Health Insurance for Seniors

Compare a variety of health insurance options for seniors to help you find the best cover for your needs.

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, updated on July 6th, 2023       

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We’ve partnered with Compare Club to bring you a range of health insurance policies to help you compare them side by side.

Choosing the best health insurance policy is an important consideration, particularly for those Aussies who are seniors or in the later years of their life. Whilst there are many health insurance policies to choose from, not all will be appropriate or a good fit for seniors. 

Savvy helps seniors by making the process of finding a great health insurance policy easy. We can help you to explore your private health insurance options by quickly providing a range of quotes for you to compare online. Just by answering a few simple questions about the health insurance you're looking for, you could soon have a number of quotes from some of Australia's leading insurers to compare. Don't delay – start getting your health insurance sorted out with Savvy today!

What is health insurance for seniors?

Private health insurance policies offered in Australia are equally available for people of all ages, as it is illegal to discriminate against anyone based on their age or gender, or to refuse health insurance cover due to a pre-existing health condition. However, there are policies that are geared towards people in the second half of their lives, which offer comprehensive cover for a wide range of treatments, whilst excluding cover for features that are not relevant to seniors, such as pregnancy and childbirth.

What is different for seniors as far as health insurance goes is the level of rebate offered by the government, which increases once a person reaches 65 years of age (based on income.)

The Private Health Insurance Rebate for Seniors

The Australian government assists all citizens with the cost of their private health insurance. The amount of rebate applicable is means tested, with the amount of rebate decreasing as income increases. The basic level of the rebate applies for those who earn under at $90,000 p.a. for a single person, or $180,000 p.a. for a couple.

  • At 65 years old, the rebate increases from 24.6% to 28.7%.
  • At the age of 70 years or older, the rebate increases again to 32.8%.

Although the rebate percentage was frozen for a period of eight years up until the 2022/2023 financial year, the amount of the rebate and relevant income levels may change, so be sure to check with the ATO site relating to private health insurance rebates for the very latest information.

How do I compare the best health insurance for seniors?

When comparing your health insurance options as a senior Australian, you will first have to decide whether you want hospital cover, extras only cover or a combination of both.

Hospital cover

The main features of hospital cover are:

  • You may be able to have access to a private room in a public or private hospital
  • You may be able to choose the doctor who treats you, and the hospital where you receive your treatment
  • You may be able to avoid the lengthy delays often associated with public hospital surgery, and choose when to receive your treatment without having to join a waiting list 

All of these potential benefits are subject to eligibility and availability, and the terms and conditions of the individual health insurance policy you choose to buy.

Extras cover

The main features associated with extras cover include:

  • You may be able to claim back some or all of the cost of a variety of outpatient treatments or services that are excluded from Medicare, such as dentistry, optometry and the provision of subsidised hearing aids. 

However, the amount you'll be able to claim back, and the range of outpatient services that are covered will depend on the specific policy you choose to buy.

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. It may be a good idea to prioritise existing conditions you may have, and make sure these are covered by your policy. Some treatments that are more common later in life, such as heart surgery, eye surgery and joint replacement, may only be available with top-tier policies. 

After identifying specific treatments you need cover for, you'll then need to consider what cover you can afford. While more expensive policies may not be within everyone's budget, they will offer the most comprehensive level of cover for senior Australians.

What does health insurance for seniors cover?

The inclusions in your health insurance will depend on the type of cover you choose (hospital cover, extras cover or perhaps a combination of the two.) Furthermore, your inclusions will depend on the tier of cover you choose, ie. basic, bronze, silver or gold. Hospital cover can have many of the inclusions which are popular with seniors including:

  • Private patients accommodation in private or public hospitals
  • Operating theatre fees
  • Fees charged by doctors, surgeons and anaethetists
  • In-patient MRIs, x-rays, CAT scans and blood pathology
  • Hip and knee replacements
  • Cardiothoracic surgery for heart, lungs or chest
  • Organ transplant
  • Back surgery
  • Dental surgery
  • Hernia repair
  • Colonoscopies
  • In-patient pharmaceuticals
  • Cancer and stroke treatment
  • Prostheses
  • Eye surgery
  • In-patient pshchiatric services
  • Palliative care
  • Ambulance cover

Extras cover health insurance can include some or all of the following, depending on the level of cover you choose:

  • Optical services including glasses and contact lenses
  • Dental cover, including checkups, root canal treatment, dentures and extractions
  • Physiotherapy
  • Chiropractic services
  • Hearing aids
  • Podiatry
  • Occupational therapy
  • Psychology
  • Blood pressure monitors
  • Preventative tests such as bowel cancer screening and bone density testing

What isn't covered by health insurance for seniors?

