Are you over 65? Find out if seniors health insurance is for you.
When you're over 65 you have access to a range of age benefits and seniors health insurance options.
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.
Side by side comparison to review costs, compare cover and apply.
Why is health insurance important for seniors?
Australia's public health system allows seniors to access free or subsidised medical care for an extensive range of services and treatments. And if you qualify for a Commonwealth Seniors Health Card, you can access an even greater number of health cover benefits. However, despite the many advantages of growing old in the “lucky country”, there are still several important reasons why all older Australians should consider taking out seniors health insurance (or review their existing policy):
- Medicare doesn’t cover everything. Medicare certainly doesn’t cover all the medical costs you may incur, so a trip to the hospital could still leave you with extensive out-of-pocket costs. Private health insurance acts as an extension of Medicare, allowing you to enjoy a higher level of cover.
- You face increased health risks. The older you are, the higher the risk of suffering a wide range of health issues. This means there’s a greater chance that you’ll require medical treatment, surgery or medication as you head into old age and having private health insurance in place can guarantee that you’ll be able to access the best possible care.
- Your health priorities have changed. 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.
- Your personal circumstances have changed. Your health insurance needs change as you age, so the policy you’ve had in place in previous years may no longer be suitable. If you’re 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.
- You can access increased government rebates. People who are over 65 receive a larger government rebate for private health insurance, while health insurance for people over 70 comes with an even higher rebate.
- You can avoid waiting lists. Waiting times for non-emergency surgery in the public hospital system can be extensive. With private cover in place, you’ll usually be able to get procedures done much faster, and with your choice of surgeon.
- You can pay less tax. The Medicare Levy Surcharge (MLS) is a tax imposed by the Australian Federal Government on high-income earners who do not have any private hospital cover. If you earn $90,000 or more per year ($180,000 or more for families) and don’t have health insurance, you’ll pay an extra 1-1.5% in tax each year.
- You can enjoy peace of mind. The biggest benefit of private health insurance is that it provides peace of mind, allowing you to receive the treatment you need whenever you need it, and providing more flexibility when you access a wide range of healthcare services.
What options are available?
|Health insurance type||Main features||What else is covered|
Seniors-specific policies vs creating your own cover
There are two options you can choose from when buying seniors health insurance:
- Choose a pre-packaged policy. Some health funds offer cover packages specifically designed to meet the needs of seniors. Seniors health insurance is private health cover that’s specifically designed to meet the needs of Australians aged 50 and over, including those over the retirement age of 65. These policies will typically include cover for a variety of common health risks older Australians face, and they can be a convenient option if you’re a little unsure of what level of cover you need. However, never assume that just because a policy is marketed as being perfect for seniors means that it will be right for you. Check the fine print to find out what’s covered and what’s not before making your final decision.
- Create your own policy. The other option is to tailor a policy based on your specific health needs. Many health funds offer a range of hospital and extras cover options which you can peruse and then choose based on your personal circumstances. You can choose hospital cover only, extras cover only, or opt to mix-and-match hospital and extras cover for a higher level of protection. While researching the different cover options can be time-consuming, it can also help you choose health insurance that’s right for you.
What does a seniors hospital policy usually cover?
The exact cover provided by your health insurance varies depending on the health fund and the policy you choose. However, just like policies for people at other life stages, seniors can choose hospital cover, combined hospital and extras cover or extras-only cover. Hospital cover policies for seniors will generally cover the following:
- Ambulance costs
- Accommodation as a private patient in a private or public hospital
- Operating theatre fees
- Intensive care costs
- In-patient X-rays, MRIs, CAT scans and pathology
- Eye surgery
- An extensive assortment of other surgeries and procedures (such as hip and knee replacements, back surgery, colonoscopies, dental surgery, hernia repair, renal dialysis and more)
- Cardiothoracic surgery (heart, lungs and chest)
- Cancer and stroke treatment
- In-patient pharmaceuticals
- Rehabilitation services
- Organ transplant
- In-patient psychiatric treatment
- Gap cover for when you visit your GP
- Palliative care
What about extras cover?
If you choose a seniors health insurance policy that includes extras cover, you can usually expect the policy to cover:
- Optical (glasses, contact lenses)
- Dental (check-up, clean and scale, crowns and bridges, root canal therapy, dentures, implants, teeth extraction etc.)
- Hearing aids
- Health aids
- Non-Pharmaceutical Benefits Scheme (PBS) pharmaceuticals
- Blood pressure monitors
- Occupational therapy
- Podiatry (such as arthritis complications affecting the legs and feet, skin and nail problems, corns, calluses, ingrown toenails, bunions, orthotics etc)
- Preventative tests (such as bowel screening and bone density testing)
How does Lifetime Health Cover affect seniors?
