When should I get private health insurance?

Figuring out when to get private health insurance can feel like a big decision, but it doesn't have to be daunting. Whether you're just starting your adult life or thinking about your long-term health, here are a few things worth keeping in mind so you can make the best choice for your needs.

Should I consider health insurance in my 20s?

Health insurance might not be on your radar in your 20s, but it might be the perfect time to start considering your options.

4 reasons to consider private health cover in your 20s:

Stress-free living

The unexpected happens – including medical expenses – and private health insurance may give you peace of mind. This is especially important as you become more independent.

Here’s an example. Do you play sport? 

If you do, you might want to look at hospital cover. Did you know that joint reconstructions are one of the top claims for Medibank members aged 25-39?1 Or maybe you want cover that pays towards dental surgery in case you need your wisdom teeth removed in hospital and you’re worried about the cost?

You can access these services through the public system too, but with the private system, you could have the option to choose your own doctor and private hospital, possibly have your treatment sooner2 and get the comfort and privacy of your own room.*

Supports your health AND your finances

Health cover isn’t just for emergencies. It helps you maintain that amazing body of yours through tune-ups like dental, physio, chiro, optical, remedial massage and more. 

With eligible Medibank extras, you can get 100% back on up to two dental check-ups on top of your annual limits a year at a Member’s Choice Advantage dentist.= Wear glasses or contacts? You could get 100% back on them too, up to annual limits.±

We also understand the importance of mental health, so we have a range of mental health support services available. Medibank health insurance members can chat to a mental health professional, over the phone or online, at no extra cost¥¥ at any time of the day or night. There are also no waiting periods for counselling and psychology consultations on Medibank extras and packaged products.$

Score long-term discounts on your hospital cover

Take out eligible hospital cover@ before you’re 30 and you could get a discount with some serious mileage. The young adult discount is available to 18-29 year olds and ranges from 10% to 2%, depending on your age when you first join.<

Learn more about Young Adult Discount and calculate your potential savings.

Added perks

Medibank membership comes stacked with reward-earning potential. The beauty of our Live Better rewards program is that you can be rewarded for healthy actions you’re probably already doing, like going to a dental check-up, getting a good night’s sleep or clocking step counts!

Once you’ve racked up your Live Better rewards points in the My Medibank app, you can redeem them for rewards from our range of partner brands including THE ICONIC, Apple, adidas and more. In fact, Medibank members with eligible hospital or extras cover could earn up to $400 every year in rewards# from our range of partners, or you could redeem Live Better rewards points to save on your premium. 

Do I need health insurance if I'm turning 31?

If you’re about to turn 31, you’ll want to learn about the Lifetime Health Cover (LHC) loading. It’s a government initiative designed to help ease the reliance on the public system.

What happens if I'm over 31 and don't have health insurance?

If you're an Australian resident and don’t have hospital cover by 1 July following your 31st birthday and choose to take it out later in life, a loading of 2% (up to a maximum of 70%) may be added to your hospital cover premium for each year you were aged over 30 without it. This loading will need to be paid on your hospital cover premium for 10 continuous years. Some people may be exempt from this loading.

Will I pay more for health insurance later if I don't get it now?

Getting hospital cover before you’re 30 could help save you money. 

Take Andrew, for example. He’s decided to wait until he’s 35 to take out hospital cover. His Lifetime Health Cover loading is calculated at 10%. Andrew's base hospital monthly premium is $100 before any government rebates or discounts are applied so it would now become $110 with the loading added.

My income is over $97k. Do I need to get private health insurance?

To encourage Australians to take out private hospital cover and relieve stress on the public system, the government applies an additional levy for those without private hospital cover, depending on your annual income. This is known as the Medicare Levy Surcharge.

You could save money on tax with hospital cover If you earn more than $97k as a single or $194k as a family, couple or single parent. You could be paying an additional tax surcharge of 1% (up to 1.5%) of your income if you or any of your dependants don’t hold an appropriate level of hospital cover for the full financial year.+

You can use our Medicare Levy Surcharge Calculator to find out how much extra tax you could be paying without hospital cover.

Still unsure about private health insurance? Let’s talk.

Private health insurance is a financial commitment, and financial commitment deserves careful consideration. 

We’re fortunate to live in a country with one of the world’s best public health systems.3 However, there are times private health insurance can offer added support like you could have the option to choose your own doctor and private hospital, generally shorter waiting times and get the comfort and privacy of your own room in hospital.* 

When you combine that with extra perks like being rewarded for healthy habits and having access to round-the-clock mental health support over the phone or online, private health insurance is worth considering. 

If you’d like to chat about your needs, cover for a specific health condition, or even what cover might be available in your budget, get in touch. We’d love to take you through what we can offer you.