Common exclusions to health insurance policies include: 

  • Laser eye surgery 
  • Acupuncture
  • Appointments with specialists outside of hospital
  • Surgery not considered medically necessary, such as tattoo removal or face lifts
  • Self-inflicted injuries
  • In-home nursing care (which is frequently provided by Medicare if considered necessary)
  • Chinese medicine
  • Some alternative medicines and therapies

It is vital to get a thorough understanding of a policy’s inclusions and exclusions, so you understand exactly what you are covered for.  Savvy makes this easy by helping you to compare a number of policies side-by-side so you can cleary see the differences. Start comparing health insurance policies here with Savvy today.

How much does health insurance for seniors cost?

It’s a common misconception that health insurance for seniors costs more than for younger Australians. Health insurance is community rated, which means that everyone pays the same for their insurance no matter your age, health status or claims history. 

The amount you'll pay for your health insurance will be impacted by several factors, including:

  • The level of cover you choose. Top-tier 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 you choose
  • Your location and the state you live in

What are the benefits of seniors’ health insurance?

  • Choose your doctor – if you have private health insurance, you may have a choice about which doctor you see and which surgeon performs your surgery
  • Skip public hospital waiting lists – having private health insurance can help you skip lengthy public hospital waiting lists
  • Have your own room whilst in hospital – it is possible (but not guaranteed) that you may be able to be accommodated in a single room in a public or private hospital if you are a private patient. This will depend on the terms and conditions of the policy you buy, and the availability of single rooms.
  • Decide which hospital you wish to receive treatment in – you may be able to choose which hospital you receive your treatment in, although this will depend on which hospitals the surgeon of your choice operates out of
  • Save thousands on treatments not offered by Medicare – some of the Medicare exclusions can end up costing thousands – for example, hearing aids and complex dental treatment. Rather than pay the full cost of such treatments, having health insurance may mean you're covered for all or part of these costs
  • Avoid the Medicare Levy surcharge – the Medicare Levy Surcharge (MLS) is an additional levy imposed on Australian taxpayers who don’t have private health insurance (and who earn over $90,000 p.a. for a single person, or $180,000 for a couple.) It starts at 1% of your income and goes up to 1.5% on a sliding scale.
  • Receive an Australian Government rebate – all Aussies are assisted with the cost of private health insurance by the Australian Government, However, 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 also increase again once you reach 70.

Types of health insurance

Why compare health insurance through Savvy?

Top tips for choosing health insurance as a senior

Write a priority list

By writing a list of what types of treatment you need (or have used in the past two years) you'll get a better idea of which areas to prioritise when choosing between insurance policies

Determine your health cover budget

Many people pay their health insurance premiums on a monthly basis, so work out what you can afford based on your whole household income per month, minus the essential costs of paying your rent or mortgage and buying food.

Review your insurance needs regularly

You may be surprised at how health insurance policies have changed recently. Regularly review your level of cover to make sure you’re still getting the best deal for your health budget.

Compare policies through Savvy

By comparing health insurance policies you'll gain an understanding of whether your current policy offers you a great deal or not. By giving your health insurance a free check-up through Savvy, you'll get a range of no-obligation quotes almost immediately to help get you a realistic idea of how good your current policy fits your needs as a senior Australian.

Frequently asked questions about health insurance for seniors

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

No, all health insurance policies cost the same regardless of the age of the person wishing to purchase the policy. However, those aged over 65 may receive a higher private health insurance rebate from the Australian Government (if they qualify under the income means test).

Why are there waiting periods on 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 then cancel their insurance immediately upon receiving the benefit. This would impact others and result in an increase in the cost of health cover across the fund’s membership.

How long are standard waiting periods for 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 for most other benefits
What is 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. It only applies to hospital cover, not extras cover. This excess is typically paid directly to the relevant hospital before or after treatment.

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

This decision depends on your individual financial situation and general health. If you expect that you will require surgery at some point in the near future, you may think about considering a a policy with an excess that is more affordable. While paying more overall for a lower excess, you could potentially save money in the event that you do need a stay in hospital.

Is it possible to transfer my seniors’ health insurance cover between funds without being left uninsured?

Yes. If you do decide to switch to a new insurer, your new fund can contact your previous insurer and cancel your cover the same day you buy a new policy. This can ensure a seamless transition without any breaks in coverage.

Is there any upper age limit for seniors taking out private health insurance?

No, there is no upper age limit on when you can take out a private health insurance policy in Australia. Under Australia's community rating health insurance system, it is illegal to discriminate against anyone based on their age, gender or pre-existing health conditions. 

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Disclaimer:

Savvy is partnered with Compare Club Australia Pty Ltd (AFS representative number 001279036) of Alternative Media Pty Ltd (AFS License number 486326) to provide readers with a variety of health insurance policies to compare. Savvy earns a commission from Compare Club each time a customer buys a health insurance policy via our website. We don’t arrange for products to be purchased from these brands directly, as all purchases are conducted via Compare Club.

Savvy’s comparison service is provided by Compare Club. Compare Club compares selected products from a panel of trusted insurers and does not compare all products in the market.

Any advice presented above or on other pages is general in nature and doesn’t consider your personal or business objectives, needs or finances. It’s always important to consider whether advice is suitable for you before purchasing an insurance policy.

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