Choosing the Right Health Insurance for Over 70’s Is Vital – Here’s What You Need to Know
Life is full of unexpected twists and turns. We can do our best to stay healthy by eating well and staying active, but as we get older, our bodies naturally become more vulnerable to certain health issues.
That's where health insurance for seniors can step in and ease the financial burden and give you peace of mind if you ever fall ill or get injured. While there isn't a specific insurance product called "seniors' health insurance," some insurance providers offer plans that cater to the needs of older individuals.
These policies are created with seniors' healthcare requirements in mind. However, the right policy for you will ultimately depend on your personal health and financial situation.
When it comes to health insurance for seniors, you can choose from various options such as hospital coverage, extras coverage, or a combination of both, available for both singles and couples.
So, if you’re searching for the right insurance company that will cover you for the things you actually need, keep on reading.
Or, use our handy (and free) tool below to compare policies and find the right health insurance for over 70’s plans in just a few minutes.
What Should the Best Health Insurance for Over 70’s Cover?
Health insurance is a broad term that encompasses various types of coverage, including hospital cover, extras cover, combined hospital and extras cover, and ambulance cover (including emergency ambulance). The type of health insurance that's right for you depends on your individual healthcare needs.
Private health insurance offers more options and flexibility when it comes to your healthcare. The services covered can vary significantly between policies, so seniors can choose a health insurance plan that suits their current and future requirements. It's important to note that there are waiting periods when you first take out a policy, so it's wise to plan ahead.
When considering which health insurance policy to choose, think about the services that are most important to you. Here are some key features of hospital cover and extras cover that may be particularly beneficial for seniors:
Hospital Cover
Health insurance is a broad term that encompasses various types of coverage, including hospital cover, extras cover, combined hospital and extras cover, and ambulance cover (including emergency ambulance). The type of health insurance that's right for you depends on your individual healthcare needs.
Private health insurance offers more options and flexibility when it comes to your healthcare. The services covered can vary significantly between policies, so seniors can choose a health insurance plan that suits their current and future requirements. It's important to note that there are waiting periods when you first take out a policy, so it's wise to plan ahead.
When considering which health insurance policy to choose, think about the services that are most important to you. Here are some key features of hospital cover and extras cover that may be particularly beneficial for seniors:
- Heart surgery, such as bypass surgery, angiograms, and stents
- Joint replacement, including surgery and joint replacements
- Major eye surgery, like cataract surgery
- Tests and scans as an inpatient (e.g., x-rays)
- Inpatient cancer treatments
- Palliative care
- Renal dialysis
Extras Cover
Extras cover provides coverage for out-of-hospital services that may not be fully covered by Medicare, such as dental work, prescription glasses, and physiotherapy appointments.
An extras policy can include:
- Optical services covering prescribed glasses and contact lenses
- Physio and occupational therapy, which may include exercise programs, manual therapies, and electrotherapy techniques
- Remedial massage for injury treatment and recovery
- Chiropractic care for nerve, muscle, and skeletal issues
- Podiatry and orthotics
- Non-PBS prescription medicines
- Speech therapy (including post-stroke treatment)
- Hearing aids, including their design, repair, and replacement
- Major dental services (e.g., dentures and partial plates)
- Health aids and appliances, such as glucose monitors, crutches, and blood pressure monitors
These are just some examples of the services that can be covered under hospital and extras insurance. By carefully considering your healthcare needs, you can select a health insurance policy that best meets your requirements as a senior.
What Isn’t Covered?
When you have private health insurance, it's important to be aware of certain restrictions and exclusions that may apply. Exclusions refer to specific medical services that your health insurance won't provide benefits for if you receive treatment as a private patient.
Similarly, restrictions can limit the extent of coverage for certain services. For example, your health fund might only cover treatment as a private patient in a public hospital or partially cover the cost of treatment in a private hospital.
When it comes to hospital cover, the restrictions and exclusions are regulated by the government and depend on your health insurance tier. However, for extras cover, the excluded services are determined by your health fund's discretion. Additionally, there are certain natural therapies that may not be covered by health funds.
Some commonly excluded or restricted services that can affect seniors include:
- Hip and knee replacements
- Cardiac-related services
- Cataracts and eye lens procedures
- Rehabilitation and psychiatric services (although they may be offered as restricted benefits on all policies except Gold)
Remember, not all policies have these exclusions, so it's a good idea to compare different options. To get a comprehensive list of exclusions and restrictions, it's best to consult with your health fund and carefully read the relevant policy brochure.
How Much Does Health Insurance for Over 70’s Cost?
The cost of health insurance largely depends on the type of cover you choose. Seniors over 70 can get a higher government rebate than younger policyholders to help reduce the cost of their premiums.
| Singles | ≤ $97,000 | $97,001 - $113,000 | $113,001 - $151,000 | ≥ $151,001 |
| Families | ≤ $194,000 | $194,001 - $226,000 | $226,001 - $302,000 | ≥ $302,001 |
| Rebate | ||||
| Base Tier | Tier 1 | Tier 2 | Tier 3 | |
| < age 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% |
Source: Australian Taxation Office (ATO), Private Health Insurance Rebate. Current from 1 July 2022
Do You Need Private Health Insurance When You’re Over 70?
