If you’re over 50, it’s time to check whether your health cover is:
- Still offering the best value
- Supporting your changing needs
- Still affordable
- Not including old services you no longer use (thus ensuring your premiums remain affordable)
Key Points
- The Seniors Card and the Commonwealth Seniors Health Card (CSHC) are available to older Aussies, both offering benefits in the way of your health. However, eligibility criteria applies.
- Medicare provides some healthcare benefits to seniors but they are limited. For example, Medicare offers rebates on certain medications but not all, so it’s important to check whether you’ll need additional cover.
- As we age, our health needs change, too. This is only natural. Compare policies quickly and easily to ensure you’re getting the most from your cover and your money.
Medicare for Seniors
Medicare looks after the basic health needs of all eligible Australian citizens. This, of course, includes senior citizens with changing health needs. However, Medicare benefits are often limited.
Since the medical needs of seniors may be, on average, greater than the rest of the population, private health insurance is an option those aged 50+ may want to learn more about.
Seniors may require more operations, more prescription medications and more ancillary services. With Medicare, you will be restricted as to which hospitals you can use for an operation and which doctor you can see. You also may not receive cover for certain medications or health services that are important to you.
Commonwealth Seniors Health Card
If you don’t have a pension, you can apply for the Commonwealth Seniors Health Card. This card is designed for individuals over the age of 65 (pension qualifying age) who do not qualify for a pension and have certain maximum income levels. This card helps with prescription medications and some health services.
To be eligible for this card:
- You must be of Age Pension qualifying age (65+)
- You must not be eligible for Age Pension payments or a Veterans’ Pension payment
- You must meet an income test
- You must provide your Tax file number to the Australian Department of Human Services
- You must live in Australia (as either an Australian resident or a special visa holder)
- You must not work more than a set number of hours per week in paid employment
Benefits of this card include:
- A reduction in health care costs, including ambulance, dental and eye care
- Access to cheaper medicine under the Pharmaceutical Benefits Scheme
- Bulk-billed doctor’s appointments (though this is at the discretion of your doctor)
- A larger refund for medical costs when you reach the Medicare Safety Net
Over 55 health insurance Australia
There are a few considerations you need to make when shopping for over 50 health insurance. You may need to upgrade or downgrade your coverage based on your needs.
For instance, if you haven’t reevaluated your health insurance needs since your kids moved out of home, it might be a good idea to downgrade your cover to save money. If you’re still paying for things like pregnancy or birth-related services but you’ve stopped having kids, you can drop these services and compare cover for a more suitable policy. We often find customers paying for services on their policy they had forgotten about.
On the other hand, you may want to upgrade your cover to receive higher benefits for other services. You should evaluate your needs based on the services you currently use or are most likely to need. You may want to upgrade your hospital cover to include things like eye surgery, joint reconstruction, and cardiac services.
You might not need these services now, but getting older puts you at a higher risk of developing general health problems. Sorting out your health insurance now will prevent waiting periods from getting in the way of claiming for services you need.
On this note, it’s important to understand that you will only re-serve waiting periods on upgraded cover, and even then, only for the services you add or upgrade. If you downgrade cover, for instance, you won’t re-sit waiting periods. In other words, switching policies does not always affect waiting periods—it’s upgrading to a higher level of cover that does.
At the end of the day, your health insurance should give you peace of mind that you’re covered for everything you use and potentially will need. But you don’t want health insurance that’s overkill. Gold-level policies will include cover for pregnancy and birth-related services along with reproductive assistance. Keep this in mind when shopping for health cover, as you don’t want to pay for more services than you need.
Here are some quotes for health policies that may be what you’re looking for.
If you’re over 50, you may also want to shop around for extras cover. If you visit a dentist or wear glasses, for instance, consider including dental and optical on your policy as it may help you save money in the long run.
A health insurance adviser can help you figure out whether an extras policy will benefit you. They’ll also help you find a policy that includes everything you need (hopefully nothing more, nothing less) so that you can get the best value out of your policy. Remember: buying enhanced extras might cost you in the short-term, but they can save you money over time, provided you use the services you’re covered for.
