Health insurance helps you access medical care in the private hospital system.
The private system has shorter wait times for surgery, plus a few other nice quality of life benefits.
Everyone is different, but people over 50 are likely to need more complex coverage offered by Silver and Gold policies.
What does seniors health insurance cover?
Hospital
Hospital cover gives access to treatment in a private hospital as a private patient. You can choose your doctor, get your own hospital room (where one is available) and have more flexibility over scheduling procedures. You can choose from 4 levels of hospital cover in Australia: basic, bronze, silver and gold. Which you choose is very much dependant on your specific health needs - bit more on that below.
Extras
Extras insurance helps pay for out-of-hospital treatments which Medicare doesn't usually cover. This can include dental, physiotherapy, chiro and optical. Many policies also cover ambulance fees which the public system does not pay for, unless you live in Queensland or Tasmania. What level of extras plans you pick is a personal choice. Extras area a lot like one of the old coupon books you bought from your kid's school - so long as you use the benefits, they are good value for money.
What kind of hospital policy is right for seniors?
Hospital policies come in four main flavours: basic, bronze, silver and gold. The specific treatments each tier of policy needs to cover is set by law, so it makes it a bit easier to compare apples to apples.
For most seniors, a silver of gold policy is probably going to be the best place to start comparing. This is just because we have more complex health needs as we get older, many of which are only covered by the more comprehensive policies. That's not to say you will need a silver or gold policy though - you gotta make that call for yourself.
Clinical category
Basic
Bronze
Silver
Gold
Rehabilitation
R
R
R
Hospital psychiatric services
R
R
R
Palliative care
R
R
R
Brain and nervous system
Eye (not cataracts)
Ear, nose and throat
Tonsils, adenoids and grommets
Bone, joint and muscle
Joint reconstructions
Kidney and bladder
Male reproductive system
Digestive system
Hernia and appendix
Gastrointestinal endoscopy
Gynaecology
Miscarriage and termination of pregnancy
Chemotherapy, radiotherapy and immunotherapy for cancer
Pain management
Skin
Breast surgery (medically necessary)
Diabetes management (excluding insulin pumps)
Heart and vascular system
Lung and chest
Blood
Back, neck and spine
Plastic and reconstructive surgery (medically necessary)
Dental surgery
Podiatric surgery (provided by a registered podiatric surgeon)
Implantation of hearing devices
Cataracts
Joint replacements
Dialysis for chronic kidney failure
Pregnancy and birth
Assisted reproductive services
Weight loss surgery
Insulin pumps
Pain management with a device
Sleep studies
Do seniors need health insurance?
Private health insurance can provide access to more services like private hospital rooms, elective surgeries, and treatments not covered under Medicare. It also offers more options for doctors and hospitals and can shorten your wait times for non-urgent procedures.
In general, it is recommended that seniors evaluate their needs, budget and existing coverage through Medicare before deciding to purchase private health insurance and compare various plans and policies offered by different insurance providers before making a final decision.
It can cancel out the MLS if you still earn an income.
Emergency ambulances are covered with basic policies.
When you hit 65, you're entitled to a higher rebate.
Cons
It may be too expensive for you – policies start from around $77 per month.
You may be happy to wait longer on the public health system.
If you've never had health insurance, you will have to pay the LHC loading – a 70% additional charge on top of your premiums.
Do seniors get a discount on private health insurance?
Yes! If you're over the age of 65 and are a medicare holder, your private health insurance rebate increases, provided you're not classified as a high-income earner ($151,001 or more for singles and $302,001 and over for families, single parents and couples).
You can claim the rebate either as a premium reduction through your health fund or as a tax offset when you lodge your tax return with the Australian Taxation Office (ATO). Keep in mind, if you've never held private health insurance before, the Lifetime Health Cover (LHC) loading may still apply if you buy a health insurance policy.
Singles
≤$97,000
$97,001–$113,000
$113,001–$151,000
≥$151,001
Families
≤$194,000
$194,001–$226,000
$226,001–$302,000
≥$302,001
Base tier
Tier 1
Tier 2
Tier 3
Up to 65
24.608%
16.405%
8.202%
0%
Age 65–69
28.710%
20.507%
12.303%
0%
Age 70+
32.812%
24.608%
16.405%
0%
Thresholds above are based on new tiers brought in by the government from 1 July 2024. Source: Private Healthcare Australia.
