Couples Health Insurance

Contemplating couples health insurance? Not sure how to find the best policy for you and your partner? Find the right health insurance policy to suit you and your partner.

Couples Health Insurance

If you’re a couple, taking out couples health insurance can be a great idea to protect your health and finances going forward. It can prove difficult figuring out what the best option is for you and your partner while trying to get the best value possible. Find out what to look for in a policy and how to choose the best couples health insurance based on your situation.

How does couples health insurance work?

Couples health insurance will place you and your partner under a single policy which covers two adults. To be eligible for couples health insurance, you don’t need to be married. Couples health insurance can be taken out by couples that are either married, de factor or in a relationship.

With an array of couples health insurance policies on offer, there are options which suit everyone including: healthy couples, young couples, couples planning a family, middle-aged couples without kids, and maturing couples with a need to cover their growing list of health conditions or concerns.

Under couples health insurance, both you and your partner will be covered for the same inclusions with matching levels of coverage. Having the same policy and coverage will make your health insurance easy to understand and keep things simple.

What types of couples health insurance are there?

There are three types of couples health insurance available to you: hospital cover, extras cover or combined cover. The ins and outs of each type of cover will vary based on both your health insurer and the level of coverage you choose to take out.

Hospital cover will predominantly benefit you by getting you treatments and services as a private patient in a private or public hospital. The inclusions of hospital cover will vary based on the level of coverage you choose but can include some of the following:

  • Access to private or shared rooms in a private hospital.
  • The ability to choose your preferred doctor and the hospital you go to.
  • Avoid the lengthy delays often associated with public hospitals and their procedure wait lists.
  • Certain surgeries.
  • In-hospital rehab treatments and services.
  • In-patient pharmaceuticals.

 

Extras cover will provide a focus on preventative treatments to improve your health and wellbeing and prevent injury or illness. Depending on your level of coverage, extras cover may include:

  • General and major dental
  • Dental and/or orthodontics
  • Optical
  • Pharmacy
  • Physiotherapy
  • Podiatry
  • Chiropractic
  • Diet/nutrition services
  • Speech therapy

 

Combined cover is an option which will give you the benefits of both hospital cover and extras cover. It is the most expensive option but it will give your health and finances the best range of protection. Combined cover can also be mixed and matched – a silver-level hospital cover can be paired with a basic extras cover policy and vice versa. 

Couples who are young, fit and healthy may best suit a basic or bronze hospital-cover only policy. With limited medical needs and little reason for concern over more complex treatments and services, a basic hospital cover policy will more than adequately serve your health insurance needs while keeping costs low.

If you’re a couple who is planning for a child, you should seriously consider taking out a gold-level hospital cover policy. Under a gold hospital cover policy, you will be able to take advantage of all birth and pregnancy-related services in private hospitals. This will help provide the support you and your partner need in one of the most important times of your lives. Make sure to take out gold-level hospital cover at least 12 months prior to birth as waiting periods apply.

Mature couples who have a growing need for medical treatments and services may require a higher-level health insurance. You may wish to consider taking out a silver or gold-level hospital cover policy in addition to your choice of extras cover. This will ensure you are eligible for more complex treatments, such as knee replacements, which become more relevant the older you get. An extras cover policy will also help maintain your health and wellbeing while preventing health conditions which could cause you problems as you grow old.

What’s included in couples health insurance?

The inclusions of your couples health insurance will depend on the type of cover and level of cover you take out. As inclusions will vary, it’s important you read up on your policy’s Product Disclosure Statement (PDS) to know what you’re covered for. The inclusions of your couples health insurance policy can include treatments or services for the following:

Hospital cover inclusions Extras cover inclusions
  • Rehabilitation
  • Palliative care
  • Brain and nervous systems
  • Psychiatric services
  • Heart and vascular system
  • Dental surgeries
  • Joint replacements and reconstructions
  • Back, neck and spine
  • Birth or pregnancy-related services
  • Ear, nose or throat
  • Physiotherapy
  • Optical
  • Chiropractic
  • General dental
  • Major dental
  • Massage treatments
  • Speech, occupational and eye therapy
  • Podiatry
  • Non-Pharmaceutical Benefits Scheme prescription medicine
  • Hearing aids and health aids/appliances

The exclusions under your couples health insurance policy depend on the type and level of coverage taken out. While high-level hospital cover policies will feature most or all the possible health cover benefits, a basic policy’s exclusions could be:

  • Joint reconstructions and replacements.
  • Dental surgeries
  • Pregnancy-related services
  • Heart, brain, lung, or kidney treatments and services.
  • Appointments with specialists or obstetricians or outside of hospital.

For a full understanding of the exclusions in your couples health insurance policy, read the terms and conditions and the policy’s PDS.

How do I compare couples health insurance?

