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Last Updated on 19 November 2018

Children Leaving Home? What Now With Your Health Insurance?


Child Moving Out of Home

Choosing the right type health cover is an important decision for anyone. When obtaining insurance, it is key to consider the various circumstances and aspects of your life. And as those circumstances change, it is just as important to reevaluate your health insurance choices to ensure that they still match your priorities and needs.

Having children and family size is, often , one of the biggest factors in considering health insurance. But what happens when those children grow up and move out?

If your children have recently left home, or are planning to leave soon, this guide can help you ensure that you and your adult children have the necessary health insurance needed.

Key Points
  • Private health insurance provides a range of coverage options with great flexibility and personalisation of care, which may be especially important for older Australians.
  • When confronting life changes, like children moving out, it is important to reevaluate your health care needs and coverage options.
  • Consider your children’s coverage and how tax liabilities can affect those without private health insurance when becoming an empty-nester.

Know the Benefits of Private Health Cover For You

Medicare coverage may not be adequate for all individuals. Fortunately, Australians also have the option to supplement their Medicare coverage through private health cover. In fact, about 50% of the adult population invests in private health insurance – and those numbers are expected to grow.

People invest in private health insurance because it can provide broader and more flexible healthcare options. This flexibility can be great for families with children who are in the home or are transitioning out of the home.

If your children are transitioning out of the home, it is especially important to consider their coverage eligibility. Children can be covered on a family policy until age 21. If they are students, they can remain on the family policy until age 25. However, if your children are no longer eligible for private health insurance through a family policy, they might need to establish their own plans.

When looking into private health cover for your changing family dynamics, consider all benefits available to you. We’ll discuss some of these benefits within this guide.

Expand Coverage for All Medical Situations

While Medicare provides some coverage for certain medical circumstances, it does not cover everything a patient may encounter. As we cannot foresee our future health, it’s best to cover as many bases as possible for peace of mind.

The following services are not covered by Medicare in full or at all:

  • Private hospital costs
  • Ambulance services
  • Dental examinations
  • Dental treatments
  • Physiotherapy services
  • Occupational therapy
  • Speech therapy
  • Chiropractic services
  • Podiatry
  • Psychology services
  • Home nursing

Private health cover provides customers peace of mind for unforeseen health and life events. This flexibility and vastness of coverage allows people to customize their health coverage to suit their personal and lifestyle needs.

Additionally, private health insurers cannot charge more based on health status, age, or claims history.

They also cannot deny coverage to anyone based on those factors.

Gain Flexibility and Ownership Over Your Care

It’s no secret that the wait and treatment times in public hospitals under Medicare can be long and inconvenient, sometimes leading to periods of prolonged pain and discomfort. Unfortunately, waiting times have increased over the past decade.

Wait times for some elective surgeries (non-emergency) can take up to a year in the public system.

Health Insurance Waiting Period Estimator

You will have to serve a waiting period when you start a new private health insurance policy or increase your level of cover. A waiting period protects members of the fund by ensuring that individuals aren't able to make a large claim shortly after joining and then cancelling their membership. This kind of behaviour would result in increased premiums for all members.

Use this calculator to choose a hypothetical date in the future (or leave it on the default setting, which is today's date) to determine when you will be covered for various types of coverage.


Months Standard Waiting Period
0
  • Accidents
  • Ambulance
2
  • Chiropractic/Osteopathic
  • Alternate/Natural Therapies
  • Dietetics
  • Eye Therapy
  • Hospital Treatment
  • Occupational Therapy
  • Pharmaceutical Perscriptions
  • Physiotherapy
  • Podiatry
  • Speech Therapy
  • General Dental
6
  • Optical
12
  • Orthotics
  • Major Dental
  • Pre-Existing Conditions
  • Pregnancy Related Services

With adequate private health insurance, patients have the option to be treated in a private hospital and therefore, patients often experience much shorter wait times. Often, patients even have the opportunity to schedule their own procedures at times that are convenient for them. Patients can also choose which doctors will perform their procedures and if they want to be treated in a private hospital or a public hospital as a private patient.

Why Should You Reevaluate Your Health Cover?

When your children leave home, this is a major shift for both you and for your kids. Reevaluating health insurance coverage needs is important because:

  • If your children are no longer covered on a family policy, they may need coverage of their own.
  • You (or your kids) may need help with the transition. Leaving home is difficult for parents and kids. Seeing a psychologist can help. Medicare rebates are available for up to 10 individual and group services under specific circumstances, but you may need more care or a different type of treatment than is provided.
  • Your medical needs will change. Adult children often need help with family planning issues. Seniors whose kids have left home frequently need more medical help, especially if children were serving in a care-giving role.
  • Your insurance costs will change. If your children no longer need to be covered by your insurance, a couples or singles policy is cheaper than family coverage.

