As you get older, your health needs can change, so it’s vital to check you’ve got the right insurance policy for your current stage of life.
You’re more likely to need treatments like cataract surgery or knee replacements and unfortunately these are often only covered by the more expensive health insurance policies.
So we’ve sifted through the policies in our health insurance comparison to find the best value health insurance policies for older Aussies.
Over 65s make up nearly harlf of hospital admissions.
Private health insurance can be expensive, but hospital cover can help to skip the hospital waiting list and choose your own doctor to perform surgery on you in a private hospital. Extras cover for items outside of hospital though, like optical and dental, may not give you the same benefit, or even save you money.
It will come as no surprise that older Australians are more likely to end up in hospital. Over 65s make up less than 20% of the population, yet account for more than 40% of day and overnight hospital admissions, according to the Australian Institute of Health and Welfare.
The good news is that you’ve been paying the Medicare Levy Surcharge for all of your working life so whether you have private health insurance or not, you’ve got free cover in the public system.
Over 65s account for more than 40% of day and overnight hospital admissions
But more than 40% of all hospital admissions for elective surgery (for example hip and knee replacements) carried out in Australia in 2022–23 were for people aged 65 and over. Elective surgery is where private health insurance comes into its own.
CHOICE tip: Unlike other insurances, hospital insurance is unlikely to cover all of your expenses in hospital. It will cover your hospital stay, after you’ve paid an excess. But it often won’t cover the total fee for your surgeon, or the anaesthetist. So if you do have hospital insurance, you will still need to put savings aside to pay for the additional out-of-pocket costs should you have a hospital stay.
The typical hospital procedures you may need as you get older include:
Heart surgery
Joint replacements
Cataracts
Dialysis
Rehabilitation
Palliative care
Most of these procedures are available in Silver Plus or Gold level hospital cover. If you just want cover for everything, then a Gold hospital policy will cover it all, but they are unfortunately becoming expensive.
You might find cover for some of these treatments in lower level tiers, like Bronze Plus hospital cover.
Your health needs out of hospital may also increase as you age. Particularly for items like general dental, major dental, optical, physiotherapy, podiatry and hearing aids.
If you’re using your extras insurance to its full capacity every year, it can be helpful for managing your budget. But the problem with extras insurance is that most people fork out more than they’ll ever get back.
On average, Australians receive $475 from their health insurance extras each year, according to the Australian Prudential Regulation Authority. But the average annual extras premium for a single person in NSW is $936, almost double the average benefit.
The problem with extras insurance is that most people fork out more than they’ll ever get back
If you want to cut back on health insurance cover to save money, then consider what value you’re getting out of your extras policy.
Ask your fund for a statement of claims for the last year, or even the last few years if you’ve been with the same fund for a while. Compare that to what you paid out in premiums.
If you’re getting bang for your buck, then that’s great. But otherwise you may save a lot of money just taking out hospital insurance, and dropping the extras.
CHOICE tip: In years when you don’t make a hearing aid claim, you’ll have to work hard to claim back the full premium for these policies. On top of this, you’ll need to take into account waiting periods for cover, and sometimes there are restrictions on the number of hearing aids you can claim over a few years.
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 older Australians.
We’re not loyal to brands. We’re loyal to you.
Unlike for-profit comparison websites, we don’t get paid by any of the insurers we compare. This means we don’t recommend insurers based on how much they pay us. We only recommend the best insurance policies for you.
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Hospital cover
We select the cheapest Silver Plus hospital policies that cover cataract and joint replacement surgery, with above average gap cover in your state. The policies have a maximum of $750 excess but some policies may have co-payments, which are an amount that you contribute for each day of your hospital stay.
We do select Gold hospital policies where they’re good enough value, but none were this time. If you still want a Gold policy, you can select one in our health insurance comparison.
Extras cover
We compared policies in this category on price and cover, particularly for services commonly claimed by people over 65. We’ve selected policies that cost less than $90 a month (before the government rebate) and offer the best level of cover for general dental, major dental, optical, physiotherapy, podiatry and hearing aids. We excluded policies that have a high complaint rating.
Some funds have restricted membership for employees of specific industries or professions, such as the armed forces, teachers, union members or CommBank. Where available (and where cheap enough), we’ve included these as well.
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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