Consider the premium cost of various policies

  • Compare the premium costs of your policy options. Taking out a basic hospital cover or extras cover policy will save you significantly on premium costs in both the short term and long term. However, if you require treatment or service for something not included in your cover, these savings from choosing a cheaper policy will be useless. Instead, you will now be left to foot an expensive medical bill you may struggle to afford.
  • While comparing prices, you mustn’t let the cost of a premium outweigh the importance of getting the appropriate level of health cover. While a cheap level of health cover will be good for your finances initially, it may do more damage than it’s worth if you do get injured or sick and are required to foot a bill you can’t afford. Look for a level of balance between cost and health coverage when comparing your couples health insurance options.
Monthly premium Total cost after one year Total cost after five years Total cost after ten years Savings compared to $500 premium
$350
$4,200
$21,000
$42,000
$18,000
$400
$4,800
$24,000
$48,000
$12,000
$450
$5,400
$27,000
$54,000
$6,000
$500
$6,000
$30,000
$60,000
N/A

*Note: calculations are based on estimations and are not necessarily reflective of current premium rates. Calculations do not account for rate rises over time.

Compare levels of coverage and the relevant inclusions or exclusions

In addition, you should compare the levels of coverage available and the relevant inclusions and exclusions of each level. It’s important to get good value in the level of cover you opt for, but don’t pay extra for a higher level of cover if you definitely won’t require it and you’re on a budget. You should prioritise looking at policies with cover for any pre-existing health conditions which apply to you or your partner, as well as inclusions which may be necessary based on your current or future health situation.

Look at the financial coverage of each policy

Furthermore, the financial coverage of couples health insurance policies should be considered. While a certain policy may have all the inclusions you want, it’s important that it doesn’t have a low benefit limit. If a policy features a low benefit limit for an inclusion you make claims on regularly, you will be required to pay for treatment or services once that benefit limit is reached. More expensive premiums tend to have higher benefit limits while cheaper premiums tend to have lower benefit limits.

How are my couples health insurance premiums calculated?

Pros and cons of couples health insurance

PROS

Could be eligible for a higher government rebate

Depending on your income as a couple, you could be eligible for a higher government rebate with a couples health insurance policy as opposed to that of a singles health insurance policy. Couples earning a combined income of less than $180,000 are eligible for the full rebate and singles earning less than $90,000 are eligible.

Same cover makes it easier to understand

Health insurance can be a complex product but by sharing the same policy and the same inclusions, it will help simplify your coverage.

Reduces applicable Life-time Health Cover (LHC) loading

If you or your partner is charged LHC loading and one is not, your applicable rate will be averaged down. E.g., if your partner has 8% LHC loading and you have no LHC loading, your couples health insurance loading amount is now 4%. This can save the both of you a significant amount of money in the long term.

CONS

Benefits may not be relevant to each individual

As the inclusions of your couples policy apply to both individuals, the benefits may not be relevant to each of you. While one partner may require cover for many treatments or services, the other may not and your couples health insurance may not be an effective financial decision.

If you’re fit and healthy, you may not make full use of your cover

As a fit couple, you might not require much of the cover offered by even the most basic couples health insurance available. However, should something ever go wrong, you will be thankful you did take out that policy.

If your health needs are likely to change and you need to change cover, you will still have to serve a 12-month waiting period

Any hospital cover policy will come with a waiting period of up to 12 months. Extras policies can even be subject to waiting periods which may exceed a year. You need to be aware of this should you or your partner’s health needs change and you be required to change your cover.

Frequently asked questions about couples health insurance

Is a couples health insurance policy cheaper than taking out two singles health insurance policies?

When initially paying for a couples health insurance policy, it won’t be any cheaper than two singles health insurance policies as health insurance is community rated. However, given that you may be eligible for a higher government rebate as a couple earning less than $180,000 annually, it could end up being the cheaper option. It’s important you explore your options broadly and don’t let the cost of your insurance outweigh prioritising your health.

How long do we have to be together to be eligible for couples health insurance?

There is no minimum amount of time for which you must be together as a couple to be eligible for couples health insurance. You simply need to be either in a relationship, de facto or married.

If we’re a young and healthy couple, is it still worth taking out couples health insurance?

Even if you’re fit and healthy, there are still many perks and safety measures by taking out couples health insurance. In the off chance of a medical event occurring, you could be saving yourself from an expensive medical bill you otherwise couldn’t afford. In addition, you can get a significant government rebate by taking out private health insurance and will avoid paying the Medicare levy surcharge which could help you put money towards rent or other bills.

What type of couples health insurance will we need to receive pregnancy cover?

You can get cover for birth-related services under a gold-level hospital cover. It’s important to know that you must take out gold-level hospital cover at least 12 months before you give birth to account for the waiting period. 

What is Lifetime Health Cover (LHC) loading and how does it apply to my couples health insurance?

LHC loading applies to individuals who don’t take out hospital cover before July 1 after they turn 31 years old. If this is you, a two percent increase in your health insurance premiums will apply for each year that you are uncovered.will cap at 70%, with increased premiums ceasing once you’ve had ten years of hospital cover. If you’re on couples health insurance and LHC loading applies to you, your partner or both, the percentage amount will be averaged.

As a senior citizen, should we choose couples health insurance or seniors health insurance?

While there is no right or wrong answer, seniors health insurance is specially designed to benefit seniors and their health or medical needs.