Public vs private waiting times for procedures
Why you can trust Finder's health insurance experts
You pay nothing. Finder is free to use. And you pay the same as going direct. No markups, no hidden fees.
You save time. We spend 100s of hours researching health insurance so you can sort the gold from the junk faster.
You can trust us. We say it like it is. We aren't owned by an insurer and our opinions are our own.
Frequently Asked Questions
Yes. You will usually have to serve a 2-month waiting period for most treatments or 12 months for pre-existing conditions. The good news is you won't have to re-serve any waiting periods for items if you held a previous policy that also covered that treatment. However, if the policy you're switching to has higher benefit limits or cover for treatments not covered by your original policy, you will have to serve those waiting periods.
Once you turn 65, the Australian government officially considers you a senior and you may be eligible for a Commonwealth Seniors Health Card (CSHC). This is a concession card for older Australians that allows you to access cheaper pharmaceuticals and government-funded medical services. The eligibility requirements and benefits you can claim with this card are outlined below:
Eligibility criteria
Benefits
To qualify for the CSHC, you must meet the following criteria:
Be of pension age (65) or older.
Be an Australian resident currently living in Australia.
Don't qualify for a Department of Veterans' Affairs pension.
Don't qualify for any other Department of Human Services payments.
Meet an income test.
CSHC holders can access the following:
Bulk-billed visits to your GP (depending on your doctor).
Other benefits that vary depending on where you live. These may include discounted utilities bills and property rates, cheaper health care costs (including ambulance, dental and eye care) and discounted public transport.
Health insurance is community rated, which means whether you're 18 or 88, you're going to pay the same amount for the same level of cover. On average, a single hospital + extras policy can cost from $67.15 per month to $277.41 per month for a female living in NSW.
All health insurers are required to cover pre-existing conditions. However, you'll generally need to serve a 12-month waiting period starting when you take out a policy before you can submit a claim.
As with any health insurance policy, there are a number of common exclusions. Typically, this includes treatments such as laser eye surgery and specialist appointments outside of the hospital. Another common exclusion is non-medically necessary surgery. Examples include surgical face-lifts or tattoo removal.
In most cases, yes. There are some exceptions where seniors won't have to pay the LHC – for example, if you were born on or before 1 July 1934.
If you've never had health insurance before, you will likely have a LHC of 70% applied to your premium, unless you were born before 1 July 1934. This is the maximum LHC loading that can be applied. You'll also need to hold cover for 10 continuous years before the fee is removed. For example, if the normal annual premium for your seniors health insurance policy was $1,800, you'd need to pay an extra $1,260 per year, not counting any rebates you might be eligible for.
A seasoned journalist with over 10 years of experience in news, politics and finance reporting, Tim has previously held roles at the ABC, SBS and Fairfax Media. Tim’s expert insights have been quoted in The Australian, The Daily Telegraph, The Courier Mail and more. He regularly appears on TV and radio, and has been interviewed on 7 News, Sunrise, SBS News, ABC Local, 3AW and 5AA. Tim is passionate about simplifying complex insurance topics for Australian consumers. He holds a Bachelor of Arts (Politics) from Macquarie University and a Tier 1 General Insurance (General Advice) certification, which meets the requirements of ASIC Regulatory Guide 146 (RG146).
If you’re interested in a media interview with Tim, please reach out to our PR team at aupr@finder.com. See full bio
Tim's expertise
Tim has written 149 Finder guides across topics including:
am aged 86 and am insured with Australian Unity for hospital cover
Is this a good choice or should I be looking at another health fund.
I keep in good health
Finder
ZubairMarch 28, 2017Finder
Hi Rosemary,
Thank you for your question.
finder.com.au is a comparison and information service and we are not permitted to provide our users with personalized financial advice or product recommendations.
It would be a good idea to first check the current benefits that you have with your existing insurer. From there, you can then check the list of insurance brands featured on our website and make a quick comparison. From there, you should get a better idea of whether you should make the switch or not.
Cheers,
Zubair
barryFebruary 10, 2017
BOTH MY WIFE AND SELF ARE 82 YEARS AND HAVE ALWAYS SINCE WORKING DAY STARTED HAVE BEEN INSURED,CURRENT WITH MEDIBANK PRIVATE AND HAVE TOP HOSPITAL COVER.
