When to review & update your health insurance cover

Like any insurance, it’s important to make sure your health insurance keeps up with you and your life stage. That’s why we encourage nib members to review and find a cover that’s right for you – and we’re here to help whenever you need us via online chat, phone or email.

We want to ensure you’re getting the best value for money, so we recommend you relook at your policy each year. However, there are a few signs that you and your family might be outgrowing your current health cover. To help get you started, we’ve put together seven signs it’s time to review your cover.

Related: A guide to saving money on your health insurance cover

You started with a plant, upgraded to a goldfish and finished with a kitten, so you’re basically qualified to look after a small human… right?

If you’re thinking about expanding the family, it’s important to decide whether you’d like to be covered for pregnancy and birth-related services. If you would, a 12-month waiting period will apply if you’re new to nib or have just changed to that cover. That means you’ll need to be on a health cover that includes pregnancy at least three months before you start trying to fall pregnant¹. For more information, visit our dedicated page, Managing your family's health cover.

There’s a lot to consider when it comes to having a baby – you can choose to give birth in a private hospital or in a public hospital as either a private or a public patient.

Regardless of what you decide, nib is here to help you every step of the way. That’s why we launched our nib Nurture program, an online training program that provides advice, information and support for those looking to start a family.

Is one of your little bundles of joy about to officially become a big bundle of joy? When your child turns 21, they are no longer recognised as a ‘child dependent’ (unless they’re a full-time student who is under 31 and not married or in a de facto relationship). This means it’s the perfect opportunity for you to review your current policy and make sure you’re not paying for services that aren’t relevant anymore. For example, maybe now that your kids are a bit older and no longer require braces, you might not need a high limit for orthodontia.

Congratulations! You’ve officially been alive for more than 11,000 days, and you’re about to reach your cognitive peak. However, turning 31 is also an important milestone when it comes to private health insurance. If you don’t have an appropriate level of cover by 1 July after you turn 31, you’ll be required to pay the Federal Government’s Lifetime Health Cover (LHC) loading if you ever take out health insurance. For more information, check out our article: Why do I need to get health insurance if I’m 31?

If you hold an Extras policy and you can’t remember the last time you used it, it’s definitely time to look at what your policy includes. We recommend booking in to see your dentist every six months for a check-up and an eye check with your optometrist every two years.

The last thing we want is for you to fear the cost of visiting a dentist or optometrist. That’s why we have our nib First Choice Network. It’s our community of specially-selected health providers who have agreed to provide nib members with quality healthcare at an affordable price.

At nib, we have a range of Extras cover options that provide benefits for things like chiro, physio and nutrition, so you can find the perfect cover for you and your needs.

Related: Taking the confusion out of Extras cover

Never has looking after our health been more important. We want to make sure private health insurance remains affordable for our members while ensuring we can continue to pay claims on behalf of our members when they require treatment or hospitalisation. To help cover the rising costs of healthcare, private health insurers work with the Federal Government every year to come up with a fair price for your premium which members are notified about via their preferred method of contact (you can update your details by logging into your member account or the nib App). We also want to make sure you’re getting the best value for money when it comes to your cover, which is why we offer a range of benefits and inclusions that make being an nib member worthwhile. From deals and discounts with some of the country’s biggest retailers, free health and wellbeing tools and unlimited emergency ambulance cover regardless of what Hospital cover you have², if you’re an nib member, you receive access to some fantastic perks. For more, visit our article, Things you get with nib regardless of product tier.

We've also got a few suggestions on ways you can save money on your policy, from increasing your excess to setting up direct debit payments. For more tips and tricks, check out our article, A guide to saving money on your health insurance cover or give one of our consultants a call on 13 16 42 to chat through your options.

We offer a range of combined Hospital and Extras covers so you can find one to suit your individual needs.

Recently received a pay rise? If you don’t have Hospital cover and you earn $97,000 or more as a single, or $194,000 or more as a couple or family, you may have to pay the Federal Government’s Medicare Levy Surcharges (MLS), which is an extra 1% to 1.5% in tax on top of the normal 2% Medicare Levy we all have to pay.³

So, if you’ve only taken out Extras Cover and your income is above the tier, it might be a good time to look at taking out a Hospital policy too. At nib, we offer a range of combined Hospital and Extras covers so you can find one to suit your individual needs.

Did you just find out that you have a family history of heart disease or cancer? Are you concerned you might be at risk of developing diabetes? Do you think you might need a hip or knee replacement over the coming years? If your health needs have changed or you think they may change over the next few years, it’s important to make sure your health insurance provides the necessary coverage. It’s also a good idea to take note of waiting periods and become familiar with pre-existing conditions, so you don't end up disappointed with your cover selection later on.

A great way to start reviewing your current cover is to check out your current policy inclusions via member account, and then you can get comparing. To keep things simple, you can now update your cover using the nib App or via member account.

Check out our complete guide to reviewing your cover for more information.

If you’d prefer to get guidance from one of our health insurance consultants, we’re here to help you always – but especially when you need us most. Give us a call on 13 16 42.

The information shared in this article is general and not meant to guide specific financial choices. Always consult with a professional who understands your personal situation before making any financial decisions.

¹Terms and conditions and exclusions apply.

²1 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).

³If your income is over $97,000 for singles ($194,000 for couples/families) and you take out and maintain Hospital cover for the full financial year, you could avoid paying an extra 1% to 1.5% in tax via the Medicare Levy Surcharge (MLS). Visit the Australian Tax Office website for specific rules for calculating income for MLS purposes. This information is accurate as of 1 July 2024. See the ATO website for changes that may be made to income tiers from time to time.