Seniors Health Insurance for over 65

Seniors health insurance

Are you over 65? Find out what you need to know about 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 exercise, by accessing all the age benefits you’re entitled to and by having adequate seniors health insurance.

Compare your health insurance options from Australian funds

What does health insurance for over 65s cover?

Despite our best efforts, our health issues increase as we age, so having access to health care in later life is very important. The only way to ensure this access is to have adequate health insurance, which is where over 65s health insurance comes in. This type of insurance is for those over 65 and usually includes cover for the following:

  • A private or shared room in a private or public hospital
  • Ambulance fees
  • Theatre fees
  • Cardio Thoracic (heart/chest) care
  • 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

If necessary, you can add extras cover for optical, dental, physiotherapy and other services to an over 65s health insurance policy.

Why get health insurance for seniors?

Once you turn 65, the government considers you a senior and you may be eligible for a Commonwealth Seniors Health Care Card. You may have already had private health insurance for many years, but it may be worth reviewing your circumstances and considering seniors health cover. Here are several reasons why:

  • Your health priorities are changing and rather than having cover for things like pregnancy, you now need cover for hip replacements, cardiac surgery and cataract removals.
  • Your personal circumstances are changing and you now need 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 health insurance for seniors and an even higher rebate 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 since you won’t be eligible to receive any government rebate.

The private health insurance rebate allows you to access a higher level of cover than you might otherwise 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 following are the applicable rebate levels from 1 April 2016 to 31 March 2017:

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 as 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 daily living tasks.
  • 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 will 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 and shopping assistance as well as nursing and physiotherapy services. You may also get assistance with travel to and from your doctor's office.
  • Private home care agencies. These services do not receive any government funding and you will need to pay for them yourself. 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 for over 65s from 35 health funds

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 the following range of concessions:

  • 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 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.

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 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.

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 tailor a management plan that may include the following:

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

Alzheimer's disease

Alzheimer’s disease is the most common form of dementia and affects around 70% 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 and thinking processes as well as behavioural issues.

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

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

The following are some of the symptoms of Alzheimer’s disease:

  • 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 that 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 cover, 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 the following:

  • Plenty of fruit and veggies
  • 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, as well as calcium-rich foods to help avoid osteoporosis, zinc-rich foods to boost your 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 attack or stroke, 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 (ie, 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. Drink 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 as well as other health problems.

Eye health tips

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

  • 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 policy options from 35 health funds and speak with an adviser

Latest headlines

Picture: Shutterstock

Back to top

Read more on this topic

Compare health insurance on finder.com.au

Ask a Question

You are about to post a question on finder.com.au

  • Do not enter personal information (eg. surname, phone number, bank details) as your question will be made public
  • finder.com.au is a financial comparison and information service, not a bank or product provider
  • We cannot provide you with personal advice or recommendations
  • Your answer might already be waiting – check previous questions below to see if yours has already been asked

Disclaimer: At finder.com.au we provide factual information and general advice. Before you make any decision about a product read the Product Disclosure Statement and consider your own circumstances to decide whether it is appropriate for you.
Rates and fees mentioned in comments are correct at the time of publication.
By submitting this question you agree to the finder.com.au privacy policy, receive follow up emails related to finder.com.au and to create a user account where further replies to your questions will be sent.

17 Responses to Seniors health insurance

  1. Default Gravatar
    Rosemary | March 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
      Zubair | March 28, 2017

      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.

      Cheers,
      Zubair

  2. Default Gravatar
    barry | February 10, 2017

    BOTH MY WIFE AND SELF ARE 82 YEARS AND HAVE ALWAYS SINCE WORKING DAY STARTED HAVE BEEN INSURED,CURRENT WITH MEDIBANK PRIVATE AND HAVE TOP HOSPITAL COVER.
    WHY DO WE BOTH HAVE TO PAY $500 EXCESS TO GO INTO HOSPITAL AS WE BOTH DID 2016 FOR SLEEP TESTING ,WE HAVE NO OTHER INCOME EXCEPT GOVT: PENSION .NOW INSURANCE GOING UP AGAIN AND AT THIS MOMENT LOOKS LIKE WE HAVE TO STOP INSURANCE AND LET GOVT:TAKE THE BILL FOR HOSPITAL CARE ,I FIND IT HARD TO PAY MEDIBANK AS IT IS ,WE HAVE TO GO WITH OUT WHICH IS BLOODY AWFUL ALL THESE YEARS PAYING BENEFITS AND WE GET EXCESS WHY
    BARRY.

    • Staff
      Richard | February 10, 2017

      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,
      Richard

  3. Default Gravatar
    Denise | January 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
      Richard | January 16, 2017

      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,
      Richard

  4. 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

  5. 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

  6. 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

  7. 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

Ask a question
feedback