Arming yourself with the key questions to ask when comparing health insurance options for your family could make all the difference when it matters.
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Family health care costs can really add up throughout the year, especially when the unexpected happens, whether it’s one of the kids getting injured due to sports after school or a member of the household who needs glasses.
Family health insurance with supplements and hospital coverage could be an option to consider as a financial safety net for your partner and children, for serious and minor illnesses.
Below are some of the basics to help you make these important decisions when considering purchasing a policy that’s right for your family.
A health insurance expert also details key questions to ask your health insurer when choosing family health coverage.
What is family health insurance?
Family health insurance policies can cover you, your partner, and your children. The insurance covers medical appointments or treatment that is not covered by health insurance.
There are generally three different types of family health insurance policies, each of which operates through different tiers – gold, silver, bronze, and basic coverage:
1. Family hospital coverage
This covers treatment as a private patient in a public or private hospital for:
â¢ Hospital treatment with your choice of doctor
â¢ Room accommodation
â¢ Theater fees for the surgery
2. Extras only cover
This helps to cover all or part of the costs of non-hospital health services such as visits to the dentist or optometrist.
The amount of coverage will vary from insurer to insurer, but more comprehensive policies will provide more services and higher benefits.
Extras may include:
â¢ Dental / orthodontic treatment
â¢ Speech therapy
â¢ Pharmaceutical prescriptions
3. Combined cover for hospitalization and extras
This policy allows you to combine different hospital and extras policies based on your family’s needs.
It is important for consumers to note when comparing health insurance policies that you do not need to have your hospital coverage with the same health insurance fund that you have for your health insurance. extras if you can find a better deal by purchasing the coverage options separately.
What are the advantages of family health insurance?
Private health insurance allows patients to be treated in a private or public hospital, as a private patient. Often you can choose which doctor is treating you and are more likely to find a time of treatment that is right for you.
Private Healthcare Australia CEO Dr Rachel David said private health insurance also covers services not covered by Medicare.
These can include services such as physiotherapy, dental, optics and a number of other extras.
âMany people depend on private health insurance to access services they would not otherwise be able to afford,â said Dr David.
There are two types of private health insurance cover: hospitalization cover and general care cover (ancillary or additional cover).
Hospital insurance covers all or part of the costs of hospital treatment as a private patient, including the costs of a doctor and hospital accommodation.
General care coverage helps cover the cost of non-medical services such as physiotherapy, dental and optical care.
Who can be covered by family health insurance?
To be eligible for family health coverage, you must be a single or two-parent family with children typically under the age of 21 (or 25 if they are dependent students and study full-time, although some funds have started to extend this age to 31 due to the new regulations). This includes caregivers with children under the age of 21 (or 25 if a student).
Children are covered up to a specified age, but some insurers will extend it to full-time students.
From April 1, 2021, the federal government raised the maximum age of dependents for private health insurance policies from 24 to 31 and removed the age limit for dependents with disabilities.
The updated policy will help ensure continuity of care for young Australians and encourage them to continue to purchase health insurance when they reach the age of 31 (the age at which the loading of health coverage begins at life).
A disabled dependent is defined by law as a person aged 18 or over and participating in the National Disability Insurance Scheme (NDIS). Insurers have some discretion to provide coverage to people who do not participate in NDIS.
What are the key questions to ask yourself when choosing family coverage?
Nib’s Managing Director for Australian Resident Health Insurance Ed Close said it was important to choose a policy that best meets the health and lifestyle needs of your family members, and to ask for at your fund if these health needs will be covered.
âThe most popular product among families is our combined hospital and extras coverage,â he said.
âThis gives families the reassurance that they are covered for unforeseen events that may require hospital treatment as well as daily check-ups and health needs, such as dental and optical care.
“Before choosing a policy, you need to consider your personal circumstances, such as your medical history and family lifestyle, and from there we can help you tailor the policy to those needs.”
For a family with young children, he recommends purchasing hospital and ambulance coverage for unforeseen accidents such as a broken arm, which may be more common in young active children.
“If your children are a little older and like to play sports, you can add extras to your policy, so that they can attend these regular physiotherapy appointments to help maintain or avoid injuries,” he said. he declared.
Planning for the future is another thing to keep in mind. If you are considering starting a family, it may be worth considering switching to a hospital policy that includes pregnancy coverage.
âIt’s important to note that you may have to meet a waiting period for certain services, like pregnancy and childbirth, so it’s best that you find out before choosing your policy,â Mr. Close said. .
What is the price of a family mutual insurance company?
According to the private health insurance ombudsman’s policy comparison, gold policies for hospitals and extras could cost families up to around $ 800 per month before any discounts or charges are taken. into account.
Can you get a discount if you buy family health insurance?
Most Australians with private health insurance receive reimbursement from the government to help cover the cost of their insurance premiums.
According to the Australian Taxation Office (ATO), reimbursement for private health insurance is income-based, which means your eligibility depends on your combined income and that of your spouse – the higher your income, the lower your income. right to reimbursement can be.
ATO has details of its website income thresholds that may apply to you and your family.
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