Family health insurance: compare private health cover for families
Family health insurance covers two adults and their dependent children on one policy, and a single parent policy covers one adult and their dependants. Adding more children generally does not add to the premium, which is what makes family cover comparatively good value as a household grows.
The details that matter most are how long your children can stay on the policy, how the excess applies when more than one person goes to hospital in a year, and whether the extras half matches what your family actually claims.
By Better Rate Mate Editorial Team · Last reviewed
Family, single parent and adult dependant policies
The rules that change what a family policy costs you apply in the same way to each kind of family membership. What differs is who is on it.
| Membership | Who it covers | Surcharge threshold | Excess limit for the surcharge | Lifetime Health Cover loading | Age-based discount |
|---|---|---|---|---|---|
| Family | Two adults and their dependent children | Family threshold on combined income ($210,000 in 2026–27, plus $1,500 per child after the first) | $1,500 a year | Averaged across the adults on the policy | Averaged across the adults; not given to dependants |
| Single parent | One adult and their dependent children | Family threshold on the parent's own income | $1,500 a year | The parent's own loading | The parent's own discount; not given to dependants |
| Family with adult dependants | As above, plus dependants aged 18 to 31 who meet the fund's rules, often full-time study | As for the family or single parent policy | $1,500 a year | A dependant with a disability counts as an adult in the average | Not given to people covered as dependants |
How much does family health insurance cost?
We don't publish premiums, because funds change them every 1 April. What the Government's data does show is how a family premium relates to a singles premium for the same policy. In the hospital policies open to new members at 1 October 2026, the cheapest family membership on a policy was exactly twice the singles premium in 2,383 of 3,521 matched versions, and between 1.7 and 2.2 times it in the rest, whatever the number of children. A single parent membership was a median 1.65 times the singles premium, and between 1.6 and 1.68 times it in half of the versions.
So a family policy usually costs the same as a couples policy, and adding children rarely adds to it. What moves the price from there:
- Hospital tier: Gold costs most because it must cover pregnancy and birth, joint replacements and every other category.
- Excess: a higher excess lowers the premium. Keep it at $1,500 a year or less if the policy is also to avoid the surcharge.
- Adult dependants: keeping adult children on the policy often needs an extended family option at a higher premium.
- Your state, your rebate tier on combined income, and any Lifetime Health Cover loading averaged across the adults.
- Extras: family claims for dental, optical and orthodontics add up, so the extras half often decides the price.
| Membership | Matched policy versions | Typical multiple of the singles premium | Range |
|---|---|---|---|
| Couple | 3,682 | 2.0 (exactly double in 84%) | 1.55 to 2.01 |
| Family (cheapest family membership on the policy) | 3,521 | 2.0 (exactly double in 68%) | 1.70 to 2.20 |
| Single parent | 3,521 | 1.65 (median) | 1.40 to 2.00 |
How to choose the best family health insurance
There's no best family policy for everyone, and we don't name one. These are the criteria that separate family policies, in the order we'd check them; the best policy for your family is the cheapest one that passes them all.
- The clinical categories your family is likely to need, which set the tier. Pregnancy and birth is guaranteed only on Gold; once your family is complete you may not need it.
- How the excess applies: per person, per policy, or per person capped per family, and whether it's waived for children.
- The fund's dependant age limit and whether adult children need an extended family option.
- Extras benefits and limits for what your family claims: check-ups, glasses, physio and orthodontic lifetime limits.
- The fund's agreement hospitals in your state, its no-gap rate and its complaints against market share. Our health fund comparison has the Ombudsman's 2024–25 figures for every fund.
How long children can stay on a family policy
Legislation passed in June 2021 lets insurers keep adult dependants on family policies up to age 31, and removes the age limit for dependants with a disability who are NDIS participants. The law defines an adult dependant as a single person aged 18 to 31, but each insurer chooses its own age range within that, and some stop earlier. One fund might cover non-student dependants to 25 while another covers them to 31.
Adult dependants are sometimes on an 'extended family' or 'dependant extension' option at a higher premium, so read the fine print. A dependant who marries or enters a de facto relationship is no longer a dependant and needs their own policy.
Two different definitions of 'dependant'
The Medicare Levy Surcharge uses its own definition. For the surcharge, your dependants are your spouse, children under 21, and full-time students under 25. That is narrower than what many funds now allow on a family policy.
In practice: an adult child covered as a dependant on your family hospital policy is not liable for the surcharge on their own income as long as they have no spouse or dependants of their own. A 26-year-old who has left your policy needs their own hospital cover if their income is above the singles threshold.
The family surcharge threshold
Families and single parents are assessed on combined income against the family threshold. You must hold hospital cover for yourself, your partner and all your dependants to avoid the surcharge, and the yearly excess can be no more than $1,500.
| Income for MLS purposes | Singles | Couples and families | Surcharge without hospital cover |
|---|---|---|---|
| Base tier | $105,000 or less | $210,000 or less | 0% |
| Tier 1 | $105,001 to $123,000 | $210,001 to $246,000 | 1.0% |
| Tier 2 | $123,001 to $164,000 | $246,001 to $328,000 | 1.25% |
| Tier 3 | $164,001 or more | $328,001 or more | 1.5% |
Family excess: the hidden difference between policies
Excess structures vary more on family policies than anywhere else. Some funds apply the excess per person per year, some per policy per year, and some per person but capped per family. Many waive it for children. In a year when two family members are admitted, the difference between those structures can be significant. Compare the excess structure before the premium, because the cheaper premium often comes with the less generous structure.
