What is couples health insurance?
Couples health insurance allows a couple (generally either de facto or a married couple) to be covered under the same policy. The level of cover and inclusions are the same for both partners.
Couples cover can be handy if you and your partner are likely to claim for similar conditions and treatments. But the thing to remember is that couples health insurance is no different to health insurance for singles. It does not have any additional inclusions by default.
For example, you might assume that health insurance for couples would cover the likes of pregnancy and birth-related claims that some couples might need. But that’s not the case. If a couple wants to include pregnancy in their cover, they would need to choose the appropriate level of cover, just like a single person would.
What’s covered under couples health insurance?
Couples health insurance can be for Hospital-only, Extras-only or combined Hospital and Extras cover. For couples health insurance, each partner will have the same policy type – you can’t mix and match.
Hospital cover for couples
This will cover each partner for costs related to being treated as a private patient in a public or private hospital. For example, it might cover the cost of undergoing surgery, including medical costs and related costs like accommodation, transport and even meals while you’re in hospital.
Couples can choose the tier of hospital cover that suits them (Basic, Bronze, Silver or Gold), with varying inclusions and cover levels depending on what you choose. With a couples Hospital policy, each partner will be covered by the same tier of cover.
If you and your partner want to be covered for pregnancy and birth-related services, you will need to choose a suitable level of hospital cover (usually this means the highest cover levels). There is typically a 12-month waiting period on claims relating to pregnancy and birth.
Extras cover for couples
Extras policies cover couples for certain out-of-hospital treatments and expenses (like dental and optical). Like Hospital cover, the inclusions and limits will depend on what level of Extras cover you choose.
But Extras levels cover is not as clearly defined as Hospital cover, meaning you and your partner will need to pay close attention to what exactly is covered and up to what limit when you’re comparing Extras policies.
Again, under couples health insurance, each partner will need to be covered by the same level of Extras cover. You generally can’t pick certain inclusions to apply only to one partner. To do that you would need to take out separate singles policies.
Depending on the policy, the claim limits on your Extras cover will either be per person, or a total limit for both partners. It’s worth checking this before you sign up and it could impact how likely you are to get maximum value from the policy.
Is couples health insurance better than two singles policies?
Couples policies and singles policies are very similar in terms of what can be covered. In other words, you don’t get anything extra by default for being covered as a couple. In addition, according to analysis by Money.com.au, the base premiums for couples health insurance are typically no cheaper than two singles policies for the same level of cover.
But there are some potential advantages to having couples cover, because of how the government rebate applied to couples and families versus single policyholders.
When a couples policy might be best
For example, a higher level of government rebate could apply to a couples policy (benefitting both partners) if one of the partners is eligible for a higher rebate.
That’s because, as well as income, the rebate that’s applied is based on the age of the oldest person covered by a policy, and higher rebates apply to people aged 65 or older. So someone under 65 would benefit if the partner they share couples health insurance with is over 65
As well as this, with a couples policy, your rebate is generally assessed based on your combined income, which may mean that together you qualify for a higher rebate covering both partners.
When a singles policy might be best
There are also some potential drawbacks to couples health insurance versus singles cover. Most notably, the greater flexibility singles cover offers each individual.
For example, if one partner has complex health needs, that partner could opt for a higher (more expensive) level of cover through a singles policy, while a separate lower (less expensive) level of cover might be sufficient for the other partner.
In that scenario, getting a high level of couples health insurance covering both partners might not be necessary and may cost more than purchasing two singles policies.
Pros and cons of couples health insurance
Pros
- You may be able to claim a higher government rebate with a couples policy depending on each partner’s age and income
- It may be easier to manage one couples policy compared to two singles
- It may be easier to convert to a family policy if you have children down the track
Cons
- You can’t tailor the level of cover for each partner
- Generally the base premiums are no cheaper compared to having two singles policies
How to choose the best couples health insurance policy
What level of cover is going to suit both partners?
For any essentials, you may want to make sure these are covered for you both even if the specific cover is only likely to be used by one partner. For any nice-to-haves, it’s more about weighing up the overall benefit for each inclusion and deciding if it’ll be worth having.
