What’s different about a family-specific health insurance policy?

Your healthcare needs change at each life stage, which is why insurers offer family-specific health insurance. Whether you’re starting a family, a young family, a single parent family, or an established family, you could be be better protected as a household with the right policy.

  • Family-specific needs – Your policy covers the entire family as a whole. It’ll be designed for the needs of a family, and this means your healthcare needs might be better addressed.
  • One premium – You usually pay one premium for the whole family rather than individual premiums.
  • Limits – Annual limits for extras usually apply to individuals, not the whole family.
  • Coverage level – Each member of the family has the same coverage level rather than individualised coverage levels.


When should I go from a single to a family health insurance policy?

If you’re married or with a de facto partner, you’ll want to switch from single to a family health insurance policy. If you’re a single parent and you’re having children, it’s also a good time to switch to a family health insurance policy.

While a family health insurance policy may or may not be cheaper than two individual policies for a couple, what’s for certain is it offers convenience as you only have the one policy to manage. Considering family policies might require waiting times for birth, IVF, and pregnancy claims, switching family sooner rather than later could help you with family planning.

Also, it is important to note, families tend to pay the same premium as couples, so effectively kids are insured for free. This could be another reason to switch to family insurance as a couple as soon as you plan to have kids.

Sometimes whether you switch might not be up to you. This is because some insurers might require people related by birth or in a relationship to be covered under the same policy.

Whose name will the health insurance policy be in?

Family health insurance policies are typically held in the parents’ names (or the single parent’s name), but the children’s name will be listed on the policy as dependants. This means they will be covered at the same level.

What circumstances might affect my family’s health cover?

As with any other type of policy, you’ll want to keep checking your policy to make sure it meets your family’s needs. With each new addition to the family, as your children get older, and as your family reaches new life-stage milestones, your needs will change. You might decide to upgrade your insurance policy to access more coverage.

  • Before and during pregnancy – Your family health cover needs can change when you or your partner is trying to get pregnant. For example, you might want to be covered for things like assisted reproductive services, birthing classes, and other pregnancy-related services
  • New babies – As you expand your family, having a higher coverage level could help you pay for pregnancy, birth, postnatal, and other related services. It could give you more options, like choosing your preferred hospital and obstetrician and having your own private room.
  • Growing kids – As your kids grow, you might benefit from additional coverage for services like speech therapy, occupational therapy, dental and orthodontics (braces), and optical. And accidents or illness can happen to healthy, active kids. With an appropriate level of cover, you can ensure your kids get access to high-quality healthcare by your chosen healthcare professional without long waiting lists.
  • Established family – If you’re an established family with no more kids planned, you could change your level of cover to reflect this. For example, you won’t need pregnancy, obstetrics, and other related services.

The government’s private health insurance rebate won’t affect your cover, but it could change how much your premiums are subsidised as your income thresholds increase with each child you have.

How long are my children covered by my policy?

Typically family health insurance cover your kids up until the age of 25, as long as they’re full-time students and dependants. Some health funds will even cover your children if they are undergoing a full time apprenticeship as well. This means if your child turns 25, they’ll usually need to arrange their own individual health insurance policy. Similarly, if they’re under 25 but stop studying full time, they should also have their own insurance policy. Some insurers might allow your child to be covered under the family policy until 25 even if they’re not a full-time student, undergoing apprenticeship, but you might need to pay extra in premiums.

Understanding how family health insurance policies work can help you with planning as you expand your family. While it’s easy to add new members to your policy or switch to a family policy, you’ll want to be aware of things like waiting lists and restrictions. Ensuring your family has the right type of health insurance policy not only protects you against unexpected events in life; it could give you more choice in services and treatment along with better quality healthcare.