Private health insurance companies generally offer bronze, silver, and gold policies that give you comprehensive coverage in a private hospital. With one of these policies, you’ll be able to relax knowing that you’re fully covered in case of an unexpected illness or injury. Remember to compare and review various policies before making your final choice to ensure you’re getting the best value for yourself and your family.
Compare Health Insurance Quotes
Protect what’s most important to you. It’s easy, convenient and free!
By clicking ‘Request Your Quotes’, you agree and accept our Privacy Policy and Terms of Use and consenting to us contacting you about the products and services provided.
What are Health insurance product tiers?
Private hospital insurance in Australia is generally categorised using a 4-tier system.
Every policy will be classed as basic, bronze, silver or gold, and the coverage becomes more comprehensive with each increasing tier you go up. However, the higher your level of private health insurance cover, the more costly the premium prices are in order to pay for this privilege.
Gold-tier hospital cover is the best option for those who need coverage of all 38 treatments outlined by the Australian government. This includes joint replacements, pregnancy and insulin pumps.
Silver-tier policies offer at least 29 treatments outlined by the Australian government, including dental surgeries, lunch and chest treatments, and more.
Bronze tiered policies in Australia cover a wide range of treatments, including joint reconstructions and ear, nose, and throat services. Gynaecological care is also covered under bronze-tier policies – alongside 21 other types/services recommended by the Australian government.
The basic tier only offers restricted coverage for treatments and is not required to provide full cover for any treatment. This tier is generally used to help members avoid the Medicare levy surcharge and the lifetime health cover loading fee.
What does Basic health insurance cover?
A Basic tier under hospital cover is the lowest level policy one can purchase. This private health insurance product tier only offers restricted cover for three clinical treatments, including rehabilitation, palliative care, and hospital psychiatric services. This level generally costs around $75.00 a month for a single policy.
What does Bronze health insurance cover?
The hospital cover bronze plan is a great option for those who need some coverage but don’t want to break the bank. This type of policy will cover common treatments such as joint replacements, bone issues and hernia procedures. Other treatments include but are not limited to the list below.
What does Silver health insurance cover?
A Silver tiered healthcare policy is a much more comprehensive form of coverage. It covers all treatments included in the Bronze tier, with a range of additional treatments. While this level of hospital cover certainly costs more per month, it provides members with fewer limits and more coverage.
What does Gold health insurance cover?
The Gold tier in health insurance is the most comprehensive level of coverage that can be purchased. It usually covers every treatment offered with few or no restrictions at all.
What is a “plus” policy?
Health insurance policies come with a set of minimum requirements for each category tier; these are then appended by an additional + or word ‘plus’. Your health fund isn’t required to offer you any coverage beyond what’s included in the basic plan. Still, if you want extensive coverage or unrestricted cover for certain treatments, you can take out a policy with plus.
This level of cover will cost more, as you are purchasing extra protection, but will provide you with the funds required for specific treatments that were not on the original policy tier.
Are all “plus” health insurance policies the same?
No. Most “plus” tier policies are different from one another. A policy can meet the minimum requirements of their core tier but offer some extra benefits too! And while these two sets may have similar necessities in them – like what’s required for both levels– there could still be differences between how they’re delivered and marketed to customers who want that particular coverage.
Compare benefits across all 4 private health insurance product tiers
The requirements for a policy to be categorised into different tiers are universal across the entire industry, so every insurer is working from this same system.
Below is a table outlining the hospital treatments included in each policy tier:
Compare the four private health insurance tiers
| Treatment Category | Basic | Bronze | Silver | Gold |
|---|---|---|---|---|
| Rehabilitation | R | R | R | ✓ |
| Hospital psychiatric services | R | R | R | ✓ |
| Palliative care | R | R | R | ✓ |
| Brain and nervous system | O | ✓ | ✓ | ✓ |
| Eye (not cataracts) | O | ✓ | ✓ | ✓ |
| Ear, nose and throat | O | ✓ | ✓ | ✓ |
| Tonsils, adenoids and grommets | O | ✓ | ✓ | ✓ |
| Bone, joint and muscle | O | ✓ | ✓ | ✓ |
| Joint reconstructions | O | ✓ | ✓ | ✓ |
| Kidney and bladder | O | ✓ | ✓ | ✓ |
| Male reproductive system | O | ✓ | ✓ | ✓ |
| Digestive system | O | ✓ | ✓ | ✓ |
| Hernia and appendix | O | ✓ | ✓ | ✓ |
| Gastrointestinal endoscopy | O | ✓ | ✓ | ✓ |
| Gynaecology | O | ✓ | ✓ | ✓ |
| Miscarriage and termination of pregnancy | O | ✓ | ✓ | ✓ |
| Chemotherapy, radiotherapy and immunotherapy for cancer | O | ✓ | ✓ | ✓ |
| Pain management | O | ✓ | ✓ | ✓ |
| Skin | O | ✓ | ✓ | ✓ |
| Breast surgery (medically necessary) | O | ✓ | ✓ | ✓ |
| Diabetes management (excluding insulin pumps) | O | ✓ | ✓ | ✓ |
| Heart and vascular system | O | O | ✓ | ✓ |
| Lung and chest | O | O | ✓ | ✓ |
| Blood | O | O | ✓ | ✓ |
| Back, neck and spine | O | O | ✓ | ✓ |
| Plastic and reconstructive surgery (medically necessary) | O | O | ✓ | ✓ |
| Implantation of hearing devices | O | O | ✓ | ✓ |
| Cataracts | O | O | O | ✓ |
| Joint replacements | O | O | O | ✓ |
| Dialysis for chronic kidney failure | O | O | O | ✓ |
| Pregnancy and birth | O | O | O | ✓ |
| Assisted reproductive services | O | O | O | ✓ |
| Weight loss surgery | O | O | O | ✓ |
| Insulin pumps | O | O | O | ✓ |
| Pain management with device | O | O | O | ✓ |
| Sleep studies | O | O | O | ✓ |
Source: privatehealth.gov.au
Are there tiers for Extras policies?
No, there are no official tiers when it comes to Extra’s policies. Each health fund has its own set of rules for treating extras. Luckily, this type of policy tends to be easier than hospital plans because there are fewer details that need clarification or consideration when it comes time to make a claim.