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Different stages of life as a couple

No two relationships are the same and every decision is based on your specific needs. It’s possible you’re considering couples health insurance for the first time, but just want to make sure there are options which reflect where you’re at.

Here are some common situations that motivate couples to consider health insurance:

  • you’re both a picture of vitality and really just want to be covered for basics, like ambulance cover for couples
  • you’re thinking about starting a family some time soon and want flexibility with new health cover
  • you’re both very career focused right now and want comprehensive health insurance
  • one of you is dealing with a specific condition which you would like covered with health insurance
  • you could even be trying to convince your partner about the benefits of health cover with some statistics (we can help there if you keep reading)

Basically it comes down to ensuring that if you do take out couples health insurance, you get tailored cover and don’t pay for things you will never use.

Before you work out if couples health insurance is right for you, here’s a snapshot of everything you need to know

If you’re confident of getting started on a quote to see what’s available, you can always dive right in with our easy-to-use comparison tool. You might even both have an existing health policy as singles and want to know how you can switch to couples cover.

Compare & Join

Our comparison tool will quickly show you a range of options from our not-for-profit health funds. Simply mix and match what you need from hospital and / or extras, and then leave out what’s not important. Easy!.

Did you know that the Members Own Health funds exist to give their members more benefits and better coverage? Our funds achieve this while investing a higher percentage of your premiums to improve services and keep you happy.

In fact, over one million Australians and thousands of couples are already with one of our not-for-profit or mutual funds.

Why do Australian couples take out Private Health Insurance?

Private health cover has the potential to give couples more choice and control with their health needs. This could be for standard but lifesaving ambulance coverage, getting great dental benefits for you both, or wanting the peace of mind which comes with health insurance.

Currently, around 50% or 11 million Australians have some form of private health insurance. But as we mentioned, the average policy isn’t cheap so every couple should expect value in return.

Regardless of the decision you make, remember that all Australians have access to the public health system when they need it. Australia has some of the best public hospitals in the world and many of the doctors, surgeons and specialists work in both the private and public sector.

Understanding the different types of cover for couples health insurance

This is where you can really start to decide what’s important to you as a couple, what you want out of health insurance and how much you’d like to budget for.

There are only 3 possible combinations with your health insurance:

  • Hospital only cover

  • Extras only cover

  • Combined hospital
    and extras cover

Hospital Only Cover

Hospital only cover is designed to pay benefits toward the cost of your treatment in hospital. By law, there are only 3 levels of hospital cover available to Australians: top, medium and basic.

There are plenty of ads on TV and the web that might use names like ‘gold’, ‘silver’ or ‘saver’. These are just different names for those 3 levels.

In short, the higher the level of cover you get as a couple, the more procedures you will both be be covered for.

Hospital cover also also means you can avoid long public hospital waiting lists by being treated in private hospital. That way you have the freedom to decide:

  • Who you are treated by:

    some couples may want a surgeon recommended by their doctor, family or friend

  • Where you are treated:

    access to a private hospital close to home and a more comfortable environment can reduce worry

  • When you are treated:

    on average, waiting times are usually shorter in the private system so you don’t have to live with discomfort for as long.

When a procedure is “covered”, that means 100% of the cost (minus any excess) of your hospital visit is paid by your health fund. This includes everything from accommodation, food, theatre fees, medication and general services.

And just in case you were wondering, having hospital cover before you turn 31 means you won’t pay the annual Lifetime Health Cover Loading.

Hospital waiting periods might come into play when taking out couples health insurance

Waiting periods are designed to prevent Australians from claiming immediately after joining a health insurer and then cancelling their policy once they’ve received treatment.

This kind of “hit-and-run” behaviour would very quickly drive up health premiums and negatively affect the world class health services our country has.

It’s critical to understand “pre-existing conditions” with hospital cover as well. This way you won’t waste time and money taking out a new policy, only to find you won’t be covered for a current condition.

A pre-existing condition is classified as any ailment, illness, or condition that you had signs or symptoms of during the 6 months before you began a health insurance policy with hospital cover.

If you decide to take out health insurance, your new fund will need time to advise you if your condition is pre-existing. Always check well before you go into hospital to ensure you’re covered.

Pre-existing conditions have a 12 month waiting period for health insurers. The Australian Government has published an overview of this which you can download here.

Extras Only Cover

Extras cover reduces the cost of treatment for things that Medicare doesn’t cover. This cover is there for non-GP (General Practitioner) services, such as:

  • General Dental

  • Major Dental

  • Optical

  • Physiotherapy

  • Remedial Massage

  • Occupational
    Therapy

  • Chiropractic

  • Osteopathy

  • Naturopathy

  • Podiatry

  • Orthodontics

Remember, waiting periods for major dental work is 12 months and for general dental it’s 2 months. Most other extras services listed above will also have a 2 month waiting period before you can access benefits.

