The best family health insurance is specific to the size and shape of your family and their needs
It’s often better to mix and match hospital and extras policies to get the best value cover
Health funds may offer different benefits for kids, so it pays to shop around
Determining which health insurance policy is right for your family depends on the size of your family, how old your kids are, and everyone’s specific needs. If you’re just starting out then pregnancy cover may be top of mind. But if you’ve got teenagers, you may be more interested in orthodontics than birth cover.
If you’re a two-parent household with children, the value for money you’ll get out of private health insurance is (regrettably) much better than if you’re a single-parent household.
Finding the right health insurance for a family is all about balancing the health needs of your kids with your own health needs. For many families, the parents are more likely to need hospital cover than the kids are. But the kids might place a lot of demands on health costs out of hospital, which requires extras cover.
Extras cover for kids
The typical cover kids may need at this stage in life is:
General dental – Routine treatment for check-ups, teeth cleans, scale and polish, local X-rays, fluoride and similar treatments.
Major dental – For more complex treatments like wisdom teeth extractions.
Orthodontic –Cover for braces, plates and retainers.
Optical –Contributes to the cost of prescription glasses and contact lenses (eye tests are covered by Medicare, not your health fund).
Psychology – You can’t claim from Medicare and private health insurance at the same time. So it’s more cost effective to obtain a Mental Health Care treatment plan from your GP for 10 sessions, and if your child needs more sessions than that in a calendar year, then use your extras cover.
Speech therapy – Similar to Psychology, you can’t use Medicare and private health cover for the same appointment, so it’s better to maximise your use of Medicare rebates first.
Non-Pharmaceutical Benefits Scheme medicines. Many prescriptions in Australia are subsidised by the government under the Pharmaceutical Benefits Scheme, but for prescriptions that aren’t you can use extras cover to subsidise the cost. Typical medicines under this banner may include melatonin and specialised ADHD medications.
The cost of extras policies across Australia that cover all these items ranges from $24 to $480 a month.
There are limits on the cover for each item, so it really pays to know what these items may cost your family each year versus how much you’ll have to fork out in insurance premiums (and how much they’ll pay back).
The cost of extras policies across Australia that cover all these items ranges from $24 to $480 a month
If you already have health insurance, then it’s easy. Just ask your fund for a statement of claims for the last year, and weigh up what your fund paid you versus what you paid them, and the specialists.
If you don’t already have health insurance, ask your specialist for an estimate of what the costs for your child’s treatment may be in the next year, or in the case of orthodontics, the next few years.
Many health funds offer special benefits for kids. If you’re taking out health cover for your kids or switching to a better deal, keep an eye out for these features.
1. No excess or co-payments for children
Many funds have family policies that don’t charge an excess or co-payment for children who need to go to hospital.
CHOICE tip: Basic, Bronze and Silver policies (with some cover restrictions) often charge an excess for children, so check the fine print before you sign up.
2. Free or discounted extras
Some funds offer free or discounted extras services for children, such as dental check-ups or discounts on glasses. Note, though, that you’ll usually need to visit preferred providers to take advantage of these benefits.
3. Extended coverage for older children
Children and full-time students up to age 31 can often stay on the regular family policy for free. Older dependents and non-students can stay on an extended family policy for up to 30% extra on your premium.
As couples mostly pay the same for health insurance as families, there’s no real advantage to switching to a couples policy.
However, as you both may have different health needs, especially for extras services such as dental, optometry and physio, it may make sense to switch to different singles policies. Singles policies usually cost half as much as a family or couples policy.
Should you downgrade to cover without pregnancy?
You could consider downgrading to a policy that doesn’t include cover for pregnancy and fertility if you’re done having children, or happy to use the public system.
But even though you might be happy to take out a policy that restricts conditions you think you won’t need – for example, pregnancy, fertility treatment and gastric banding – keep in mind that with these kinds of policies, health funds can change and add to the procedures that they exclude or restrict for Bronze Plus or Silver Plus policies without changing the classification of the policy.
So, unless you keep track of all the materials the fund sends you and you regularly check your policy, you might find yourself without cover for something you’ll actually need.
What does health insurance cost for a family?
Silver and Silver Plus health cover for a family policy with a $750 excess costs on average about $345 for Silver and $428 for Silver Plus (without the health insurance rebate). The cost varies depending on which state you live in, how much you earn, the level of excess, and when you first bought health insurance.
If you’d like something more budget friendly or simply to save on tax you might like to look at Bronze or Basic insurance.
The best health insurance policies for a family
It’s often better value to mix and match different hospital and extras policies from different insurers, but they’re not always easy to find.
So, exclusively for CHOICE members, we’ve searched through our database to find the best hospital and extras policies for a family.
Log in to unlock this members-only content, or join CHOICE to get instant access to all of our expert, independent reviews.
Hospital: We’ve selected Silver Plus policies that waive the excess for children. These policies include cover for the 26 standard categories of Silver services, including for a heart attack, cancer surgery and plastic surgery needed after a burn or accident, as well as cover for rehabilitation, and possibly more. We’ve narrowed our selection to the cheapest two policies from open funds, and restricted funds where they’re cheaper than the second-cheapest open fund. We’ve omitted funds with a high level of complaints. Prices are for two adults plus children with an excess of $750.
Extras: We’ve selected extras policies for high usage under $200 a month (before the rebate) for a family of two adults and two kids. They cover dental, orthodontic and at least one other of the items listed above under ‘Extras cover for kids’. We’ve narrowed our selection to the top two extras policies from open funds and the top two from restricted funds, and omitted funds with a high level of complaints.
Jane Bardell is a Content producer in the Insurance and utilities team. She writes about home, car, pet and health insurance.
Previously at CHOICE, she checked facts, figures and statistics as a Verifier with the Editorial and investigations team.
Jane has a Bachelor of Science from the University of New South Wales. LinkedIn
Jane Bardell is a Content producer in the Insurance and utilities team. She writes about home, car, pet and health insurance.
Previously at CHOICE, she checked facts, figures and statistics as a Verifier with the Editorial and investigations team.
Jane has a Bachelor of Science from the University of New South Wales. LinkedIn
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