WHY DO WE BOTH HAVE TO PAY $500 EXCESS TO GO INTO HOSPITAL AS WE BOTH DID 2016 FOR SLEEP TESTING ,WE HAVE NO OTHER INCOME EXCEPT GOVT: PENSION .NOW INSURANCE GOING UP AGAIN AND AT THIS MOMENT LOOKS LIKE WE HAVE TO STOP INSURANCE AND LET GOVT:TAKE THE BILL FOR HOSPITAL CARE ,I FIND IT HARD TO PAY MEDIBANK AS IT IS ,WE HAVE TO GO WITH OUT WHICH IS BLOODY AWFUL ALL THESE YEARS PAYING BENEFITS AND WE GET EXCESS WHY
BARRY.
Finder
RichardFebruary 10, 2017Finder
Hi Barry,
Thanks for your inquiry.
Sorry to hear you are having issues with the price rise. Increasing health costs due to the aging population, improved medical testing, and other factors have forced health funds to increase their premiums.
If you would like to compare your options in hopes of finding a more affordable option, you can do so by entering your details into the comparison tool for seniors health insurance.
Please make sure to read the eligibility criteria, features, and details of the policy, as well as the relevant Product Disclosure Statement of the policy before making a decision and consider whether the product is right for you. If necessary, speak to the insurance brand to verify any details.
All the best,
Richard
DeniseJanuary 15, 2017
I am not a member of a health fund but would like to get cover for my 74 year old husband and myself at 69 years old is it possible to get it.
Finder
RichardJanuary 16, 2017Finder
Hi Denise,
Thanks for getting in touch.
While you will be able to get cover, as you’ve not held a policy before you may be subject to the lifetime health cover loading.
To speak with an adviser about your cover options, please select the enquire now button in the table on this page. Once you’ve completed the contact form, an adviser will be in touch.
All the best,
Richard
WendyNovember 12, 2016
I would like to enquire about seniors hospital cover with no extras
Finder
RichardNovember 14, 2016Finder
Hi Wendy,
Thanks for getting in touch.
You can enquire either directly or with help from an adviser, by entering your details into the comparison tool for seniors health insurance.
Please make sure to read the eligibility criteria, features, and details of the policy, as well as the relevant Product Disclosure Statement of the policy before making a decision and consider whether the product is right for you. If necessary, speak to the insurance brand to verify any details.
All the best,
Richard
JeanSeptember 11, 2016
I have no health insurance I just want to have a first idea of how much it would cost approximately.
I am 66 years old and am still working full time
Finder
RichardSeptember 12, 2016Finder
Hi Jean,
Thanks for your question. Finder is a comparison service and we are unable to provide our users with personalized financial advice. Since you’ve not had health insurance before, you may have to pay the Lifetime Health Cover loading. If you would like to speak with an adviser about your options and to get a quote, please complete the contact form found on top of this article.
If you’re over 80 and want good value for money in your health insurance, here’s what’s good, what to avoid and how to maintain good health along the way.
Important information about this website
Finder makes money from featured partners, but editorial opinions are our own.
Finder is one of Australia's leading comparison websites. We are committed to our readers and stand by our editorial principles.
We try to take an open and transparent approach and provide a broad-based comparison service. However, you should be aware that while we are an independently owned service, our comparison service does not include all providers or all products available in the market.
Some product issuers may provide products or offer services through multiple brands, associated companies or different labeling arrangements. This can make it difficult for consumers to compare alternatives or identify the companies behind the products. However, we aim to provide information to enable consumers to understand these issues.
We make money by featuring products on our site. Compensation received from the providers featured on our site can influence which products we write about as well as where and how products appear on our page, but the order or placement of these products does not influence our assessment or opinions of them, nor is it an endorsement or recommendation for them.
Products marked as 'Top Pick', 'Promoted' or 'Advertisement' are prominently displayed either as a result of a commercial advertising arrangement or to highlight a particular product, provider or feature. Finder may receive remuneration from the Provider if you click on the related link, purchase or enquire about the product. Finder's decision to show a 'promoted' product is neither a recommendation that the product is appropriate for you nor an indication that the product is the best in its category. We encourage you to use the tools and information we provide to compare your options.
Where our site links to particular products or displays 'Go to site' buttons, we may receive a commission, referral fee or payment when you click on those buttons or apply for a product.