Depending on your current lifestyle as a couple, extras cover is the area where you can save the most money while accessing services that provide genuine benefits.

Who doesn’t love a brand new pair of prescription glasses or a therapeutic remedial massage or just maintaining their dental hygiene?

A health fund contributes to your overall costs when using extras services in one of two ways:

  • - as a percentage proportion of the fee charged by the provider. For example, 65% back for a General Dental consultation
  • - as a fixed dollar per visit. For example, $40 per Remedial Massage visit.

People often say that extras is the cover you’ll actually use, whereas hospital cover is there just in case.

Remember to check your Total Annual Limit on Extras

If you do take out extras on your couples health insurance, always find out what the total annual limit is on your cover. This is the maximum amount you will be allowed to claim for certain extras services per financial year (July 1st - June 30th). Once you go over an annual limit for a particular service or treatment, your fund will no longer contribute to it - meaning you will pay the full cost.

If you’re unsure or just want to clarify a specific detail about extras only cover, call a health insurer directly and get an expert to talk you through the finer points.

Combined Hospitals & Extras Cover

Taking out hospital and extras cover is called combined cover, which is very popular with couples. You can decide on different levels of cover for each and then mix and match.

Perhaps you’ve found yourself using extras services a bit more lately and want comprehensive cover, which you would like to match with basic hospital cover.

It’s important to remember that health insurers won’t allow one partner to be on top level for hospital while the other partner is on basic. The same goes for your extras cover. You’ll both be on the same level for hospital and extras if you decide to take out couples health cover.

Most online services will provide a breakdown of your weekly or monthly costs for each. That way you can go up and down on each level of cover to suit your budget.

You have to decide what you think you’ll actually need and what you value

There’s no point being covered for things like hip replacements or heart surgery if these aren’t relevant to you. That all sounds blatantly obvious right? Well, you’d be surprised how many Australian couples are paying for things they might never use!

We can become complacent with health insurance, especially if we’ve had a particular policy for a long time and can’t be bothered updating it. Maybe you’ve enjoyed a good experience with them and feel your money is being well spent.

It pays to stay on top of your health insurance and check in every 3 or 6 months to make sure your cover is still tailored for your lifestyle

Planning a family as a couple but not sure exactly when?

Many couples who are considering starting a family will have health forefront in their minds. The comfort and peace of mind you get with private health cover for such an important part of your lives can be worth it.

Most health funds will have a 12 month waiting period before they allow you to claim benefits for pregnancy cover. This includes specialised services such as:

  • Obstetrics and
    Gynaecology

  • Prenatal and / or
    Antenatal Classes

  • Fertility Treatments
    (IVF)

So if you want to access the private system for your pregnancy and birth, you’ll need to plan well in advance.

How can Members Own help couples with their health insurance needs?

Members Own fundamentally believe that health insurance should be there when people need it and it should never exploit someone’s ill-health or misfortune.

Our team are incredibly passionate about giving people the right information, always being transparent and providing health cover with a heart. That’s why you’ll always be a member, not a number, if you choose to go with one of our funds for your couples health insurance.

Did you also know our funds are all run as either not-for-profits or mutuals?

Not everyone is aware that not-for-profit or mutual health funds even exist. And those that do sometimes think they won’t qualify for them, which isn’t true at all!

The 20 funds that are under the Members Own brand exist solely to deliver you the best possible service and benefits.

Why is this such a powerful fact?

Because our health funds are here to serve all Australians, not investors or overseas owners like the for-profit insurance companies, like Bupa, Medibank and nib and comparison services like Compare The Market.

Members Own have one of the biggest number of funds and policies to compare, choose and buy from online in Australia.

And the cherry on top is that we refuse to promote sponsored products because it’s critical that customers are only ever given unbiased results to compare. Here’s an example of what someone who used the our service had to say:

“Members Own was a refreshing change from the high pressure sales techniques used by their competitors. Professional knowledge, prompt communication and the best health fund recommendation are what prompted us to change our health fund of over 30 years.”

Rather than comparing a policy from one provider across numerous of websites, why not do it all in one place in around 5 minutes?

What’s next when deciding on couples health insurance?

Couples health cover can come in handy when you least expect it, even if both of you feel like your health is perfect right now.

Many couples enjoy benefits on things which enhance their overall wellbeing. This could be access to discounts on gym members or getting rehabilitation on an old sports injury from an osteo.

The great thing is, it only takes a few minutes to see a range of options based on your needs. Our super smart comparison tool will guide you through everything and help you understand every policy option.

Compare health insurance now and get a quote

Select your level of cover

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If you have any questions or queries with your single health insurance, we have friendly staff who are all health insurance experts. You can call one of our team on 13 10 66.

As seen on The Morning Show X

Setting the Record Straight

Members Own CEO Troy Sheahan busts some common health insurance myths on The Morning Show



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