Do you need private health insurance in your 40s?


4 minutes

10 January 2022

A happy couple outside their house

Here’s what HBF members in their 40s claim for the most on hospital and extras insurance.

Your 40s are a time when you might be thinking more about your health, the future and your family.

With that in mind, you might be wondering if private health insurance is a good idea for you.

The short answer is: it’s an individual choice. But it’s well worth considering the advantages private health insurance can offer you.

In this article

Your health in your 40s

To decide if private health insurance is worth it for you, it can be useful to look at some of the common health considerations for your age group.

In your 40s, preventative health becomes especially important, as your risk of health problems such as diabetes, heart conditions and cancer increases with age.1 

Now is the time to create and maintain healthy lifestyle habits (like eating a balanced diet, getting regular exercise, reducing alcohol and not smoking), and make sure you’re keeping up with regular health checks and screenings.1

So where could private health insurance fit in? Let’s take a look at some of the common HBF claims for people in your age group.

Popular hospital claims

When it comes to hospital cover, some of the most common claims for HBF members in their 40s include:2

  • Chemotherapy, radiotherapy and immunotherapy for cancer. One in two Australians will be diagnosed with cancer by age 85, and risk for many cancers increases with age.3
  • Hospital psychiatric services. This includes hospital treatment for mental illnesses, eating disorders and addictions.
  • Digestive system. This covers investigation and treatment of issues affecting all areas of the digestive system, such as gall stones, haemorrhoids and irritable bowel syndrome (IBS). Around 3 in 10 people are affected by IBS.4
  • Gastrointestinal endoscopy. This is for procedures using an endoscope (a long, thin tube with a tiny camera attached) for the diagnosis, investigation and treatment of issues affecting the gastrointestinal system.
  • Gynaecology. This includes treatment for women’s health conditions such as endometriosis, polycystic ovary syndrome (PCOS) and cervical cancer.
  • Bone, joint and muscle. This category covers conditions and injuries of the musculoskeletal system, such as bone fractures, and is a common claim across all age groups.2

Other benefits of private hospital cover

You can also choose to have these treatments in a public hospital, and this can be a good option.

However, it’s worth considering some of the perks of being treated in a private hospital. For example:

  • You can avoid public hospital waiting lists. In a private hospital you can often be treated more quickly, giving you some more convenience.
  • You can choose your doctor and hospital. Some people like to have this extra choice in how they receive treatment.
  • You can get your own room, if one’s available.* Having a bit of extra privacy can help make your hospital stay a more comfortable experience.

Plus, there are a couple more things to consider:

  • You can avoid the Medicare Levy Surcharge. Having private hospital insurance means you can avoid this tax, which is applied to high income earners (over $93,000 or $186,000 for couples and families) who don’t have an appropriate level of private hospital cover. 
  • You can avoid more Lifetime Health Cover Loading later in life. If you do decide you want private hospital cover, it can be a good idea to get it earlier rather than later in life. This is because of Lifetime Health Cover Loading – another government initiative that makes private hospital cover 2% more expensive for each year over the age of 30 that you haven’t had it before.

Popular extras claims

Extras cover can help you manage the costs of some of the more everyday, non-hospital health services that Medicare generally doesn’t cover.

For HBF members in their 40s, some of the most-frequently claimed extras services are:2

  • Dental (Preventative and Restorative). Get benefits towards your regular check-ups and scale and cleans, plus things like fillings and extractions.
  • Physiotherapy. A physio can help with things like aches and pains, recovery from injury and mobility issues. One in four people aged over 45 experiences back pain – one common reason for seeing a physio.5
  • Chiropractic. Similarly, chiropractic consultations are popular for helping manage problems relating to your muscles and bones, such as back and neck pain.
  • Optical. More than half of all Australians need glasses or contact lenses, and optical cover can help you manage these costs.6 In your 40s, it’s also common to start needing reading glasses that you didn’t before, due to presbyopia (age-related long-sightedness).7
  • Remedial massage. This can help with things like recovery from exercise, injuries, and other aches and pains. 

For parents

If you have kids, private health insurance can also provide extra choice and convenience for treatments that may be needed.

Popular hospital claims

At HBF, some of the most popular hospital claims for children and teenagers include:1

  • Ear, nose and throat
  • Tonsils, adenoids and grommets
  • Dental surgery
  • Hospital psychiatric services
  • Bone, joint and muscle

Extras cover claims for things like dental, optical, physio and chiro are also common for children and teenagers.1

It’s important to know that not all levels of hospital and extras cover include the treatments and services described in this article. To find out more about levels of cover, check out HBF cover options.

Extras explained – how much do I get back?

Certainty feels good, that’s why we’ve created a line-up of extras options that give you a guaranteed % back^ on your visits to popular services like Physio, Chiro, and Dental.

Explore HBF Extras


  1. 1HealthDirect – Manage your health in your 40s (2020)
  2. 2HBF claims data, 2019-2021
  3. 3Australian Institute of Health and Welfare – Cancer in Australia: In brief (2019)
  4. 4HealthDirect – Irritable bowel syndrome (IBS) (2020)
  5. 5Australian Institute of Health and Welfare – Back problems  (2020)
  6. 6Australian Institute of Health and Welfare – 1 in 2 Australians affected by eye problems (2015)
  7. 7Optometry Australia – Presbyopia (2020)


This article contains general information only and does not take into account the health, personal situation or needs of any person. In conjunction with your GP or treating health care professional, please consider whether the information is suitable for you and your personal circumstances.

*For the treatment of included services at Member Plus hospitals only.

^Annual limits and waiting periods apply. Percentage back benefits are payable for services, programs and providers approved by HBF, when provider charges in accordance with the Member Plus schedule fee. Excludes Basic Extras and closed products.