 

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Things you need to know

1 Based on FY23 Medibank internal claims data for Bronze Plus Progress. 

2 Better Health Victoria; Hospitals in Victoria; retrieved October 2024. 

3 Department of Health and Aged Care – Australian Government; The Australian health system; retrieved October 2024.

* Subject to Hospital resourcing, availability, and clinical need. 

= Eligible members on Medibank extras (excluding Healthy Living Extras and Gold Ultra Health) can claim a maximum of two 100% back dental check-ups per member, per year at a Members’ Choice Advantage provider (including bitewing x-rays where clinically required). For members on eligible extras, the first two check-ups do not count towards your annual limit. Members with Healthy Living Extras can get 100% back on one dental check-up each year at a Members’ Choice Advantage provider (including up to two bitewing x-rays, where clinically required) or at a Members’ Choice dentist (excluding x-rays). Members with Gold Ultra Health can get 100% back on up to three dental check-ups at a Members’ Choice or Members’ Choice Advantage provider. Members’ Choice and Members’ Choice Advantage providers are not available in all areas. Two month waiting period applies. Some products may have other dental benefits, check your cover summary for details.

± Excludes Healthy Living Extras and select products that are no longer available for sale (for more information check your cover summary or check this page). Applies to prescription glasses and select contact lenses. Some glasses lens coatings and contact lenses are excluded. To find which specific items are included or excluded, call us on 132 331. 6 month waiting period applies.

¥¥ Some referred services may involve out of pocket costs and waiting periods may apply.

$ For members with mental health support included in their Extras cover. Annual limits apply. Counsellors must be registered with Australian Counselling Association, Psychotherapy and Counselling Federation of Australia, Australian Traditional Medicine Society.    

@ Eligible hospital cover includes residential hospital covers. Extras cover, Ambulance cover, Overseas Student Health Cover, Overseas Workers Health Cover, Overseas Visitors Health Cover and Corporate Elevate products are excluded. 

< To be eligible you'll have to have your own policy or a policy with your partner, you can't be a dependent on your parents' policy. If you are on a couple or family policy, the discount is calculated by taking an average of the discount applied to the adults on the hospital cover. So, if one person has a 10% discount and their partner has no discount, or 0%, the discount applied is 5% overall.

Must be 16 years or over to register for Medibank Live Better rewards in the My Medibank app. Some program partners and earning activities require a person to be at least 18 years of age to be eligible to earn and/or redeem a reward. Must be a Medibank member with hospital cover, extras cover, or hospital and extras cover, and be up-to-date with premium payments. Excludes Overseas Student Health Cover (OSHC), Ambulance only cover, ahm covers and other selected covers. Live Better Management Pty Ltd, ACN 003 457 289 has entered into commercial arrangements with Medibank Live Better program partners and may receive commissions. Please choose carefully as rewards will not be amended, cancelled, exchanged or refunded due to change of mind. Points earning activities and rewards are subject to change without prior notice and may be subject to availability. Additional terms and conditions may apply to points earning activities and rewards. See full Medibank Live Better rewards terms.  

# Live Better rewards members could earn up to 40,000 Live Better rewards points each calendar year for successfully completing select Live Better rewards points-earning activities. These activities include, but are not limited to, health and wellbeing challenges, the Weekly Goal, onboarding actions, partner activity earn and the daily auto-tracking bonus. This does not include points earned by shopping with Live Better rewards partners or visiting Members' Choice Advantage providers. 40,000 Live Better points could be redeemed for up to $400 worth of rewards from the Live Better rewards store.

Medibank Live Better Challenges & Goals Earning Policy: The participant of a Medibank Live Better Challenge or Goal may not receive Live Better points or may have their already credited Live Better points reversed in accordance with the Medibank Live Better terms and conditions. To earn Live Better points, the participant needs to complete 100% of the eligible Challenge according to the instructions. The number of Live Better points available for Medibank Live Better Challenges and Goals is subject to change without prior notice. To the extent of any inconsistency between this Policy and the Medibank Live Better rewards terms and conditions, the terms and conditions will take precedence.

+ The single parent/couple/family income threshold is increased by $1,500 for each MLS dependant child after the first child. 'income’ and 'dependants' have a specific meaning for Medicare Levy Surcharge purpose. Learn more.

While we hope you find this information helpful, please note that it is general in nature. It is not health advice and is not tailored to meet your individual health needs. You should always consult a trusted health professional before making decisions about your health care. While we have prepared the information carefully, we can’t guarantee that it is accurate, complete or up-to-date. And while we may mention goods or services provided by others, we aren’t specifically endorsing them and can’t accept responsibility for them. For these reasons we are unable to accept responsibility for any loss that may be sustained from acting on this information (subject to applicable consumer guarantees).