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Last Updated on 27 May 2018

Health Insurance for Single Parents


Being a single parent is no walk in the park. You’re faced with all sorts of new demands and responsibilities. You’re busy caring for your children and making sure food is on the table every day, and at the same time, you’re also responsible for ensuring their health (and yours) remains number one. That’s a lot to keep on top of.

At Health Insurance Comparison, we’ve summarised all you need to know about private health cover for single parents so that you can focus on caring for your loved ones.

Key Points
  • Health insurers have been able to offer single parents reduced premiums (compared to two parent family cover) since 2007. If you have stayed with the same fund and policy for ten years or more, check with your health care provider to ensure you are not still on a two parent family policy (prior to changes made in 2007). It’s important to find out as your insurer may restrict the lower single parent premiums to newer policies released after 2007.
  • If you are expecting/planning for a baby, keep in mind that pregnancy and birth-related services covered by private health funds have a standard 12 month waiting period in place. So it’s important to upgrade your policy ahead of time.
  • There is a Government rebate for family and single parent health insurance. Provided you are eligible to receive the rebate, you can claim it through a reduced premium or through your tax return with the ATO.

Finding the Right Health Fund as a Single Parent

Are you thinking of taking out private health cover, or switching from your current premium? There are so many options out there that sometimes, it can become difficult to understand which one is best for you.

As a single parent, you have the following coverage options for your family:

  • Dependent-child only policy
  • Single parent family policy
  • Single parent extension policy
  • Traditional family policy

But… What exactly is a dependent? Health funds separate dependents into three categories:

  1. Child dependent: If your child is under the age of 21, unmarried and reliant on the policyholder for financial support, they are considered a child dependent.
  2. Student dependent: If your child is aged between 21 and 25 years old, unmarried and studying full-time, they are considered a student dependent.
  3. Adult dependent: If your child is unmarried, aged between 21 and 25 years old, and not studying full-time, they are considered an adult dependent. In this case, some funds may charge an additional fee under the single parent health policy to cover the adult dependent.

A dependent-child only policy will cover your children for unexpected medical expenses but not yourself. On the other hand, a single parent family policy will cover both you and your children, where your children are considered child dependents or student dependents.

A single parent extension will similarly cover both you and your children, but this extends to young adult dependents as well. Lastly, you can still purchase a traditional family policy, and in some cases, the pricing between policy types will be similar. However, it makes sense to shop around because you could potentially save cash through a single parent premium.

Here’s why. Since April 2007, health insurers have been able to offer single parents a reduced premium in comparison to the traditional family rate. Prior to 2007, single parent families paid the same amount as a two-parent family for their premium. While single parent families don’t pay as much as they used to, they still pay more than singles.

It’s also important to note that not all health funds offer significant savings for single parent families compared with traditional family cover. If you’re looking to cover your whole family, it’s beneficial to shop around for a policy specifically designed for single parent families so that you can enjoy the extra savings.

What Benefits Do Insurers Provide for my Kids?

  • No excess or co-payments for children should they need to go to the hospital
  • Gap free extras for children e.g. dental visits
  • Students can stay insured on the family and single parent policy for free up to age 25

If you have stayed with the same fund and policy for ten years or more, check with your insurer to see whether you are still on a traditional family policy (prior to changes made in 2007). It’s important to find out as your insurer may offer lower premiums for a single parent policy made available after April 2007.

Lastly, it’s important to check what’s included in a policy before ruling it in or out as an option. Some funds may not offer a significant discount for single parent families, but may offer better value-for-money policies.

I’ve Finished Having Kids, Should I Switch Cover?

Are you thinking about downgrading to a policy without pregnancy or fertility cover? It seems to make perfect sense if you’ve finished having children, but is it really the way to go?

The problem with downgrading applies to cases where discontinuing one aspect of your premium may force you to discontinue others, too. In other words, sometimes it’s ‘all or nothing’ when it comes to downgrading your cover. If you don’t check your policy regularly, you may face a rude shock when you need cover for something that your policy does not provide.

Even if you do downgrade, the savings may be insignificant. If you’re considering downgrading your cover, it’s important to be wary of these drawbacks before making any final decisions.

Planning to Expand Your Family?

If you see yourself continuing to expand your family in the future, you’ll need to prepare in advance when it comes to private health insurance.

Pregnancy and birth-related services covered by private health funds have a standard 12 month waiting period in place. So it’s important to upgrade your policy ahead of time. Some might suggest you upgrade and at least 3 months before you attempt to conceive but you also need to allow for the early arrival of the new family member. Remember, the waiting period is 12 months from the date of the upgrade to the birth of the baby.

But what exactly should you look for when thinking about making the switch? This depends on your individual situation and needs, but here a few things to consider:

  • Whether your policy covers pregnancy. If it does, you’ll likely be covered for accommodation at your chosen private hospital, and for labor ward expenses.
  • Doctors and obstetrician fees may be covered in full or partial payment. The level of cover varies between insurers and policies, so for peace of mind, make sure you’re aware of what will be covered.
  • Do you require any assisted reproductive services such as IVF? It might be worth looking for a policy that covers in-hospital procedures related to egg collection and embryo transfer.
  • Expect some out-of-pocket expenses for any pregnancy-related services you receive outside of hospital. While some of these services may be covered by Medicare, note that your private health insurance only covers in-hospital services.

What Types of Coverage Are Available?

Every family is different, and there is no right or wrong policy. Finding one that suits you and your family best can take time, so it’s a smart idea to shop around and consider all your options. There are three levels of coverage you may want to consider depending on your needs.