For the sake of your finances and health, changing your insurance is important when your life changes.

Coverage for Empty Nesters

While private health insurance provides an array of benefits for the general public, its assets are particularly advantageous for empty-nesters and soon-to-be empty nesters. As previously stated, the transition involved in kids moving out can be hard – and harder than anticipated. Keeping your mental health in check is important, and you can have this covered in a potentially difficult stage of life.

What’s more? As your children move out, and we all continue to age, you may find your medical needs expanding. This is a normal part of life, and does not have to end up being a painful or negative experience for you.

But what exactly do we mean by ‘expanding medical needs’? Generally, seniors need more medicine, adaptive devices, and overall care. In addition, after children leave the house, you may need extra assistance in taking care of your general health and life matters.

We’ve created a quick coverage list below for you to check off. Most of these items will be covered by standard private health insurance:

  • Glasses/contact lenses
  • Hearing aids
  • Travel insurance if you’re thinking of spending your retirement seeing the world. Travel insurance is sold separately from standard health insurance. Frequent traveller policies are available that can cover multiple trips over 12 months, or you can buy individual policies for each trip you take.
  • Physio and chiro if you want to reduce pain and live a fuller life during retirement
  • Surgical coverage for ageing joints and potential need for surgery later
  • Home Nursing coverage in case you need assisted living

According to the ABS, people between the ages of 55 and 74 in Australia make the most use of extra healthcare coverage.

 

Choosing the Right Coverage

When looking for new coverage, it is important to consider:

Premiums

How will the policy change affect your premiums? Often, premiums will decrease after children leave the household and are removed from the policy. Use our policy cost calculator below to find out exactly how much you could be paying for your premium over the course of a day, fortnight, quarter or year.

Policy Cost Calculator

How it works
This policy cost calculator is designed to convert a typical monthly health insurance premium into daily, fortnightly, quarterly, and yearly increments.

If your children are no longer eligible to be members of a family policy, will they take out private insurance on their own? If so, can they afford the premiums? If not, will you be able to provide financial assistance?

Waiting Periods

Generally, there is a two-month waiting period on services after joining a health fund. However, some services, like hearing aids,cover for pre-existing conditions and dental procedures, can have longer waiting periods. How Long Is the Waiting Period?

Extras

Consider what is included in each policy. Will you need extras cover?

You may want to consider the following services:

  • Hearing aids
  • Health aids
  • Optometry
  • Chiropractic services
  • Natural therapies
  • Home Nursing
  • Physiotherapy
Annual limits

Annual limits dictate how many times you can claim an extra and the amount you can claim in dollars. These annual limits reset each year, but it is important to understand any restrictions before committing to a policy.

Percentage back

Percentage back is the amount of money you receive back on any extra medical treatments you claim. The percentage back generally ranges from 60% – 75% of the cost of the service.

Recognised providers

Many policies will only pay out to providers that are on their recognised lists.

Before committing to a policy, make sure that your health care professional of choice is included on the list of recognised providers.

Coverage for Seniors: Summary

Your coverage needs will depend on your health status and your life plans as an empty-nester.
Consider:

Coverage Eligibility for Children

Children can remain on their family’s health insurance until age 21 – or until age 25 if they qualify as a full time student. To qualify as a full time student, a child must be:

  • Single
  • Enrolled in a full time academic program

Even if your child does not meet the general criteria for remaining on a family policy, some insurance companies will allow parents to continue coverage for them at an extra cost. Also, your adult children have the option to find their own insurance policy tailored to their individual life, health, and financial circumstances.

While waiting periods may apply, your children can avoid unnecessary waiting periods if they avoid a break in coverage. To avoid the break in coverage, your children must choose a policy that:

  • Is the same or lower that the family policy
  • Can be backdated to their 25th birthday or until the time they were no longer covered by the family policy

Surveys have shown that most children in Australia become financially dependent at age 23. Whether your kids are above this age or below it, they may need help from mum and dad in understanding insurance coverage options. Talk to your children when they are moving out about getting coverage.

Still Not Sure About Private Health Insurance Coverage?

Without private health cover, you could be subject to:

  • Longer wait times for elective surgeries and other care
  • Less flexibility and personalisation in your care options
  • Extensive gap fees
  • Extra Medicare Surcharges if you earn $90,000 or more (or $180+ for families)
  • High fees for items not covered by Medicare

Medicare Levy Surcharge Calculator

The Medicare Levy surcharge is an additional fee paid on top of the 2% Medicare Levy Surcharge that most Australian taxpayers pay. You can avoid the surcharge if you have Private Health Insurance (Hospital Cover).

The exact surcharge level you'll need to pay depends on your income level and relationship/family status. Use the slider and dropdown menu below to determine what surcharge you're liable for if you don't have private hospital cover.




