Health Insurance for Seniors

Checking out your seniors’ health insurance options? Savvy is here to help you to choose the best option for your situation.

Last updated on May 4th, 2022 at 03:30 pm by Bill Tsouvalas

Compare health insurance options for seniors

Choosing a great seniors’ health insurance cover is a very important component of later life. While there are many options out there, not all will fit you and your situation. Here we explain the ins and outs of seniors’ health insurance and how to ensure you are getting the best cover for your health and life situation.

What is seniors' health insurance? 

Unlike traditional health insurance, seniors’ health insurance is specifically designed for the needs of senior citizens. In terms of what is defined as ‘senior’, some policies will classify any person over 50 years old as senior, while other insurers may determine 65 years old as the minimum age of eligibility. Seniors’ health insurance policies will provide cover specifically relevant to conditions common for people of this age while also excluding cover for features not relevant to seniors, such as pregnancy.

In terms of how seniors’ health insurance differs from more standard policies, you’ll find that they cover many of the same features. However, there are a couple of key differences, including:

The rebate percentage applicable to seniors’ health insurance. At 65 years old, if you’re a single earning an income of up to $90,000 annually, or a couple earning up to $180,000 annually, your rebate will increase from 24.6% to 28.7%. Furthermore, this rebate will again increase at 75 years old to 32.8%.

Seniors’ health insurance will typically not include cover for any pregnancy or birth-related service.

How do I compare the best seniors' health insurance?

In comparing your seniors’ health insurance options, you will first have to decide whether you want hospital cover, extras only cover or a combination of both. The main basic features of hospital cover are that you have:

  • Access to private or shared rooms in a private hospital.
  • The ability to choose your doctor and the hospital you go to.
  • Avoid the lengthy delays often associated with public hospitals and their procedure wait lists.

The main features associated with extras cover include:

  • A variety of claims from out-of-hospital treatments or services that are excluded from Medicare.
  • An array of benefits that are usually on offer, including chiropractic, dentistry and even exercise classes.

Once you have decided on hospital cover, extras cover, or the benefits of both, you will need to work out what features are most important to you. If you have a pre-existing condition for which you will be utilising your health insurance regularly, you will need to ensure that you are covered for that and any relevant illness or injury that could arise from it.

Furthermore, you will want policies that will cover you for treatments relevant to seniors later in life such as heart surgery, eye surgery and joint replacement. This sort of cover usually only comes with top-tier policies – that being gold level.

In addition, after identifying specific features you need cover for based on your health condition and age, you will need to break down what cover you can afford. You will need to truly consider paying more for better cover and protection for your health and wellbeing. While more expensive premiums might not be in some people’s budgets, a more comprehensive seniors’ health insurance policy should be atop your priority list when comparing your options if you can afford it.

What does seniors’ health insurance cover?

The inclusions of your seniors’ health insurance depend on the type of cover you choose; this being hospital cover, extras cover or perhaps a combination of the two. Furthermore, your inclusions will depend on the tier of cover you choose, this being basic, bronze, silver or gold. Hospital cover can have many of the inclusions often sought by seniors including:

Private patient accommodation in private or public hospitals

Intensive care costs

Operating theatre fees

In-patient MRIs, x-rays, CAT scans and pathology

Other surgeries and procedures including: hip replacements, knee replacements, back surgery, dental surgery, hernia repair, colonoscopies and more

Cancer and stroke treatment

In-patient pharmaceuticals

Cardiothoracic surgery for heart, lungs or chest

Rehab services

Organ transplant


Eye surgery

In-patient psychiatric treatment

Palliative care

Gap cover for GP visits

Seniors’ health insurance with extras could include some of the following:

Ambulance cover

Optical, including glasses and contact lenses

Dental cover, including check-ups, crowns and bridges, root canal treatment, dentures, teeth removal, etc.



Hearing aids

Occupational therapy

Blood pressure monitors



Preventive tests such as bowel screening, bone density testing, etc.

What doesn’t seniors’ health insurance cover?

Under a basic seniors’ health insurance policy with only hospital cover, the common exclusions will be:

  • Joint replacement e.g. knee or hip replacement.
  • Heart surgeries
  • Eye surgery
  • Pregnancy or any birth-related services.
  • Appointments with any specialists outside of hospital.

The exclusions of joint replacements and heart surgeries in lower-level health insurance policies are crucial for seniors. To get a thorough understanding of a policy’s exclusions, contact the insurer directly or read up on the product disclosure statement to make sure you get cover for what you need.