You may also want to consider buying cover for extras like hearing aids. They are typically expensive and while you might not need hearing aids right now, as we mentioned, waiting periods need to be considered. Typically, cover for hearing aids comes with a 12 month waiting period so it’s wise to get covered sooner rather than later. Most insurers cover hearing aids under their top-level extras policies.
Private Health Insurance for Seniors
Comparing health insurance can help you understand the differences between each private health fund and what their policies can offer you. While every fund sets out to offer you better options for care, each fund has its own premiums, benefits, pros and cons.
If you require extra care or services due to older age, or you’re simply not willing to take risks when it comes to paying for your health, having cover in place may help to offset the extra charges you could encounter.
Private health insurance covers several services in greater need by the senior community that are not covered by Medicare, including:
- Home nursing
- Contact lenses and glasses
- Ambulance
- Physiotherapy
- Occupational therapy
- Podiatry
Private Health Insurance Rebate
One important development is government reimbursement for private health insurance. The government encourages people to take out private health insurance and therefore offers a Private Health Insurance Rebate to people who choose to do so. For any private health fund, the government will reimburse you for some of the cost of the policy.
For seniors, that percentage increases. This higher government reimbursement rate helps to make private health insurance more affordable for seniors, who may not be bringing in any income besides a pension. Those who do bring in more income can still take advantage of the reimbursement rate for their private health insurance.
Pre-Existing Conditions
If you have a pre-existing condition, you may have to wait up to 12 months before private cover kicks in. Compare private health insurance funds to evaluate their waiting periods. No health fund, however, can refuse anyone based on age or pre-existing conditions.
What is the best health insurance for elderly?
The best health insurance for elderly Aussies is a policy that keeps you covered for life’s unexpected turns. On the other hand, it’s one that keeps prices down and doesn’t make you pay for services you won’t use.
You will likely need a policy that includes joint replacements and cardiac services, but not one that includes pregnancy cover. The latter will be far more expensive and unnecessary for elderly Aussies.
For health insurance, we recommend looking at Silver and Silver Plus policies. Silver Plus policies typically include some of the most comprehensive coverage out there. From many insurers, this includes everything but pregnancy and birth-related services.
You will have to decide which extras policy is best for you, but you will likely want one that includes major dental, optical podiatry, hearing aids, and other services that are essential to your wellbeing.
It’s often better to err on the side of caution if you’re an elderly Australian so you can avoid waiting periods for services you need right away.
How much does health insurance cost for early retirees?
Health insurance costs go up as you need more services covered. The older you are, the more coverage you need.
Thankfully, you’ll be able to downgrade your coverage if you’re still under a policy that includes pregnancy and birth-related services. These are unnecessary, and you can likely find a similar policy without these services included.
Final Thoughts
While Medicare, the Seniors Card and CSHC offer significant discounts and benefits in the way of your health, seniors may need further cover. Thankfully, affordable premiums can be a reality for seniors. Our free comparison tool helps you find and secure a better-value policy for yourself or a loved one.
Comparing health insurance is quick and easy. Get started now and find a better deal.
People Also Ask Questions:
What is the best health insurance for elderly?
The best health insurance for elderly Aussies is a policy that keeps you covered for life’s unexpected turns. On the other hand, it’s one that keeps prices down and doesn’t make you pay for services you won’t use.
You will likely need a policy that includes joint replacements and cardiac services, but not one that includes pregnancy cover. The latter will be far more expensive and unnecessary for elderly Aussies.
For health insurance, we recommend looking at Silver and Silver Plus policies. Silver Plus policies typically include some of the most comprehensive coverage out there. From many insurers, this includes everything but pregnancy and birth-related services.
You will have to decide which extras policy is best for you, but you will likely want one that includes major dental, optical podiatry, hearing aids, and other services that are essential to your wellbeing.
It’s often better to err on the side of caution if you’re an elderly Australian so you can avoid waiting periods for services you need right away.
How much does health insurance cost for early retirees?
Health insurance costs go up as you need more services covered. The older you are, the more coverage you need.
Thankfully, you’ll be able to downgrade your coverage if you’re still under a policy that includes pregnancy and birth-related services. These are unnecessary, and you can likely find a similar policy without these services included.
Here’s a breakdown of some quotes from some of Australia’s top health funds.