Your Medicare Levy Surcharge is 0.00% of your income, or $0.00
Singles ≤ $90,000 $90,001 - 105,000 $105,001 - 140,000 ≥ $140,001
Families ≤ $180,000 $180,001 - 210,000 $210,001 - 280,000 ≥ $280,001
Medicare Levy Surcharge
Standard Tier 1 Tier 2 Tier 3
All Ages 0.0% 1.0% 1.25% 1.5%
In addition, your children could face a Lifetime Health Cover loading if they do not invest in private health insurance before they turn 30.

Under this initiative, patients who choose not to take out private health insurance by their 30th birthday, but decide to so later in life, may be subject to a 2% loading on top of their premium. This loading will increase by 2% for every year your adult child fails to take out a policy (after 30).

This would result in a 20% loading on top of the regular premium for someone who waits until he or she is 40 to invest in private health insurance. The loading reaches a maximum of 70%.

Conclusion

As you address life’s many changes, also consider reevaluating your health insurance. If you currently own private health cover, think about how children leaving the home will affect the policy and make changes as necessary. You might even save some money!

If you do not have a private health insurance policy, consider how one could benefit you and your family as you age.

As wait times apply, pro-activity is key. Don’t hesitate – get the health insurance coverage you need now.

Frequently Asked Questions About Health Insurance

There are three types of health insurance in Australia. They are:

  • Hospital Cover
  • Extras Cover (also known as general or ancillary cover)
  • Ambulance Cover

Hospital cover can ensure any unexpected surgeries, treatments or hospital stays you may require will be covered. With appropriate cover you will have the flexibility to choose your own doctor and the option of receiving treatment in a private hospital.  Most hospital covers allow you to stay in a private room. One other perk is skipping the public hospital systems’ waiting list, which can be lengthy for non emergency treatment.

Extras cover pays benefits for a a range of services, often including treatments and procedures related to the fullowing:

  • Dental/oral health
  • Glasses and contact lenses
  • Podiatry
  • Physiotherapy
  • Psychulogy
  • Acupuncture
  • Remedial massage
  • Chiropractic
  • Hearing aids
  • Travel vaccinations

Ambulance cover, as the name suggests, will cover you should you require emergency ambulance transport. In an emergency, there is enough to worry about. Having the expenses covered for provides security and peace of mind. Many hospital covers include emergency ambulance transport If yours doesn’t, you will need to shop for this separately.

Life is unpredictable. You never know when you might need cover. No matter what life stage you’re in, there’s a policy out there for everyone. You can select as much or as little cover as you want, depending on your health needs and requirements. It’s a small price to pay for the peace of mind health cover provides.

There is no one answer here. Costs vary across providers and policy types. Just because a policy is cheap, that does not mean it is ‘value for money’ and vise versa. Make sure you check what’s included and excluded in a policy before signing up, as you want to purchase a policy that best fits your specific needs.

Premium: A premium is the price you pay for your insurance policy (it may be paid annually or on an ongoing basis).

Policy: An insurance plan. In other words, it is the type of insurance you choose to select.

Policy Holder: The owner, or ‘holder’ of a policy.

Claim: In the event that you require treatment for a service covered by your policy, you can lodge a claim for reimbursement of all or part of the cost of that treatment.. These days, most claims are submitted electronically by the health care provider (dentist, physio etc)

Lifetime Health Cover: Lifetime Health Cover was put in place to encourage young Australians to seek out and maintain ownership of private health insurance early in their lives. If you do not take out a policy before you turn 31, extra charges will be applied should you take out a policy at a later time.

This means you will pay a 2% loading on top of your premium for every year that passes after you turn 30. For example, if you take out a policy for the first time at age 32, you will be charged 4% of your premium as an extra, then at age 40, 20% and so on, up to a maximum loading of 70%.

The loading is payable for 10 consecutive years of cover - after which it is removed and you premiums will be reduced.

Pharmaceutical Benefits Scheme (PBS): Medicare offers assistance for Australians with many of their their prescribed medication costs through the PBS. This assistance is in the form of subsidies towards the cost of many medications. You can check if your prescribed medication is on the list of subsidised items here.

Medicare Levy Surcharge: The Medicare Levy Surcharge is an additional charge (tax) applied to single Australian taxpayers who earn over the income threshold of $90,000 per year, or families/couples who earn over $180,000 per year. This surcharge is only applied to those who choose not to have a private health insurance policy.

The surcharge is designed to reduce pressure on the public health system by encouraging those with higher incomes to invest in private health cover.

Private Health Insurance Rebate: The government’s Private Health Insurance rebate lowers premiums for most Australians with private health insurance Older Australians may enjoy an even higher rebate. Our calculator can help you estimate the Government health insurance rebate you may receive.

Disclaimer: The above information is correct and current at the time of publication


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