 

Hospital Cover

Should you require treatment or surgery within a private hospital, taking out hospital cover is beneficial for a few reasons.

  1. You will skip the public hospital waiting list and have your treatment or procedure carried out sooner
  2. Your cover will contribute to in-hospital medical/surgical care and treatment.
  3. You will have increased flexibility to choose your own doctor
  4. You will receive better post-operative care. E.g. you may have access to a private room post-surgery
Ambulance Cover

This covers you for ambulance expenses should you or your family require assistance. It’s important to remember that not all hospital covers include emergency ambulance cover so you may need to purchase this level of coverage separately.

General (Extras) Cover

You may decide to take out general or ‘extras’ cover on top of your hospital cover. It may end up saving you extra cash long-term, and that’s just the beginning. The many benefits that come with general cover may be well worth it for you and your family. Each policy will vary in the extras they include, but it’s common for general cover to offer treatment and services such as dental, optical, remedial massage, acupuncture, chiropractic and psychology services to name a few.

If you have younger children, you’ll be well aware of how quickly they grow up. General cover may be ideal, particularly if your growing child requires extras such as orthodontic treatment, vision correction or speech therapy, for instance. As mentioned, policies will vary and you will need to make sure the services relevant to your child are offered.

How Your Child May Benefit from General Health Cover

 

Dental and orthodontic care: The Medicare Child Dental Benefits Schedule covers $1000 in dental expenses over two years for children aged between two and seventeen. If your child needs braces or some other form of orthodontic treatment, you’ll want to look into extras cover, as these treatments can be costly. The right policy can save you big bucks on dental alone.

Vision correction: Medicare will cover you for eye tests but not for glasses and contacts. You’ll want to make sure you’re covered for corrective lenses or glasses should your children require this now or in the future. If vision issues run in the family, this could prepare you for big savings down the track.

Speech therapy: It’s not uncommon for younger children to need assistance with their speech. Speech therapists help children with impediments such as stuttering, reading, writing and voice. They also commonly work with children who have more complex needs e.g. children with autism, hearing impairments or intellectual disability.

At what point should you invest in coverage for your kids?

If you’re a single parent planning on having another child, it’s important to get yourself covered for obstetrics well in advance. Insurers are permitted by law to impose a 12-month waiting period for obstetrics coverage.

Costs associated with the birth of a baby are covered under the mother’s obstetric health cover and Medicare. There is, however,  an expense involved if your child is admitted to a hospital in their own right – e.g. if there are complications. Generally, you will need to upgrade your policy several months prior to the birth of your baby to avoid these potential out-of-pocket expenses, should your newborn be admitted.

I’m in the Process of Getting Divorced. Is There Anything I Should Know About?

The process of separating from a partner can understandably come with a whole range of emotions. But when it comes to switching policies, you don’t have to worry about any added stress.

If you’re switching from family cover to a single parent policy, you can choose to do so online or over the phone and better yet, you won’t incur any additional fees, provided your level of coverage does not change.

However, keep in mind that if you have paid an annual fee for your current health insurance premium as a lump sum, you may not be able to get this money back. Check with your current private health insurer as rules around this vary.

If you want to avoid a waiting period that may apply for pre-existing conditions, make sure you switch policies as soon as possible. Provided you do not allow your policy to lapse during the divorce process, you will not have to re-serve waiting periods when you switch to a new policy of comparable cover.

Is There Any Assistance Available When Purchasing Health Insurance?

There is a Government rebate for family and single parent health insurance. Provided you are eligible to receive the rebate, you can claim it through a reduced premium or through your tax return with the ATO.

If you decide to claim the rebate through your insurer, that is, through a reduced premium, you will be asked to nominate the income tier you expect to fall into. This is to avoid a tax liability. You can contact your insurer directly or fill out the Medicare rebate claim form.

When claiming your rebate, it’s important to note:

  • Only one parent can claim the rebate.
  • The rebate depends on your level of income (see our Health Insurance Rebate Calculator below)
  • Single parents are subject to family thresholds, however, the thresholds increase by $1,500 for each dependent child after your first child

To calculate the rebate amount you may receive, use our Health Insurance Rebate Calculator below.

Depending on your age, family status, and income level, you may be entitled to a Government Rebate on your private health insurance policy. Use the sliders and dropdown menu below to calculate your rebate.






Your Rebate is 0
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
Rebate
Base Tier Tier 1 Tier 2 Tier 3
Age < 65 25.415% 16.943% 8.471% 0%
Age 65-69 29.651% 21.180% 12.707% 0%
Age 70+ 33.887% 25.415% 16.943% 0%

I’m Still Not Sure if Health Insurance is Right for Me

Health insurance is optional, but you may end up saving money long-term by taking out a policy. You’ll also enjoy peace of mind, more choices about your health care and, and extra perks should you take out general cover.

While hospital cover is optional as well, deciding against taking out a policy may come with consequences, even if you do not end up making a claim. Why? Because of the Medicare Levy Surcharge.

If your income exceeds a certain level, then you will pay a surcharge for not taking out hospital cover. Use our calculator below to find out what you can expect to pay based on your income, should you decide against taking out a policy.

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%

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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Emma Deriu

Emma Deriu is a psychology graduate from Sydney, Australia, with personal interests in health, lifestyle and wellbeing. Emma currently writes about all things health insurance, aiming to 'make insurance easy' for consumers who are looking to compare policies.