How Health Insurance Changes for Each Life Stage

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You should be consistently reviewing your health insurance policy to make sure you’re covered for what you actually need
Upgrade or downgrade, or even switch providers at any time to find the right policy for your needs
5 common life stages to review your policy: young single, long-term couple, new family, empty nester, retiree
You should be consistently reviewing your health insurance policy to make sure you’re covered for what you actually need
Upgrade or downgrade, or even switch providers at any time to find the right policy for your needs
5 common life stages to review your policy: young single, long-term couple, new family, empty nester, retiree


As we journey through life, our health needs and circumstances will evolve with us, and it's essential that your health insurance keeps pace with these changes.

Whatever life stage you’re at - whether you're seeking lower premiums, less exclusions, more comprehensive medical services, or considering the impact of higher excess and insurance premiums, we've got you covered.

Let's unpack how health insurance changes for each life stage, so you can make informed decisions and find the perfect plan to meet your changing needs.

What Life Stage Are You In?

Knowing what life stage you’re in is crucial to finding the right health insurance plan for your needs. While we don’t want to stick you in a box - because we know everyone’s life map isn’t the same - there are 5 key life stages when you should be reviewing your health insurance policy. We’ve covered them below in more detail:

Young Single

Entering the world of health insurance as a young single is an important step, especially if you're no longer covered by a family policy. With private health insurance, you can ensure coverage for optical, dental, and physiotherapy treatments tailored to your specific needs.

Here's some good news for young singles: there are financial incentives provided by the government that make private health insurance even more appealing. By having the right health insurance, you can avoid the Medicare levy surcharge (MLS), benefit from a government rebate, and steer clear of Lifetime Health Cover (LHC) loading.

If you earn above a certain income threshold, you may be subject to paying the Medicare levy surcharge (MLS) unless you have appropriate private hospital insurance. The income threshold is set at $90,000 for singles and $180,000 for families, allowing you to avoid this surcharge.

Long-Term Couple

Couples who are planning a future together should also consider the benefits of private health insurance. Financially, you can enjoy similar advantages to young singles. Additionally, it's crucial to ensure that your health insurance plan includes benefits for pregnancy, as you start preparing for a family.

New Family

New Family

Raising a family is a rewarding journey, but it comes with its own set of challenges and concerns. As your family grows, it becomes essential to have comprehensive family health coverage for your loved ones. Whether it's peace of mind when your children fall ill, pregnancy coverage, or protection in case a family member develops a chronic illness, private health insurance offers valuable support. The flexibility to choose your own doctor, access to private hospital rooms, and the ability to bypass waiting lists for important elective surgeries are all comforting advantages for growing families.

Empty Nester

As our children grow up and move out, we find ourselves in the empty nester life stage. During this time, focusing on our own health becomes increasingly important. Private healthcare can play a crucial role, especially when it comes to procedures such as eye surgery or hip and knee replacements. It's worth noting that even though our children have left the nest, some parents choose to provide cover for their adult children while they study, depending on the terms of their private insurance.


Entering retirement brings about a new phase of life, accompanied by changing needs and potential medical expenses. As retirees, it's common to require more extensive treatments and medications. By maintaining private health insurance throughout your retirement years, you increase the likelihood of receiving high-quality healthcare and accessing the best treatments available. It's a proactive approach to ensure a long and healthy life, enabling you to make the most of your golden years.

Additional Life Stages When Your Private Health Insurance Might Need Reviewing

Newly Single

When a long-term relationship ends, there's a lot to think about, and while health insurance may not be at the top of your mind, it's important to separate your cover from your ex-partner. You may need to consider switching to singles or single-parent cover to suit your new family circumstances. Our team is here to guide you through your options and ensure you find the right cover for this new chapter of your life.

From Kids to Adult Dependant

As your children reach the age of 22, there are changes to be aware of regarding their health insurance coverage. To remain on your family policy|/plans/families/policies/ at no extra cost, they need to be single, studying full-time, and not in a de-facto relationship. They can stay on your policy until the day before they turn 31 if they meet these requirements. However, if they're not studying full-time, an additional loading may apply to your family's premium. Our team can provide further information on this matter.