If you’ve been shopping around for health insurance, you might have heard the term Lifetime Health Cover (LHC) being thrown about. LHC is a government scheme designed to encourage more Australians to take out private health cover and reduce the strain on the public health system. To do this, it adds a premium loading of 2% on top of your health insurance premiums for every year that you do not have hospital cover in place after turning 31. So if you’re classified as a senior and you don’t yet have any hospital cover in place, it’s going to cost you a lot more than normal when you do buy a policy. However, there is some good news:
- The loading is capped at a maximum of 70%
- It only applies to the cost of cover for ten years, after which time it no longer applies (provided you maintain cover)
How much more will health insurance cost if the LHC applies to you?
Let’s assume you’re 70 years old and have never held cover, so the maximum loading of 70% will apply to your policy for the first ten years you hold it. So, 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. While an additional $100 or so each month is nothing to sneeze at, getting insured can still be worth it if you make the most of your policy.
What does seniors health insurance cost?
The cost of health insurance for seniors depends on whether you choose a Hospital Cover, Extras Cover or Combined Hospital and Extras policy; what the policy covers, and to what level. This table gives you an idea of the lowest and highest prices for seniors health insurance based on participating health funds on finder.com.au.
|State or Territory||Singles Premium Lowest*||Singles Premium Highest*||Couples Premium Lowest*||Couples Premium Highest*||Cover Type|
|NSW||$67.15/month||$277.41/month||$132.67/month||$554.82/month||Hospital & Extras|
|QLD||$66.86/month||$280.19/month||$133.72/month||$560.38/month||Hospital & Extras|
|VIC||$67.22/month||$283.42/month||$134.44/month||$566.83/month||Hospital & Extras|
|SA||$63.33/month||$257.50/month||$126.66/month||$515.01/month||Hospital & Extras|
|WA||$49.62/month||$218.70/month||$99.24/month||$437.39/month||Hospital & Extras|
|NT||$29.05/month||$196.36/month||$58.09/month||$393.64/month||Hospital & Extras|
|TAS||$69.18/month||$255.28/month||$135.36/month||$510.56/month||Hospital & Extras|
*Prices are based on a female aged 70 years or older, that earns less than $90,000 looking for a combined Hospital and Extras policy. To find out what you would pay, just enter your details in the quote engine above.
Are seniors eligible for a health insurance rebate?
Yes! 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 you’re over the age of 65, the rebate amount you receive increases, provided you're not classified as a high-income earner ($140,001 or more for singles and $280,001 and over for families, single parents and couples). The rebate can be claimed 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). So, how much is the private health insurance rebate for seniors? Select your age group from the tabs below to find out just how much the Federal Government will contribute to the cost of your private health insurance based on your income.
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 which 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:
|To qualify for the CSHC you must:||CSHC holders can access:|
Private health insurance in Australia doesn’t provide any cover for the fees and charges for aged care homes. However, the cost of most types of aged care for eligible seniors is partially covered by the Australian Government. As you get older, living at home can become increasingly difficult. If you want assistance to help you stay in your own home for longer, there are three options available:
- Commonwealth Home Support Program. Known as Home and Community Care in some states, this program offers support services to older people who require help with daily tasks such as home maintenance, home modification and meal delivery. The cost of these services is partly funded by the government. 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 for older Australians who want to stay in their own home, plus a case manager or adviser if required. There are four levels of packages available based on the level of care you require to stay safe and maintain independence. 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. These packages are partly funded by the Australian Government.
- Private home care agencies. The third option is to access home care services from a private agency. This allows you to choose the level of services you want, but you'll have to pay the full cost out of your own pocket. 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 services available differ from one home care agency to the next, so contact the providers in your local area for more information.
If you’re no longer able to stay in your own home, you’ll need to enter residential care in an aged-care facility. This includes accommodation, meals, laundry and electricity, and can be accessed on a respite (a few days a month if your regular carer needs a break) or permanent basis. The government can cover some or all aged care costs for low-income earners, but others will need to pay the price agreed with the aged-care home out of their own pocket.
How to choose the best seniors health insurance for you
There's no such thing as a singular policy that's best for everyone. So how can you get the health insurance you need as a senior citizen? Remember these simple tips:
- Know your needs. Take some time to work out exactly what you want your policy to cover. Do you want hospital cover only, or combined cover for hospital and extras? Do you want the highest level of cover available or something slightly more affordable?
- Read the fine print. Never assume that something will be covered by a policy; check the terms and conditions to find out what’s covered and what’s not.
- Get multiple quotes. Cost should never be the only factor you consider when choosing cover, so make sure to compare quotes from a number of health funds to see what's available.
- Shop around. The most important thing you need to remember is to compare, compare and compare some more. Weighing up the pros and cons of competing policies offered by each health fund, is the easiest way to find the best value for money.
How to stay healthy in your golden years
As well as having seniors health cover, you can insure yourself against ill health in later life by improving your diet, lowering your blood pressure and taking care of your vision.
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.
*The offers compared on this page are chosen from a range of products finder.com.au has access to track details from and is not representative of all the products available in the market. Products are displayed in no particular order or ranking. The use of terms "Cheapest", 'Best' and 'Top' are not product ratings and are subject to our disclaimer. You should consider seeking independent financial advice and consider your personal financial circumstances when comparing products.