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Everything your health insurance should cover, according to your age

Jessica Yun
(Source: Getty)
(Source: Getty)

Health insurance premiums rose by an average of 2.92 per cent over the weekend, meaning that Aussie families will be paying an average of $103.48 more every year and singles will be coughing up $35.36 more a year.

While it’s been described as the smallest decrease in 19 years, if your health cover isn’t working hard for you, it might be time to reassess whether it’s the right thing for you.

As of 1 April 2019, all insurance policies have had to classify their policies into a tiering system split into Gold, Silver, Bronze or Basic, all of which have to meet a minimum standard of cover.

Yahoo Finance asked the experts at comparethemarket.com.au to find out what your health insurance policy should include, depending on how old you are.

If you’re 18-29 years old…

You’re fairly fit and healthy , so you don’t need to be overly concerned about certain health services like joint reconstruction, dental surgery or heart conditions, said comparethemarket.com.au health expert Anthony Fleming.

“For this reason, this group are often taking out a Bronze or Bronze Plus product,” he said. Then again, if you’re about to start a family, you might want a Silver Plus or Gold product to get cover for your pregnancy and IVF.

“For those aged between 18 and 25 who decide to take out hospital cover, they could enjoy a big 10 per cent age-based discount. Young adults aged 26-29 taking out health insurance could also receive a smaller subsidy – two per cent less than the full 10 per cent for each year after they turn 25,” said Fleming.

“Alternatively, for those not considering private hospital cover, extras only products are also a popular choice for this age group with a focus on dental, optical and therapies such as physiotherapy.”

Things to consider:

  • Dental cover

  • Optical cover

  • Physiotherapy

If you’re 30-39 years old...

You might want to start thinking about any health concerns that run in your family, and whether you’re about to start a family.

“Depending on these answers, a Bronze Plus may offer the cover you need, or you could opt for a Silver product for a little more coverage including any type of cancer treatment,” said Fleming.

Some Silver Plus policies include pregnancy-related services too, he added. “Consumers in this age group are looking at hospital and extras policies for more well-rounded coverage, to help minimise costs of dental check-ups or prescription glasses, for example.”

The health expert also warned that those thinking of taking up hospital cover should do so sooner rather than later: Aussies who have turned 31 taking out health insurance for the first time after 1 July will cop an additional 2 per cent annual loading in Lifetime Health Cover (LHC) loading.

“This means you will have incremental premium increases each year you do not have hospital cover, making it more expensive to take out in the future,” said Fleming.

Things to consider:

  • Pregnancy treatment

  • Cancer treatment

  • Dental, optical cover

If you’re 40-49 years old...

Many in this age group go for a Silver or Silver Plus product: pregnancy-related services aren’t needed anymore, and hip replacements aren’t yet a consideration.

On the other hand, this demographic will see a higher demand for cancer treatments, cataracts and major eye surgeries that are available through Silver Plus products, according to Fleming.

“Similarly, this age group can receive help towards the cost of prescription glasses, contact lenses through an extras policy. Many extras policies allow you to claim on therapies such as physiotherapy and or even remedial massages to help with muscle or joint pain.”

Things to consider:

  • Optical cover, surgery

  • Physiotherapy

  • Cancer treatment

If you’re 50 years old and over…

This age group tends to go for more comprehensive health insurance cover, such as Silver Plus or Gold policies – and don’t forget to consider your family history when selecting a policy.

“Health services for treatments such as joint replacements, rehabilitation, cataracts and major eye surgeries are often covered in these policies,” said Fleming.

“It could be worth including major dental in your extras policy to assist with any crowns,

bridges or dentures needed. Prescription glasses are common in higher levels of extra cover, so look for a higher benefit back on these items.”

Things to consider:

  • Dental cover

  • Optical cover/surgery

  • Joint replacement, rehab

At the end of the day, everyone has different health needs – so don’t be swayed by friends or family, and be sure to compare products based on the treatments and services you would like cover for.

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