There are well over 50 brands of health funds for seniors to choose from, each with their unique differences. Within these health funds, there are thousands of different policy combinations to choose from. For the uninformed, it can seem quite daunting, but For compare your health will try to simplify it.
Generally, there are three main types of health insurance that Aussie seniors can purchase, namely: hospital cover, extras cover, and combined cover.
Seniors Hospital Cover
Private hospital cover is an insurance policy that will cover the costs associated with going to the hospital for elective surgery. The main benefits of private hospital coverage are that you get to choose your own doctor, choose the hospital and avoid public waiting lists for elective surgeries.
There are thousands of different hospital policies available on the market, all covering slightly different things to different degrees. In general, these can be broken down into 7 different categories:
- Basic Hospital
- Basic Plus Hospital
- Bronze Hospital
- Bronze Plus Hospital
- Silver Hospital
- Silver Plus Hospital
- Gold Hospital
There are 38 different clinical categories of procedures, which health insurance covers, ranging from hernia and appendix, all the way through to joint replacements and cataract eye surgery.
By law, if your hospital policy has the word “Bronze” in its name, then that policy has to cover all of these clinical categories Brain and nervous system
- Eye (not cataracts)
- Ear, nose and throat
- Tonsils, adenoids and grommets
- Bone, joint and muscle
- Joint reconstructions
- Kidney and bladder
- Male reproductive system
- Digestive system
- Hernia and appendix
- Gastrointestinal endoscopy
- Gynaecology
- Miscarriage and termination of pregnancy
- Chemotherapy, radiotherapy and immunotherapy for cancer
- Pain management
- Skin
- Breast surgery (medically necessary)
- Diabetes management (excluding insulin pumps)
If your hospital policy has “Silver” in its name, then it has to cover all the services in Bronze, as well as:
- Heart and vascular system
- Lung and chest
- Blood
- Back, neck and spine
- Plastic and reconstructive surgery (medically necessary)
- Dental surgery
- Podiatric surgery (provided by a registered podiatric surgeon)
- Implantation of hearing devices
If the hospital policy has “Gold” in its name, then it has to cover every clinical category, including:
- Cataracts
- Joint replacements
- Dialysis for chronic kidney failure
- Pregnancy and Birth
- Assisted reproductive services
- Weight loss surgery
- Insulin pumps
- Pain management with a device
- Sleep studies
Some of you might be reading this knowing that you’re not on Gold cover, but you’re sure you have joint replacements covered. This is more than likely because you’re on a “Silver Plus” level of hospital cover. When you see a Basic Plus, Bronze Plus or Silver Plus policy name, that means that this policy covers everything associated with that category level, but also covers at least one more surgery from the higher level. In any case, it is best to refer to your policy to have an idea of what it covers.
Seniors Extras Cover
As we age, our healthcare needs often extend beyond just hospital visits. Regular dental checkups, eye exams, physiotherapy, and the use of health aids like hearing devices or CPAP machines become more common. These services are covered under extras insurance.
When selecting an extras policy, it’s important to consider:
- What extras you use most often (e.g., dental, physiotherapy, eye tests).
- The yearly limit on extras (how much you can claim each year).
- The rebate you receive when you use these services (how much you get back for each service).
Here are a couple of helpful rules to follow when choosing an extras plan:
- Rule 1: If you don’t frequently use a service, don’t worry too much about the yearly limit. Instead, focus on the rebate. For instance, if you only visit the physiotherapist once or twice a year, it’s better to prioritize the rebate rather than a high yearly limit.
- Rule 2: If you often use a particular service (e.g., physiotherapy or chiropractic care), focus on finding a policy with a higher yearly limit. This way, you’ll get the most value from your plan.
Seniors Combined Cover
Combined cover offers both hospital and extras insurance in one policy, simplifying the management of your health insurance. Many seniors opt for separate hospital and extras cover, but a combined policy can be a more convenient option.
Typically, combined policies won’t include the words “hospital” or “extras” in their names. You might encounter names like “Top Choice $500” or “Deluxe Package Silver Plus,” which indicate a combined cover plan.
It’s important to note that there is no one-size-fits-all health insurance policy for seniors. What works best for you depends on your specific healthcare needs. For some, a combined cover is the most cost-effective and efficient solution. For others, it may be better to have separate hospital and extras coverage, or even to choose different insurers for each. The key is to find a plan that’s tailored to your individual health needs.