You're About to Turn 31

Turning 31 is a significant milestone when it comes to health insurance. The Lifetime Health Cover (LCH) loading, an additional surcharge on top of your premium, applies if you take out hospital cover after the 1st July following your 31st birthday (your base day). The LCH loading increases by 2% for each year you delay taking out hospital cover after your base day, up to a maximum of 70%. This loading is designed to encourage people to secure hospital insurance earlier in life. Additionally, if you don't have private hospital cover and earn above certain thresholds, you'll be subject to the Medicare Levy Surcharge (MLS). It's important to consider these factors and weigh the pros and cons of obtaining health insurance based on your unique circumstances.

You're Simply Getting Older

As you age or enter retirement, it's a good time to reevaluate your health insurance coverage. Consider your changing health needs and priorities, including potential procedures like hip replacements, cataract removal, or coverage specific to certain medical conditions. It may be worth considering a higher level of hospital cover to address these evolving requirements.

You Have a Health Condition

If you've been diagnosed with a health condition, your private health cover can assist in covering costs, providing more choices for hospitals and doctors, and ensuring prompt treatment. Depending on your current hospital cover and new care needs, you might want to upgrade your policy, which may entail serving a 12-month waiting period for pre-existing conditions. However, it's worth reaching out to your health fund to discuss your specific needs and determine if you're eligible for immediate cover. Even if initial procedures are not covered, they may be able to assist with subsequent procedures and ongoing medical care.

You Get a Pay Rise

If your income has recently increased, it's important to be aware that as your salary rises, you may need to pay an additional Medicare levy if you don't have the appropriate level of private hospital cover. In some cases, it may be more cost-effective to have hospital cover rather than paying the extra tax. You might also qualify for a government rebate on your premiums, which can help offset the cost. To determine the income thresholds and calculate your own situation, you can visit the ATO website.

Your Income Goes Down/Cost of Living Stress

Life can bring unexpected challenges, such as job loss or financial strain due to the rising cost of living. If you find yourself in this situation, we understand the difficulties and are here to help. Contact our team, and we can work together to ensure you get the best value out of your health insurance, aligning it with your new budget and circumstances.

You Become a Widow

Losing a partner is a difficult reality that many people, unfortunately, face, especially as they enter their retirement years. If you've become widowed, you'll need to transition from couples or family insurance to singles or single-parent insurance. Take this opportunity to review your level of cover and ensure it still meets your needs. As you age, you might find that a higher level of cover serves you better in terms of healthcare requirements.

Remember, health insurance is not a fixed entity and should be regularly reviewed as you navigate different life stages and reach new milestones. By reassessing your insurance, you can maximize your benefits, consider government surcharges and incentives, and align your coverage with your current priorities. Your health insurance is an investment in your and your family's health, so take the time to review it whenever your life circumstances change.


What is extras cover and do I need it?

Extras cover is a type of health insurance that provides benefits for services outside of hospital treatment, such as dental, optical, physiotherapy, and more. It is important because it helps cover the costs of essential health services that may not be fully covered by Medicare, ensuring you have access to a wide range of healthcare options.

Are there any government initiatives or rebates available for health insurance?

Yes, the Australian government offers various incentives and rebates for private health insurance. These include the Medicare Levy Surcharge (MLS) for higher-income earners without appropriate private hospital cover, the Private Health Insurance Rebate, and the Lifetime Health Cover (LHC) loading. It is advisable to check with your insurance provider or visit the government's official website for detailed information on these initiatives.

Is it possible to have a lower level of health insurance coverage?

Health insurance policies come in different levels of coverage. Lower-level policies generally offer more limited benefits and may have exclusions for certain treatments or services. These policies are often chosen by individuals seeking more affordable premiums or those who have fewer healthcare needs. It is important to carefully assess your healthcare requirements when considering a lower-level policy.

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