Single parent health insurance
Most funds offer a single parent (or 'single parent family') membership covering one adult and dependent children, sometimes called single parent medical insurance. It's typically priced below a two-adult family policy: a median 1.65 times the singles premium for the same hospital policy in the Government's data at 1 October 2026, against twice the singles premium for a family. For the surcharge and the rebate, single parents use the family thresholds on their own income, not the singles thresholds: $210,000 in 2026–27, plus $1,500 for each child after the first. That makes a single parent far less likely to pay the surcharge than a single person on the same income.
The excess limit for the surcharge is $1,500 a year, because the policy covers more than one person. The rebate is income tested against the same family tiers, with the percentage set by the age of the oldest person on the policy. If you are separating, tell your fund, and both parents should check that the children are covered on one of the new policies.
Adding a newborn
To cover a newborn from birth without waiting periods you generally need to be on a family or single parent membership before the birth. privatehealth.gov.au notes that insurers have different rules about how far in advance you must change, and some require the change several months before the baby is born. If you are on a singles or couples policy and expecting, call your fund well before the due date. Treatment for the baby is covered under the clinical category relevant to the condition, not under 'pregnancy and birth'.
Reviewing family cover as the kids grow
A family policy that suited you when the children were small rarely suits them as teenagers. Review it at each renewal against what the household now needs.
- Once your family is complete, you may no longer need the pregnancy and birth category, which is guaranteed only on Gold. Dropping to a tier without it can lower the premium; check the other categories you'd lose first.
- Orthodontic waits are usually 12 months or more, so add or keep orthodontic cover well before braces are likely, and check the lifetime limit.
- At 21 a child stops counting as your dependant for the surcharge unless they're a full-time student, and at 25 even then. They may still be on your policy under the fund's own rules.
- Your fund's dependant age limit can be anywhere up to 31. When a child ages out, they need their own policy, and taking hospital cover before the 1 July after their 31st birthday avoids Lifetime Health Cover loading.
Choosing extras around family claims
Family extras claims are more predictable than singles claims: regular dental for several people, glasses, physio for sport, and often orthodontics. That makes the arithmetic easier. Add up a realistic year, check the per-person as well as per-policy limits, and look at orthodontic waits and lifetime limits, which are usually long and modest. Eligible children may also be able to use the Child Dental Benefits Schedule for basic dental care.
What to watch for
- Dependant age limits are set by each fund within the 18 to 31 range. Confirm your fund's limit if you have children in their late teens or twenties.
- For the surcharge, a dependant is a child under 21 or a full-time student under 25, which is narrower than many funds' policy rules.
- Check whether the excess is per person or per policy, and whether it is waived for children.
- Move to a family or single parent membership before a birth; your fund sets how far in advance.
- Age-based discounts do not apply to people covered as dependants on a family policy.
Common questions
Until what age can children stay on a family health insurance policy?
Up to 31 at funds that have adopted the 2021 reforms, but each fund sets its own limit within the 18 to 31 range, and some stop earlier. Dependants with a disability who are NDIS participants can have no upper age limit where the fund allows it.
Do I pay more for each additional child?
Generally no. Most family policies charge the same premium regardless of how many dependent children are on it. Adult dependants may cost extra through an extended family option.
What is the best family health insurance?
The one whose hospital tier covers what your family is likely to need, with an excess structure you can live with, and extras benefits that match your real dental, optical and physio use. Compare the PHIS for each policy on those three points. If you want to know which funds are biggest, our five largest health funds table sets them side by side, but largest isn't the same as best.
What are the downsides of a family policy?
The excess can apply per person, so a year with two admissions can cost two excesses. Doctors can still charge gaps above the Medicare schedule. Extras limits that nobody uses are lost when they reset. Premiums usually rise each 1 April. And dependants age out under the fund's rules, so children may need their own policy sooner than you expect.
How do I add a newborn to my policy?
Be on a family or single parent membership before the birth, then tell your fund when the baby is born. Insurers set how far before the birth you must change, so check early.
Is single parent health insurance cheaper than family cover?
Usually, because it covers one adult rather than two. In the Government's data for hospital policies open at 1 October 2026, a single parent membership was a median 1.65 times the singles premium for the same policy, against twice the singles premium for a family membership. Single parents are still assessed against the family thresholds for the surcharge and the rebate.
What are the top 3 health insurance companies?
By market share in 2024–25, the three largest health insurers were Medibank (including ahm) with 26.5%, Bupa with 25.5% and HCF (including RT Health) with 12.8%, on the Private Health Insurance Ombudsman's figures published on privatehealth.gov.au. Largest isn't the same as best for your family: the five largest health funds compared shows how they differ on the official measures.
About the figures on this page
The Medicare Levy Surcharge and rebate income thresholds change each 1 July, and the rebate percentages each 1 April. The figures on this page were checked on 10 October 2026. For the latest figures see the ATO and the Government's privatehealth.gov.au.
