A family guide to private health insurance

Remember those days before kids when you and your partner would jet out of town for a romantic weekend by the beach? Or when a public holiday meant you could sleep in ‘til nine? Or how about the time when you could shower in peace?

Yep, things change when you have a family and it’s important to make sure your health insurance is keeping up with your (and your family’s) changing needs.

From high chairs through to high school, we’ve put together a guide on how to buy family health insurance; because despite the tears and tantrums, we all know we wouldn’t trade the crazy, fun ride of parenthood for anything.

The first thing to consider when purchasing family health insurance is your family’s individual health needs. Think about your family’s medical history, age and the type of lifestyle you live. For example, if you have a family history of chronic illnesses, you may want to look at a Hospital policy that covers you for things like heart disease and type-2 diabetes.

Another consideration is whether you’ll likely need to visit a dentist, optometrist or physio; if so, it might be a good idea to look into an Extras policy that will pay benefits for these services.

The purpose of family health insurance is to cover you, your partner and your children for health expenses that either aren’t covered by the Medicare system, or services that could mean a long wait in the public health system if needed. So, once you’ve decided on what your family’s health care needs are, it’s time to look into the different types of cover.

1. Hospital cover

Hospital cover is designed to cover your treatment in a private or public (if admitted as a private patient) hospital. This type of cover provides benefits for your hospital stay on services included on your policy, covering accommodation and patient meals, surgery fees, prostheses, nursing care, medical supplies and prescription medication.

Most people assume that if they need an ambulance, it will be covered by the Government or Medicare, but for many Aussies this isn’t true. So, as part of all nib Hospital covers, we include nib Emergency Ambulance Cover¹ which means everyone on your policy will be covered for emergency ambulance transportation in most circumstances.

There are four different levels of health insurance coverage:

Gold hospital cover

We generally recommend taking out a Gold policy if:

• You’re looking to start or expand your family and require cover for pregnancy, IVF and birth

• You may need cataract eye surgery

• You need a hip or knee replacement

• You are at risk of chronic health disease

• You may need private treatment for rehabilitation or psychiatry

• You want the most comprehensive policy available

Silver hospital cover

Silver policies are great if:

• You want cover for heart conditions or cancer surgery

• You want a comprehensive insurance policy, but you don’t wish to be covered for chronic health disease, pregnancy, psychiatric care, joint replacements or cataract eye surgery

• You want cover for dental surgery (like removal of wisdom teeth) in a hospital

Bronze hospital cover

Taking out a Bronze policy will work if:

• You’re healthy, but would like a back-up for broken bones

• You want cover for common procedures for kids such as removal of tonsils or grommets

• You are looking for health insurance to avoid tax and surcharges

Basic hospital cover

A basic policy is the lowest level of Hospital Cover and is:

• A good option if you want health insurance to avoid tax and surcharges

2. Extras cover

Extras cover provides benefits for things outside the hospital to help keep you and your family healthy. Depending on the type of Extras cover you choose, you’ll have access to services like dental, optical, occupational therapy, physio, chiro or osteo. So whether your kids need braces or your partner requires glasses, you can find an nib Extras cover to help.

We like to keep things simple at nib. That’s why we offer our Extras Covers with either 60% or 75% back. Depending on what cover you decide is best, you’ll receive 60% or 75% of the total cost of your treatment back – every time you visit².

3. Combined Hospital and Extras Cover

For most families, we recommend combined Hospital and Extras Cover. Life is good at throwing us surprises, especially when there are kids involved. So, whether your teenager needs a pair of glasses, your partner needs physio after a weekend sporting injury or someone in the family requires surgery, taking out a combined Hospital and Extras Cover can give you the peace of mind that you’ll have support both in and out of hospital³ .

If you’d like personalised advice, get in contact with one of nib’s health insurance experts to talk through which policy will be the best fit for you and your family.

The cost of your family health insurance policy will depend on the level of cover and excess amount you choose, as well as the number of people you wish to include on your policy.

However, you and your family may qualify for the Private Health Insurance Rebate – a rebate from the Federal Government that will give you a percentage off your health insurance premium. To find out whether you’re eligible, you can use the private health insurance rebate calculator.

If you take out an appropriate level of hospital cover, you may also avoid having to pay the Medicare Levy Surcharge – a surcharge of 1-1.5% of your taxable income.

When it comes to private health insurance for your family, it’s all about investing in the future health of your loved ones. At nib, we believe health insurance should be simple – get a quote online in just a few minutes.

¹1 day waiting period applies. Not available to: (i) QLD residents who have ambulance services provided by their State ambulance schemes; (ii) TAS residents who are covered under state ambulance schemes in TAS and when travelling in mainland Australia except SA and QLD; or (iii) pension and health care card holders who have ambulance services provided by State ambulance schemes (check entitlements with Centrelink if unsure)

²Subject to waiting periods and up to your annual limits.

³Individual policies and inclusions vary.