implants
  • Cover for home based rehabilitation services
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Premium Hospital
Premium Hospital
  • Policy type: Hospital only
  • Excess: Nil, $250 or $500
  • Emergency ambulance cover: Yes
  • Cover for heart and therapeutic cardiac services
  • Cover for spinal surgery
  • Cover for knee, hip and other joint replacements
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Top Hospital
Top Hospital
  • Policy type: Hospital only
  • Excess: $250 or $500
  • Emergency ambulance cover: Yes
  • Cover for heart and stroke treatment
  • Cover for back surgery
  • Cover for palliative care and rehabilitation
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Top Hospital Cover
Top Hospital Cover
  • Policy type: Hospital only
  • Excess: Nil or $250
  • Emergency ambulance cover: Yes
  • Cover for accidental injury
  • Cover for spinal fusion and disc replacement
  • Cover for eye surgery including cataracts
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What does Over 65s Health Insurance cover?

Despite your best efforts, health issues do increase as we age, so having access to health care in later life is very important. The only way to ensure this is to have adequate health insurance, which is where Over 65s Health Insurance comes in. This type of insurance is designed specifically for those over 65 and usually includes cover for things such as:

  • A private or shared room in a private or public hospital
  • Ambulance cover
  • Theatre fees
  • Cardio Thoracic (heart/chest)
  • Intensive Care fees
  • Inpatient pharmaceutical drugs
  • Prostheses
  • Non-cosmetic eye surgery
  • Joint replacement
  • Psychiatric treatment and care
  • Bone marrow transplant
  • Organ transplant
  • Visits to your GP
  • Visits to emergency departments
  • X-rays
  • Pathology
  • Palliative care

Extras cover for optical, dental, physiotherapy and other such services can also be added to an Over 65s Health Insurance policy as required.

Why get seniors health insurance?

Once you turn 65, you are considered to be a "senior" in the eyes of the government and may be eligible for a Commonwealth Seniors Health Care Card. You may have already had private health insurance for many years, but it may now be worth reviewing your circumstances and considering taking out seniors health insurance. There are several reasons why you might wish to do so:

  • Your health priorities are changing and rather than things like pregnancy cover, you now need cover for hip replacements, cardiac surgery and cataract removals.
  • Your personal circumstances are changing and you now want singles or couples health cover, as your children are no longer living at home.
  • People over 65 receive a higher than average government rebate on private seniors health insurance and even higher when they’re over 70.

Am I entitled to a rebate?

No matter what age you are, if your income falls below a certain threshold you will receive a rebate from the Australian Government to help reduce the cost of your private health insurance premiums. Once you pass the age of 65, the rebate amount you are eligible to receive actually increases, which means you pay even less towards your private health cover. However, if you’re a high income earner, your age doesn’t matter - you won’t be eligible to receive any government rebate.

The private health insurance rebate allows you to access a higher level of cover that you otherwise might not be able to afford. The older you are, the more health risks you’re likely to face, so a higher level of health insurance cover can help reduce the financial impact of expensive medical costs.

The rebate levels applicable from 1 April 2016 to 31 March 2017 are:

What is the rebate for those over 65?

Singles≤$90,000$90,001-105,000$105,001-140,000≥$140,001
< Age 65
26.791%
17.861%
8.930%
0%
Age 65-69
31.256%
22.326%
13.395%
0%
Age 70+
35.722%
26.791%
17.861%
0%
Families≤$180,000$180,001-210,000$210,001-280,000≥$280,001
< Age 65
26.791%
17.861%
8.930%
0%
Age 65-69
31.256%
22.326%
13.395%
0%
Age 70+
35.722%
26.791%
17.861%
0%
Medicare Levy Surcharge (MLS)
Singles≤$90,000$90,001-105,000$105,001-140,000≥$140,001
All ages
0.0%
1.0%
1.25%
1.5%
Families≤$180,000$180,001-210,000$210,001-280,000≥$280,001
All ages
0.0%
1.0%
1.25%
1.5%

What are my home care options?

As you get older, living at home can become increasingly difficult. If you need to get some additional care to help you stay in your own home, there are three options available:

  • Local council support. Known as the Commonwealth Home Support Program (or Home and Community Care services in Victoria and Western Australia), this option offers basic support services to those with minimal care needs. As an example, you may only require fortnightly cleaning or shopping trips. To qualify for this type of care you will need to have moderate, severe or profound (functional) disabilities that make it difficult to perform specified tasks of daily living.
  • Home Care Packages. Also known as Consumer Directed Care Packages, these provide a co-ordinated package of services, as well as a case manager or adviser if required. The services offered vary according to your needs`and are designed to help you stay safe and maintain your independence in your own home. Services include assistance with bathing and dressing, cleaning the house, gardening, washing and ironing clothes, home maintenance, shopping assistance, transport to your doctor, and nursing and physiotherapy services.
  • Private home care agencies. These services do not receive any government funding and are therefore paid for by the consumer. The services available differ from one home care agency to the next, so contact the agencies in your local area to find out what level of care is available.

Compare health insurance options for over 65s by speaking with an adviser

Commonwealth Seniors Health Care Card income test

The Commonwealth Seniors Health Care Card is a concession card available to Australian residents aged 65 and over who don’t qualify for an age pension or Veterans’ Affairs pension. It provides a range of concessions including:

  • Bulk-billed appointments with GPs depending on the doctor
  • Increased Medicare Safety Net benefits
  • Discounted prescriptions from the Pharmaceutical Benefits Scheme (PBS)
  • Various concessions from state government and private businesses

There is no asset test for the Commonwealth Seniors Health Care Card, but there is an income test. To qualify for a card, a single senior’s adjusted taxable income must be less than $51,500 p.a. and a couple’s less than $82,400 p.a.

