Last Updated on 13 February 2020

Health Insurance for Children: Making Sure Your Family is Covered

Finding out you’re about to become a parent is one of the most thrilling, yet unnerving experiences you could ever hope to have. A person’s life usually becomes a whirlwind of planning from the moment you get the (good) news from the doctor to the minute labour begins. Not only is there a nursery to prepare and an education fund to build, it would be remiss for any prospective parent to neglect planning for the new arrival’s health insurance.

Couples vs. Family Health Insurance

If you’ve never given much thought to family health insurance because you already have couples insurance, it’s definitely time for a rethink! A couples insurance policy provides cover for medical costs incurred for an individual and his or her partner, but it may not include cover for obstetrics and related services.

Making sure that the latest addition to the family is included in the health insurance policy is a good way to ensure peace of mind, especially when it comes to the myriad expenses a growing child can run up.

The Medicare Safety Net May Not Cover It All

The Medicare Safety Net would seem to be a failsafe option for couples or individuals with a child on the way. However, it operates on the basis of a family reaching a threshold amount of gap or out-of-pocket payments before you receive benefits for the rest of the calendar year.

The Medicare Safety Net and Medicare cover do not provide cover for admission to a private hospital either. Most of the time, births in a private hospital are more unlikely to require intensive care or emergency resuscitation, while births in a public hospital tend to record a higher number of such incidences.

Not only that, there is a lower incidence of low Apgar scores, neonatal death or injury to women who give birth in private hospitals. Most of the time, comprehensive cover for such maternity and neonatal requirements is available only from private health funds.

Upgrading An Existing Policy

Whether you have an existing policy or are thinking of signing up for one before starting a family, most funds advise upgrading or signing up for birth or child-related cover 12 months before the family’s newest addition arrives.

This is because most policies impose a waiting period for obstetric cover that usually spans 12 months. This means that a couple or the individual would have to pay the premiums for the related fund for 12 months before becoming eligible to claim for insurance benefits.

Getting Help With Expenses

Some people might question the need to include children in a health insurance policy. Aside from planning their education and making sure you have enough resources to keep them clothed and fed, most new parents don’t realise that a child’s health care requirements can rival that of an adult’s! In fact, a parent often has to spend the most on a child’s welfare during his or her growing years. An insurance policy is helpful when it comes to the cost of:

General dental – no one wants to countenance the prospect of a tooth extraction for an 8 year old child. This feature is included under extras cover and usually encompasses periodic checkups, preventative measures, x-rays and fillings.

Optical – Medicare may cover eye tests, but private cover takes care of measures to correct a child’s eyesight, i.e. spectacle frames, lenses/contact lenses.

Orthodontic – braces are a common feature for almost every child today. Orthodontic flaws is best corrected in youth because good results are easier to achieve.

Physiotherapy – a health insurance policy helps a family afford the necessary treatment if a child has the misfortune of being afflicted with developmental or neurological impairments.

Podiatry – abnormalities in the feet (e.g. flat feet, pigeon toeing) can be remedied quickly and effectively at younger ages

Considerations for Single Parents

Being a single parent isn’t an excuse not to make sure your child has health insurance. Where they previously had to pay the same premiums as policy-holders who bought couples insurance prior to 2007, single parents now pay only for what they and the child need, which is a reduction of up to 25% compared to the premiums a couple would pay.

This recognition of a single-parent family doesn’t mean that cover is compromised either – a single parent has the option of considering cover for pregnancy and related services as well as assisted reproductive services.

Health insurance should be a priority where children are concerned, whether you’re having your first child or adding another one to the brood. As with many of life’s other issues, making arrangements well in advance of the impending event, rather than later, is always better.


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