Would you like to include pregnancy cover?
If starting a family (or adding to it) is on the cards and you want your private health insurance to cover the pregnancy and birth, you’ll need to make sure the policy you choose (only certain Hospital policies cover pregnancy). You’ll also need to factor in the 12-month waiting period that usually applies.
What are the premiums going to cost?
The best way to keep your couples policy premiums low will be to compare private health insurance from a wide range of providers. Be sure to compare policies with the same level of cover so you’re getting an accurate comparison. Also check if it would work out cheaper to get two singles policies, with each policy tailored to your specific needs.
Are the claim limits per person or combined?
This is important but often overlooked. On Extras cover, your annual claim limits for each area of cover will either be per person or in some cases a total policy limit. If only one person in the couple is likely to use the service or treatment, per person limits will not be ideal.
Are there any special offers?
When you’re confident you’ve chosen an appropriate cover type, it’s worth taking a look at which providers currently have health insurance offers. This could mean saving a decent amount on your first year’s policy, for example. The special offers on couples health insurance are sometimes more generous than those on singles policies.
What does couples health insurance cost?
The cost of couples health insurance will depend on what level of cover you choose, your income and your age. The provider you choose will also determine how much you pay. It’s worth shopping around, particularly on Extras cover where there is generally more variation in the types of policies providers offer.
Premiums for couples can be expensive, but one of the benefits of private health insurance is that there are various government incentives available to lower the cost, if you're eligible.
Here are some examples to give an idea of the potential cost of couples health insurance based on quotes sourced from some of Australia’s largest health funds.
The table below shows the cost of health insurance for a couple (each partner aged 35) living in NSW, with combined income under $194,000. The cover is for each provider’s most basic level of Hospital cover and a medium level of Extras, covering at least emergency ambulance, general and major dental, optical and physio.
Couples health insurance cost comparison
Provider | HCF |
|---|---|
Basic Hospital (per month) | $157.76 (Hospital Basic Plus) |
Extras (per month) | $70.11 (Mid Extras) |
Combined Hospital and Extras | $227.67 (Hospital Basic Plus and HCF Mid Extras) |
Provider | HBF |
Basic Hospital (per month) | $160.24 (Basic Hospital Plus) |
Extras (per month) | $70.22 (Flex 50) |
Combined Hospital and Extras | $230.46 (Basic Hospital Plus and Flex 50) |
Provider | Bupa |
Basic Hospital (per month) | $155.84 (Basic Accident Only Hospital) |
Extras (per month) | $77.50 (Core Extras) |
Combined Hospital and Extras | $233.34 (Basic Accident Only Hospital and Core Extras) |
Provider | Nib |
Basic Hospital (per month) | $166.73 (Basic Care Hospital Plus) |
Extras (per month) | $71.15 (Core Extras) |
Combined Hospital and Extras | $237.88 (Basic Care Hospital Plus and Core Extras) |
Provider | Australian Unity |
Basic Hospital (per month) | $158.36 (Basic Plus) |
Extras (per month) | $79.91 (Focus Extras) |
Combined Hospital and Extras | $238.27 (Basic Plus and Focus Extras) |
Provider | Medibank |
Basic Hospital (per month) | $172.42 (Basic Accident and Ambulance) |
Extras (per month) | $55.64 (Healthy Start Extras) |
Combined Hospital and Extras | $238.54 (Medibank Basic Everyday Starter) |
Provider | GMHBA |
Basic Hospital (per month) | $164.50 (Basic - Accident Only) |
Extras (per month) | $91.35 (Mid Extras Set Benefits) |
Combined Hospital and Extras | $255.90 (Basic Hospital and Mid Extras) |
| Provider | Basic Hospital (per month) | Extras (per month) | Combined Hospital and Extras |
|---|---|---|---|
HCF | $157.76 (Hospital Basic Plus) | $70.11 (Mid Extras) | $227.67 (Hospital Basic Plus and HCF Mid Extras) |
HBF | $160.24 (Basic Hospital Plus) | $70.22 (Flex 50) | $230.46 (Basic Hospital Plus and Flex 50) |
Bupa | $155.84 (Basic Accident Only Hospital) | $77.50 (Core Extras) | $233.34 (Basic Accident Only Hospital and Core Extras) |
Nib | $166.73 (Basic Care Hospital Plus) | $71.15 (Core Extras) | $237.88 (Basic Care Hospital Plus and Core Extras) |
Australian Unity | $158.36 (Basic Plus) | $79.91 (Focus Extras) | $238.27 (Basic Plus and Focus Extras) |
Medibank | $172.42 (Basic Accident and Ambulance) | $55.64 (Healthy Start Extras) | $238.54 (Medibank Basic Everyday Starter) |
GMHBA | $164.50 (Basic - Accident Only) | $91.35 (Mid Extras Set Benefits) | $255.90 (Basic Hospital and Mid Extras) |
Other factors that may impact the cost of couples health insurance
Lifetime Health Cover loading for couples Hospital cover
Depending on your age, either or both of you may be subject to the Lifetime Health Cover loading, which is an extra cost on top of the standard premiums applied to people aged over 31 who have never had private health insurance. For couples, the loading is applied based on the average of the loading for each individual.
