What’s different about couple-specific health insurance policies?

Couple-specific health insurance means you and your partner are covered under the same policy. It works in a similar way to singles policies.

  • Type of cover – You can obtain couple-specific health insurance for hospital, ambulance, and extras cover as with any family or individual policy.
  • One policy and premium – You and your partner share the same policy and pay one premium, making it easier to manage.
  • Combined limits – You could have a combined limit, which could offer flexibility. For example, if one partner uses a lot of extras benefits and the other doesn’t, a combined limit could be beneficial.
  • Same level of coverage – You are covered at the same level for everything, so you might prefer to have separate policies if one of you needs a much higher level of coverage.


Potential cost savings

Health insurance policies designed specifically for couples isn’t necessarily cheaper. However, it can come with other benefits, including cost savings, when you consider things like the Private Health Insurance Rebate. For example, if one partner earns significantly more than the other partner, going on a couple’s policy might allow you to, together, claim a bigger rebate than the savings for taking out two individual policies. This is because the partner earning far less “shares” his or her income threshold with the higher-earning partner.

How long do you have to have been a couple?

If you want to switch to a couple’s policy, you’re eligible as long as you’re married, in a registered relationship, or in a de facto relationship. This applies if you’re living together in a romantic relationship, and there’s no minimum time requirement as far as how long you’ve been in the relationship or married.

You don’t have to switch to a couple’s policy if you’re in a relationship or married. However, you’ll be subject to couple/family income thresholds for things like the Private Health Insurance Rebate and the Medicare Levy Surcharge (MLS).

Same-sex relationships

If you’re in a same-sex relationship, you’re eligible for couple’s cover according to the same eligibility criteria outlined above for opposite-sex couples.

Circumstances that could impact a couple’s cover

Being aware of the circumstances that could affect your couple’s cover helps you plan ahead, change cover, and manage your costs.

  • Lifetime Health Cover – You usually need to pay the Lifetime Health Cover (LHC) loading if you don’t have private hospital insurance until after you turn 31. If the loading applies to one or both partners, the loading percentage will be averaged for your couple’s policy. So for example, if one partner is subject to 8% loading and the other 2%, on your couple’s policy you’ll be paying 5% loading.
  • Private Health Insurance Rebate – How much rebate you receive will be based on family income thresholds rather than individual. Income thresholds in each tier increase by $1,500 for each child after your first.
  • Separation – If you’re no longer in a relationship with your partner, then obviously you’ll no longer be eligible for a couple’s policy and you should switch to individual policies.
  • Excess – As with individual policies, generally the higher excess you choose to pay, the lower your premiums will be.

When to switch to family cover if you’re having a baby

You’ll want to start thinking about switching to family cover – adding children to your cover and/or getting a higher level of coverage for pregnancy-related benefits – if you’re thinking about having a baby. It’s important to consider organising your cover in advance as this will allow you to access maternal-, pregnancy-, assisted-reproductive- and obstetrics-related coverage in time, since waiting periods can apply.

Check your health fund’s rules and waiting times and consider the services you’ll need access to before and after you have your baby. Make sure you’re aware of any time limits for adding your baby to your policy as some health funds have strict rules. For example, you might have a two-year period for adding your newborn to your policy without extra cost. If you add your baby after this time limit, you might need to pay extra in premiums. Other funds might require you to switch to a family policy (and therefore pay higher premium) regardless of when you add your child.

Switching from singles to couple’s insurance could make it more convenient to manage your policy payments, access higher limits if one partner uses more of one type of benefit, and possibly save through government incentives. You’re usually eligible if you’re living together in a romantic relationship, including a same-sex relationship. If you need to switch to family cover, start thinking about it well in advance so you can be covered for the things you need.