How much does seniors' health insurance cost?

It’s a common misconception that seniors’ health insurance costs more. Health insurance is community rated and therefore, no matter your age, you will be paying the same price for the same level of cover as other members.

The cost of seniors’ health insurance will be impacted by several factors, including:

  • The level of cover you choose. Top tier level cover is going to be significantly more expensive than basic level cover.
  • Whether you opt for hospital only, extras only or a combination type of cover.
  • The insurance company
  • Your location of residence

Depending on the tier of your cover and a hospital-only policy, you could expect to pay the following approximate prices:

Hospital cover tier Hospital cover cost (per month)

What are the benefits of seniors’ health insurance?

Higher rebates – When you reach 65 years old, you will be eligible for higher rebates from the government to reduce your premiums. If you’re a single earning up to $90,000 or a couple/family earning up to $180,000, your rebate will increase from 24.61% % to 28.71%. At 70 years old, this will increase once again to 32.81%.

Peace of mind – As you grow older and your body begins to age, you may be as concerned as ever about your health and the financial costs associated with the treatments and services you need. Having health insurance will provide you and your family with a great deal of reassurance that your health and finances will be taken care of should you fall ill or find yourself injured.

Skip public waiting lists – When you’re older, surgery often can’t wait which is why it’s very beneficial to have health insurance in order to skip lengthy wait lists with public hospitals.

Top tips for choosing seniors' health insurance

Compare your options broadly. 

Make sure to explore your options broadly across as many insurers as possible. It’s possible that you might find a seniors’ health insurance cover which looks perfect for you right away. However, you will quickly discover there are more features and aspects to policies which you decide you desire. There is no need to rush the process as it is an important decision.

Prioritise extensive cover, your health matters most! 

Nothing matters more than your health and wellbeing as a senior. If you’re in a position to pay a higher premium for a higher level of health insurance cover, then you should do so. As surgeries and treatments become more common, it will give you and your family greater peace of mind as well as ensuring you don’t have to decide between your health and money.

Remember to check and update your cover accordingly

As you continue to get older, your health situation is likely to change. Therefore, it’s important that even when you have purchased and are content with your seniors’ health insurance, you keep checking and updating your cover accordingly. This will ensure you are protected against any illnesses or injuries that become relevant to you and safeguard you from any financial surprises.

When your policy is up for renewal, explore your options

When your seniors’ health insurance policy is up for renewal, make sure to explore your options elsewhere. While sticking with your current health insurer may be easier, you may find better deals elsewhere.

Frequently asked questions about seniors' health insurance

Do pensioners get a discount on their seniors’ health insurance?

Pensioners don’t get a discount as such; however, they do receive a higher rebate.

Why are there waiting periods on seniors’ health insurance?

Waiting periods are in place to stop customers from claiming on a particular part of their health insurance within a certain period of time. If there wasn’t waiting periods, customers could sign up, make a claim for an expensive treatment or service, and cancel immediately upon receiving the benefit. At this stage, a customer wouldn’t have paid anything significant on their health cover. These actions would impact other members as it would result in an increase in the cost of health cover across the fund’s membership.

How long are standard waiting periods for seniors health insurance?

Waiting periods for hospital cover are usually:

  • 12 months for any pre-existing conditions.
  • 12 months for pregnancy or other birth services.
  • 2 months for rehab, psychiatric or palliative care (no matter if it’s a pre-existing condition).
  • 2 months under most other circumstances.
What’s a health cover excess?

A health cover excess, like a car insurance excess, is a contribution you must make towards a health-related claim you make on your insurance policy. This excess is typically paid directly to the relevant hospital before or after treatment. Having a health cover excess will ensure your seniors’ health insurance remains cheaper, however, it’s also possible to pay a higher premium for cover with no excess.

Should I choose a higher excess to reduce the overall cost of my seniors’ health insurance?

This decision depends on your individual situation. If you expect that you will require surgery at some point in the next two years, you may be better off choosing a health insurance policy which has a lower excess or no excess at all. While paying more for cover with no excess, you will be saving money in the event that you do have a stay in hospital and are hit with an array of costs.

Is it possible to transfer my seniors’ health insurance cover between funds without delay?

Yes! When joining a new insurer, they can contact your previous fund and cancel that cover the day you join. This will ensure a seamless transition without any breaks in cover.