For example, let’s say one partner is 35 years old and has never had private health insurance before, but their partner who’s the same age has had cover since they were in their 20s. The LCH loading applied to their couples health insurance would be the average of their individual loadings: 10% + 0% / 2 = 5% premium loading.
Government rebate for couples
This helps bring down the cost of health insurance premiums with tiered rebates based on income (up to an income cap). For couples, the government rebate that applies is based on combined household income, with lower income households qualifying for higher rebate levels. The rebate will be based on the age of the oldest partner on the couples health policy.
| Family income | Rebate % |
|---|---|
$194,000 or less | 24.608% for under 65s 28.710% for ages 65-69 32.812% for ages 70+ |
$194,001 – $226,000 | 16.405% for under 65s 20.507% for ages 65-69 24.608% for ages 70+ |
$226,001 – $302,000 | 8.202% for under 65s 12.303% for ages 65-69 16.405% for ages 70+ |
Age-based discount for couples
If either or both partners are under 30 years old when you take out cover, you may qualify for an age-based discount on your couples health insurance. This is offered by some insurers (not all) and is a percentage discount on your policy premiums.
It’s offered as a 2% discount for every year under the age of 30 you are, with the discount you qualify for at the start of your policy applying until you are 41 years old. After that point it phases out gradually. For eligible couples policies, the discount applied will be the average of the discount for the two partners covered.
Medicare levy surcharge for couples
This is not a cost of your couples health insurance as such, but a cost you might incur if you don’t have a minimum level of Hospital cover.
For couples, the Medicare levy surcharge (MLS) is applied based on the household income thresholds shown below for the 2024/25 financial year (note the family income threshold is increased by $1,500 for each MLS dependent child after the first child).
| Family income threshold | Medicare levy surcharge |
|---|---|
$194,000 or less | 0% |
$194,001 – $226,000 | 1% |
$226,001 – $302,000 | 1.25% |
$302,001 or more | 1.5% |
The excess you choose on Hospital cover
Some health insurance providers allow you to nominate a higher excess on couples Hospital cover to reduce your premiums. The maximum excess for couples is $1,500 per membership year. While increasing your excess could save you money on your premiums, doing this would mean you will have more to pay if you need to make a claim.
How to combine your health insurance as a couple
If you and your partner decide that couples health insurance is suitable, there are a few different ways to go about getting it.
1
If neither of you have previously held private health insurance, you would simply apply together for a new policy with your chosen provider. A waiting period would apply to both partners in this scenario.
2
If one of you already has a singles policy, you may simply be able to convert it to a couples policy, with your partner added as a policyholder. The partner who has been added, may need to serve a waiting period before being able to claim if they have not recently been covered by the same or a lower level of cover.
3
If you both already have cover, you will need to decide whether to convert one of your singles policies into a couples policy, or shop around and find a different provider entirely. If the new couples policy is the same or a lower level of cover than the singles policies each partner was on, you should not need to re-serve waiting periods on the new policy.
