Best health insurance plans for seniors

Looking for the right health insurance as a senior can feel overwhelming – especially if you’re just trying to enjoy your retirement! But it doesn’t have to be stressful. By understanding the type of policy you need in your golden years, you can start comparing with confidence.

Whether you’re looking for private health cover that caters to your specific health needs or you want to take advantage of certain benefits and rebates for financial peace of mind, here’s everything you need to know about the best health insurance for seniors.

As with every stage of your life, the right policy for you will depend on a number of factors. Unfortunately, there’s no one-size-fits-all solution, so it’ll rely on you doing some research and comparing seniors health insurance before you can find the perfect fit.

First, look for policies that have comprehensive cover for services relevant to your age group, such as hospital stays, specialist consultations and preventive care like dental and optical. Also think about whether you want the policy to include extra services like physiotherapy, podiatry or chiropractic care, which can be particularly beneficial for seniors trying to maintain their mobility and overall wellbeing.

Another important aspect is the flexibility of the policy – particularly your ability to choose your own healthcare providers and get access to a wide network of hospitals and specialists. You want to have the freedom to get treatment from professionals you trust, without being restricted by limitations from your insurer. If cost is a big factor, look for lower-tier policies with cheaper premiums and reasonable out-of-pocket expenses, as well as options for flexible payment plans.

Last but certainly not least, consider whether the policy has any extra benefits tailored specifically for seniors. This might include discounts on health-related products and services, access to wellness programs or free health assessments, as well as cover for home healthcare or aged care services.

The reality is that seniors health insurance costs will be higher or lower purely due to factors like the level of cover (e.g. tier), your age, whether you have any pre-existing conditions, as well as additional inclusions like extras cover. While basic policies can start at around $80 per month, be aware that this lower cost usually means you’re only getting limited cover. If you have to get treatment or services that aren’t included in your policy, you could find yourself facing serious out-of-pocket costs, especially for dental, optical and allied-health services.

Also be aware that the average senior in Australia pays more than $1,500 in out-of-pocket expenses towards their health each year. It’s therefore worth thinking about whether upgrading to a higher tier of cover could deliver better value in the long run. While premiums for comprehensive policies might be higher upfront, they usually include much better cover for a wide range of services, which reduces the likelihood of unexpected expenses putting a dent in your bank balance.

Seniors are eligible for the government’s private health insurance rebate, which has been designed to help ease the burden of rising health insurance costs. The rebate is means-tested, which means the amount you receive gets lower as your income increases. For Aussies earning under $93,000 per year or couples earning under $186,000 per year, a basic level of the rebate applies.

After turning 65 years old, the rebate increases from 24.6% to 28.7%, which can give you greater financial support in your golden years. Then, after hitting the big 70, the rebate increases once again to 32.8%, providing even more support for seniors’ health insurance costs.

While the rebate percentage remained frozen for a number of years recently, the actual rebate amount and income thresholds – which have since risen – may change again at any time. It’s a good idea to stay across the ATO’s income thresholds and rebate rates for all the latest details.

As you may already be aware, pre-existing conditions can – and usually do – impact your private health insurance cover and premiums. Most insurers define pre-existing conditions as any ailment or illness that you were aware of or sought treatment for before taking out the policy.

While some insurers might exclude cover for certain pre-existing conditions, for the most part they will only impose set waiting periods before you can start to make a claim on your policy. Be sure to carefully review the policy’s terms, especially around pre-existing conditions, so you can know exactly what is and isn’t covered, as well as any limitations.

It's always a good idea to compare policies and choose one that best suits your health needs and financial situation.

Striking a balance between budget and your individual health needs is a good way to approach private health cover. Going for a lower-tier policy (like Basic or Bronze) might seem financially prudent due to the cheaper monthly premiums, but you’ll also be left with minimal cover, which isn’t ideal for seniors. While it can save you money in the short term, it may end up costing you much more in out-of-pocket expenses, especially as age-related health issues become more of a problem.

On the other hand, choosing a Gold tier policy gives you comprehensive cover but comes saddled with much higher premiums. While this level of cover will ensure you get access to a huge range of services, it may not always be necessary if you rarely require medical care. In these cases, paying for extensive cover might be akin to over-insuring yourself – in other words, wasting money that could be better spent on other parts of retirement planning.

When it comes to choosing the best private health insurance for seniors, many older Australians look for policies that prioritise the particular services and procedures they may need to make a future claim on. It’ll differ from person to person, but generally, you can expect Aussie seniors to look for health cover that includes:

• Hospital treatments:  Joint replacements, cataract surgeries, cardiac procedures and cancer treatments.
• Specialist consultations: Cover for visits to specialists for expert medical advice and the ongoing management of various conditions.
• Diagnostic tests: Access to a range of diagnostic procedures for the early detection and management of health issues.
• Rehabilitation services: Cover for rehab programs and therapies to support recovery from surgeries and injuries.
• Dental and optical services: Essential cover for dental treatments, including check-ups, fillings and extractions, as well as optical services such as eye exams and corrective lenses.
• Allied-health services: Cover for allied-health professionals like physiotherapists, chiropractors and podiatrists (for managing chronic conditions and improving mobility).
• Preventive care: Access to health screenings, vaccinations, wellness programs and more.

Choosing the right private health insurance plan as a senior requires a careful balance between your healthcare needs and financial circumstances. The most important thing, however, is to ensure any policy you choose provides the level of cover you need to enjoy your golden years stress-free. Remember to review your plan frequently and compare it against other health policies to make sure you’re still having your needs met.