Gold, Silver, Bronze, Basic: The new hospital cover tiers explained

Gold, Silver, Bronze, Basic: The new hospital cover tiers explained


We won’t deny it, health insurance is confusing. But we’re here to help. Last year, the government introduced a new tiered system to make hospital insurance products easier to understand. Let’s break down the tiers so you can pick the one that’s right for you. There are four tiers of cover: Basic, Bronze, Silver, and Gold. Each tier has a set number of hospital treatment categories —like digestive system or joint reconstructions— that all health funds must include. On a sliding scale of Basic to Gold, Basic covers the least number of categories and Gold covers the most. Each health fund can choose whether they’d like to add more coverage than the minimum. If they do, you’ll probably see a ‘plus’ in the product name. Watch out though. One health fund’s ‘plus’ might mean an extra 3 categories, while another might include an extra 7. If you’re comparing two ‘plus’ products, just be sure to keep that in mind. Ok, let’s talk tiers. First up, Basic Hospital. This is the lowest and most affordable level of cover a health fund can offer. Basic Hospital includes ‘restricted’ cover for just 3 categories: rehabilitation, hospital psychiatric services, and palliative care. Restricted cover means you’ll receive limited benefits for treatment and may be left with a large out-of-pocket. Basic Hospital cover is a great choice if you’re young and healthy and think it’s unlikely that you’ll need to go to hospital. Moving onto Bronze Hospital. This tier takes your cover up a notch to include 21 categories of hospital services. It covers common things like ear, nose, and throat surgery, colonoscopies and chemotherapy. It’s a great option if you’re fit and healthy but want more than the basic level of cover, just in case. Next up, Silver Hospital. With the second highest tier you’ll get cover for 29 categories of treatment. You might choose it if you want more niche hospital treatments included in your cover, like anything heart or vascular related, implantation of hearing devices, or back, neck and spine surgery. It’s a great choice if you want the peace of mind of knowing you’re covered for quite a lot, without having to pay for some services you won’t use like in-hospital psychiatric treatment and anything related to having a baby. Which brings us to Gold Hospital, the highest level of cover you can get. It’s great for people who are looking for all-round coverage and peace of mind. Since it includes all 38 categories of treatment, a ‘plus’ option can’t exist, which means that every health fund’s Gold Hospital product should be identical. You’ll want to go with Gold Hospital if you’re thinking about having a baby or need unrestricted hospital psychiatric treatment, since it’s the only cover that includes these services. And that’s the hospital tiers of cover explained! All health funds will need to be up and running with this new system by the first of April 2020, but you may see some funds begin to use it this year. If you’ve got any questions about the reforms, or just want to chat about health insurance, get in touch with your health fund, and they’ll be able to help you out.

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