Getting timely access to important surgeries can be quite challenging when relying solely on public waiting lists in Australia.
However, having private hospital cover can make a significant difference. Instead of enduring lengthy waiting times, you only need to observe the private waiting periods, which are generally much shorter.
Let's consider an example: if you required hip replacement or knee replacement surgery but didn't have health insurance, you would be placed on a public waiting list that would stretch anywhere from eight to 12 months or longer.
Conversely, with the appropriate level of private hospital cover, you may only have to wait a matter of days or weeks (after fulfilling waiting periods) to undergo the surgery and swiftly return to your normal daily activities.
Basically, private health insurance can significantly expedite your recovery process, enabling you to resume your day-to-day life much quicker.
Health Insurance vs Medicare
Private hospital insurance can be a fantastic option for seniors, offering a range of benefits when they receive inpatient treatment at a private hospital. Imagine having coverage for surgeries like knee replacements or cataract removals! Plus, extras cover can help with the cost of specific items that Medicare doesn't subsidise, such as prescription glasses, hearing aids, or dental work including dentures or partial plates.
On the other hand, Medicare steps in to cover important services like visits to your trusted GP, eye exams with your optometrist (remember, it doesn't cover the cost of glasses), and consultations with a hearing specialist (unfortunately, hearing aids aren't covered either). And let's not forget about the partially government-funded aged care that can help reduce costs for eligible seniors across many services.
Here's an important thing to keep in mind: private hospital insurance doesn't cover services that aren't listed under the Medicare Benefits Schedule (MBS). So if you're thinking about general medical check-ups for your life insurance policy, that won't be covered. To get a clear picture of what is and isn't covered by your health insurance, take a look at your health fund's policy brochure. It's always good to know exactly where you stand!
FAQs
Are seniors charged more for health insurance?
No, seniors pay the same base rate as younger individuals for the same private health insurance policy. The actual amount you pay may vary depending on factors like eligibility for the Lifetime Health Cover loading, the Australian Government rebate, or any age-based discounts.
Why are there waiting periods and how long do they last?
Waiting periods are in place to prevent people from making expensive claims for pre-existing health conditions immediately after signing up for insurance. This helps keep premiums affordable for all members. The standard waiting periods for hospital cover are regulated by the Australian Government and generally include:
- 12 months for pre-existing conditions (except for psychiatric care, rehabilitation, or palliative care, which have a 2-month waiting period)
- 12 months for obstetrics (pregnancy)
- 2 months for all other circumstances.
Extras policy waiting periods vary between insurers, so it's important to know the waiting periods that apply to you.
What services are not covered by Medicare?
Medicare covers 75% of the Medicare Benefits Schedule (MBS) fee for private hospital treatments. However, there are services that Medicare does not pay for, including:
- Hospital accommodation costs for private patients
- Non-medically necessary cosmetic surgery
- Ambulance services
- Most dental examinations
- Acupuncture
- Home nursing
- Glasses and contact lenses
- Hearing aids
- Most physiotherapy, chiropractic, podiatry, and psychology services.
How much does health insurance for seniors cost?
The cost of health insurance for seniors depends on factors like the type of policy (hospital, hospital and extras, or extras only) and the level of cover you choose. You can compare policy features and estimated premiums using the table provided. Remember, private health insurance premiums are determined by community rating, so insurers cannot charge higher premiums based on age, claims history, or health status.
Does the Medicare Levy Surcharge affect seniors over 70?
Regardless of your age, if you earn over $90,000 a year and don't have hospital cover, the Medicare Levy Surcharge of up to 1.5% may apply as an additional tax on your income. Check with the Australian Taxation Office (ATO) to determine if the surcharge applies to you.
Does health insurance cover aged care?
Private health insurance does not cover aged care. Most types of aged care, including residential care in an aged care home, are subsidised by the Australian Government for eligible seniors. The cost of aged care can vary based on factors like your finances, the services received, and care provider fees.
How does Lifetime Health Cover Loading affect senior health insurance?
Under the Lifetime Health Cover (LHC) scheme, individuals have until 1 July after their 31st birthday to take out private hospital cover. Failure to do so results in a 2% loading on premiums for each year over the age of 30, up to a maximum of 70%. However, after continuously holding any level of hospital cover for 10 years, the loading charges are removed.
Are there rebates for health insurance for over 70’s?
The private health insurance rebate is an amount the Australian Government may contribute towards your private health insurance premiums. The rebate amount depends on factors such as your income, age, and whether you are single or have a family. Generally, older individuals and those with lower incomes receive higher rebates.
What if I have a pre-existing condition?
Health insurance providers may impose a waiting period of up to 12 months on benefits for hospital treatment related to pre-existing conditions. A pre-existing condition is defined as any ailment, illness, or condition with signs and symptoms in the six months before purchasing or upgrading your policy. Psychiatric care, rehabilitation, and palliative care have a two-month waiting period regardless of pre-existing conditions.
What should seniors look for in health insurance?
When selecting health insurance, seniors should carefully compare options, considering both premiums and benefits. It's also wise to review your cover regularly to ensure it meets your changing health and financial needs as you age.
