Health Insurance Age Limits

Find out how long a dependent can remain on a family health insurance policy in Savvy's helpful guide. 

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, updated on July 10th, 2023       

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Are you wondering if there are any age limits or restrictions on private health insurance in Australia? Prior to 2020, young Aussies could remain on their parents’ health insurance policy until the age of 25. However, that all changed in 2021 when the Australian Government introduced new legislation which changed the age at which a dependent could remain on a family health insurance policy.  

You can find out about any age-related restrictions which apply to private health insurance right here with Savvy in our helpful and informative guide.

Are there any age limits for private health insurance in Australia?

Unlike life insurance policies which are based on a person’s risk factors, there are no health restrictions or medical insurance age limits on private health insurance in Australia. All health insurance policies are available to be purchased by clients of any age or health status under Australia’s private health insurance community rating system, with prices remaining the same regardless of your health profile. 

However, if you no longer qualify as a dependent on your parents’ health insurance policy, you may have to pay the Lifetime Health Cover (LHC) loading if you join health insurance after the July following your 31st birthday.   

The LHC loading is an additional 2% on top of the normal cost of your hospital insurance premium for each year you’re uninsured after this date. It's capped at a maximum of 70% and remains in place for ten years of continuous health coverage. This is a government initiative which aims to encourage Aussies to take out private health insurance in their 20s, so it’s worth looking at how close you are to the age limit if you want to avoid the loading. 

What are the age limits for dependents on a family health insurance policy?

In 2021, the Australian Government changed health insurance legislation to allow dependents to remain on their parent’s hospital cover health insurance policies until the age of 31. However, this increase from age 25 to 31 is not compulsory, so while some health funds have introduced this change, others haven’t. As mentioned above, not having insurance beyond the age of 31 can lead to the LHC loading being applied to your health insurance premiums when you eventually join.

In addition, the new legislation also permits disabled dependents who live at home with their parents to remain on their family health policy with no upper age restriction at all. This means that adults who receive NDIS funding won't have to get their own health insurance policy once they turn 31 years old.

Are there specific health insurance policies for particular age groups?

While all health insurance policies are available for purchase by all Australians, some may be aimed more at clients in a certain age demographic. For example, some cheaper extras policies may be aimed at younger, healthy Aussies who may only need periodic dental check-ups and teeth cleaning. On the other hand, more senior Australians may want extensive hospital cover for a set of pre-existing conditions but wish to exclude pregnancy and birth costs.

Frequently asked questions about age limits on health insurance

Will my health insurance costs decrease as I get older?

The basic cost of a health insurance policy doesn’t change according to the age of the customer under Australia’s community rating legislation. However, you will be entitled to a higher percentage Health Insurance Rebate once you turn 65 years old, so your health insurance will likely end up costing you less once you reach 65.  

What is the definition of a dependent for health insurance?

There is no legal definition of a dependent as defined by the Australian Government. Who is classified as a dependent will depend on the health fund you choose. However, generally, a dependent is classified as someone who: 

  • Lives in the same household as the main provider 
  • Is provided with food and basic living essentials by the household provider 
  • Is single and not married 
  • A disabled dependent is a person who lives at home with their parents and is in receipt of NDIS funding or equivalent support 
What health insurance do I need so I don’t have to pay the Medicare Levy Surcharge?

You’ll need to have a minimum of a basic hospital cover policy as defined by the government to avoid the Medicare Levy Surcharge (MLS). The policy must have an excess of no more than $750 for a single or $1,500 for a couple or family policy. The MLS is an additional health tax of between 1% and 1.5% (depending on your income) which Aussies have to pay if they don’t have private health insurance and earn over $90,000 p.a. for a single and $180,000 for a couple. 

Can I just be covered by Medicare and not have private health insurance if I'm still young?

There’s no legislation that says you must have private health insurance. In fact, more than 55% of Aussies don’t have private hospital cover, while around 45% don’t have extras cover (as of March 2023). However, if you do suffer a serious accident or illness which requires extensive out-of-hospital healthcare to assist with your recovery, you may find yourself with thousands of dollars of out-of-pocket expenses.  

You’ll also have to join public hospital waiting lists for any non-emergency in-hospital treatments and surgeries if you don’t have private health insurance. As such, it’s worth considering your priorities when determining whether you need private health insurance. 

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