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Things To Consider When Reviewing Your Health Cover

Life Changes that need to be considered when reviewing your Health Cover.

Reviewing Your Health

  • Turning 31 – Under the Federal Government Lifetime Health Cover (LHC) initiative, Health Funds are required to charge people 2% extra on top of the normal premiums for every year they are aged over 30 when they first take out hospital cover. So someone joining at age 40 will pay 20% more on their hospital premiums every year, than someone who joins before 31.
  • Having a Baby – Make sure you have family cover at least 2 months before the baby is born to ensure the waiting period is served and the baby will have immediate cover. Generally, newborn babies are not admitted hospital patients, (unless they are admitted to an approved neo-natal intensive care unit, are the subsequent baby in a multiple birth, or are in hospital without their mother). This means the cost for a baby treated by a paediatrician in hospital when not admitted, can only be claimed from Medicare.
  • Separation or Divorce – Moving from family to single or single parent cover.
  • Dependants Turning 21 – Children can remain on your family cover after age 21 if they are studying full-time.
    ACA Health policy defines a ‘student dependant’ as a policy holder’s child who:

    • Does not have a spouse or de facto partner
    • Is a full-time student at a school, college or university
    • Is between 21 – 25 years of age
    • Is not earning more than $20,000 gross per annum
    • Has been accepted by the fund as a ‘student dependant’
  • Turning 25 – Once your adult child turns 25, whether they are studying or not, they can no longer be a dependent within a family policy or on a Dependent Extension product. They will need to take out their own cover.
  • High-Income Earner – Singles with an annual income greater than $90,000 or Families/Couples with combined annual taxable income greater than $180,000 who don’t take out private hospital cover are charged an additional 1-1.5% on their taxable income on top of the usual 1.5% Medicare Levy.
  • Moving Overseas – The fund may permit the suspension of a policy where a Policy Holder is moving overseas to work for the Seventh-day Adventist Church in an employed or volunteer basis. The minimum period of suspension is 12 weeks and no maximum time limited will be imposed.
  • Leaving Australia – The fund may permit the suspension of a policy where a Policy Holder is leaving Australia to travel or to work other than for the Seventh-day Adventist Church. The minimum period of suspension is 12 weeks. A maximum period of suspension is 2 years.
  • Financial Hardship – Financial Hardship is defined as being on a Government short term income support payment paid by Centrelink including youth, Jobsearch, Newstart & Sickness Allowances. A maximum period of suspension of up to 2 years maybe allowed – but only while the Policy Holder/spouse continues to receive the allowance. Periods beyond this will count towards “leave of absence” under the Lifetime Health Cover Legislation.

A membership may not be suspended unless the premiums have been paid to the date of departure or date of commencement of any income support payment.

All our policies enjoy a 30-day cooling-off period. We encourage you to call us with any questions and look forward to helping you choose the cover that is the perfect fit for your stage in life.

Posted: May 4 2020