Adjusted taxable income (ATI) is defined as follows:

  • Taxable income
  • Fringe benefits
  • Pension payments or other benefits
  • Foreign income
  • Reportable super contributions
  • Investment losses
  • Child support

The Commonwealth Seniors Health Care Card was introduced in 1994 to encourage people to become self-funded in 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.

What is rheumatoid arthritis?

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 meant 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.

Rheumatoid arthritis usually affects 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, possibly leading to the bones being eroded away.

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.

The treatment of rheumatoid arthritis varies depending on the specific nature of your condition, and your doctor can help tailor a management plan that may include:

  • Medications to relieve your symptoms of slow the progress of the disease
  • Heat treatment, for example heat packs
  • Cold treatment, for example cold packs or a transcutaneous electrical nerve stimulation (TENS) device
  • Surgery
  • Physiotherapy
  • Complementary therapies, for example massage or acupuncture

Alzheimer's disease

Alzheimer’s disease is the most common form of dementia and affects around 70 per cent of people who suffer from dementia. 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, thinking processes and behaviour.

While doctors are unsure of the exact cause of Alzheimer’s disease, your chances of developing the disease may be increased by:

  • Ageing
  • A family history of the condition
  • Having suffered severe head injuries in the past
  • Lifestyle factors
  • Vascular disease

Some of the symptoms of Alzheimer’s disease include:

  • Frequent memory difficulties, especially involving recent events
  • Speech problems, for example struggling to find the right words
  • Difficulty understanding questions or instructions
  • Mood swings and personality changes
  • Forgetting people or places
  • Taking longer to perform routine everyday activities

Although a diagnosis of Alzheimer’s disease can lead to feelings of anxiety and fear, there are several things you can do which may help delay the onset of the condition. Eating a balanced diet and cutting down on smoking and alcohol can help, while regular health tests from your doctor are a must. Keeping as active as possible both mentally and physically is also beneficial.

There is currently no cure for Alzheimer’s disease, but research into the condition is continuing.

Healthy eating for over 60s

As well as having seniors health insurance, another way to insure yourself against ill health in later life is to improve your diet. A balanced diet will keep you healthier for longer and should include:

  • Plenty of fruit and veg
  • Wholegrain varieties of bread, rice, potatoes and pasta
  • Milk and dairy foods
  • Meat, fish, eggs, beans and other non-dairy sources of protein

Your diet should include fibre-rich foods, which can help with constipation and digestion problems, calcium-rich foods to help avoid osteoporosis, zinc-rich foods to boost the immune system and iron-rich foods for general good health. You should also use less salt, which can raise your blood pressure, and make sure you get enough Vitamin D and not too much Vitamin A (no more than 1.5 mg per day).

For maximum wellbeing, a healthy diet should also be accompanied by a healthy lifestyle. Maintaining a healthy weight through regular exercise will help to reduce your risk of heart disease and diabetes. You should also eat three times a day, stay well hydrated and avoid too much caffeine or alcohol.

Lowering your blood pressure

Another way to improve your health in later life is to have healthy blood pressure. More than 25% of adults have high blood pressure and more than 50% of those are over 60. High blood pressure means an increased risk of heart attacks or strokes, so if you suffer from high blood pressure, you might benefit by trying some of these methods for lowering it.

  • Exercise. Be active for at least half an hour of moderate-intensity exercise five times a week (i.e. walking, swimming, cycling or dancing).
  • Balanced diet. Eat a balanced diet combining the five food groups and reduce your intake of sugar and saturated fats.
  • Reduce your salt intake. Don’t add salt to food and look for processed foods containing less salt.
  • Reduce your alcohol intake – no more than two standard drinks on any given day.
  • Quit smoking – if you have high blood pressure, smoking increases your risk of heart disease, so give up.

Eye health tips

Our eyes are another area where we need to be vigilant in order to ensure healthy vision for longer. Some useful eye health tips for seniors include:

  • 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 a balanced diet to help protect against cataracts and macular degeneration
  • Wear sunglasses with UV filters to protect your eyes from the sun’s harmful rays
  • Exercise regularly, as good circulation and oxygen intake are important for eye health
  • Quit smoking, as this increases your risk of developing cataracts and macular degeneration
  • Maintain a healthy weight, as obesity can cause diabetes, which can lead to vision loss
  • Use good lighting to avoid straining your eyes, particularly for reading and close work
  • Get plenty of sleep, which helps to clean and lubricate your eyes

Compare seniors health insurance options by speaking with an adviser

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10 Responses to Seniors Health Insurance

  1. Default Gravatar
    Wendy | November 12, 2016

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

    • Staff
      Richard | November 14, 2016

      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,
      Richard

  2. Default Gravatar
    Jean | September 11, 2016

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

    • Staff
      Richard | September 12, 2016

      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,
      Richard

  3. Default Gravatar
    Chandler | June 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

      Thankyou

    • Staff
      Richard | September 6, 2016

      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,
      Richard

    • Staff
      Richard | June 6, 2016

      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,
      Richard

  4. Default Gravatar
    marie | March 1, 2016

    are all hospitals covered by health funds

    • Staff
      Richard | March 1, 2016

      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,
      Richard

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