When products are grouped in a table or list, the order in which they are initially sorted may be influenced by a range of factors including price, fees and discounts; commercial partnerships; product features; and brand popularity. We provide tools so you can sort and filter these lists to highlight features that matter to you.
Please read our website terms of use and privacy policy for more information about our services and our approach to privacy.
We update our data regularly, but information can change between updates. Confirm details with the provider you're interested in before making a decision.
How likely would you be to recommend Finder to a friend or colleague?
0
1
2
3
4
5
6
7
8
9
10
Very UnlikelyExtremely Likely
Required
Thank you for your feedback.
Our goal is to create the best possible product, and your thoughts, ideas and suggestions play a major role in helping us identify opportunities to improve.
You pay nothing. Finder is free to use. And you pay the same as going direct. No markups, no hidden fees.
You save time. We spend 100s of hours researching health insurance so you can sort the gold from the junk faster.
You can trust us. We say it like it is. We aren't owned by an insurer and our opinions are our own.
am aged 86 and am insured with Australian Unity for hospital cover
Is this a good choice or should I be looking at another health fund.
I keep in good health
Hi Rosemary,
Thank you for your question.
finder.com.au is a comparison and information service and we are not permitted to provide our users with personalized financial advice or product recommendations.
It would be a good idea to first check the current benefits that you have with your existing insurer. From there, you can then check the list of insurance brands featured on our website and make a quick comparison. From there, you should get a better idea of whether you should make the switch or not.
Cheers,
Zubair
BOTH MY WIFE AND SELF ARE 82 YEARS AND HAVE ALWAYS SINCE WORKING DAY STARTED HAVE BEEN INSURED,CURRENT WITH MEDIBANK PRIVATE AND HAVE TOP HOSPITAL COVER.
WHY DO WE BOTH HAVE TO PAY $500 EXCESS TO GO INTO HOSPITAL AS WE BOTH DID 2016 FOR SLEEP TESTING ,WE HAVE NO OTHER INCOME EXCEPT GOVT: PENSION .NOW INSURANCE GOING UP AGAIN AND AT THIS MOMENT LOOKS LIKE WE HAVE TO STOP INSURANCE AND LET GOVT:TAKE THE BILL FOR HOSPITAL CARE ,I FIND IT HARD TO PAY MEDIBANK AS IT IS ,WE HAVE TO GO WITH OUT WHICH IS BLOODY AWFUL ALL THESE YEARS PAYING BENEFITS AND WE GET EXCESS WHY
BARRY.
Hi Barry,
Thanks for your inquiry.
Sorry to hear you are having issues with the price rise. Increasing health costs due to the aging population, improved medical testing, and other factors have forced health funds to increase their premiums.
If you would like to compare your options in hopes of finding a more affordable option, you can do so by entering your details into the comparison tool for seniors health insurance.
Please make sure to read the eligibility criteria, features, and details of the policy, as well as the relevant Product Disclosure Statement of the policy before making a decision and consider whether the product is right for you. If necessary, speak to the insurance brand to verify any details.
All the best,
Richard
I am not a member of a health fund but would like to get cover for my 74 year old husband and myself at 69 years old is it possible to get it.
Hi Denise,
Thanks for getting in touch.
While you will be able to get cover, as you’ve not held a policy before you may be subject to the lifetime health cover loading.
To speak with an adviser about your cover options, please select the enquire now button in the table on this page. Once you’ve completed the contact form, an adviser will be in touch.
All the best,
Richard
I would like to enquire about seniors hospital cover with no extras
Hi Wendy,
Thanks for getting in touch.
You can enquire either directly or with help from an adviser, by entering your details into the comparison tool for seniors health insurance.
Please make sure to read the eligibility criteria, features, and details of the policy, as well as the relevant Product Disclosure Statement of the policy before making a decision and consider whether the product is right for you. If necessary, speak to the insurance brand to verify any details.
All the best,
Richard
I have no health insurance I just want to have a first idea of how much it would cost approximately.
I am 66 years old and am still working full time
Hi Jean,
Thanks for your question. Finder is a comparison service and we are unable to provide our users with personalized financial advice. Since you’ve not had health insurance before, you may have to pay the Lifetime Health Cover loading. If you would like to speak with an adviser about your options and to get a quote, please complete the contact form found on top of this article.
All the best,
Richard