What’s the difference between Gold, Silver and Bronze Hospital cover?

Fact Checked
Updated 28/11/2022
What’s the difference between Gold, Silver and Bronze Hospital cover?

Are you on the right health insurance?

Time to read : 4 Minutes

What's the Difference Between Gold Silver And Bronze Hospital Cover

Australia regularly ranks well for public healthcare. It's not perfect, though. That’s why many of us also hold private health insurance.

But it can be confusing.

  • You can take out hospital cover, extras cover (non-hospital health services, like dental checkups and physio visits), or combine the two.

  • The government tried to simplify hospital cover in 2019 by organising it into Gold, Silver, Bronze and Basic tiers.

  • But Compare Club's health insurance team tells us it's actually confused a lot of people.

So, what does it all mean? Let's break it down.

🫱 Gold tier hospital cover includes all Medicare eligible treatments. Silver and Bronze both have fewer items covered than the tier above.

🚑 Basic hospital cover generally covers ambulance rides and a handful of restricted services. 

💰Basic has been called "junk insurance" as it doesn't cover much... but most eligible policies will help anyone earning over $90k (or $180k for couples) avoid the Medicare Levy Surcharge tax.

Be aware: Many insurers also offer "Bronze Plus" and "Silver Plus" policies. These contain extra items from the tier above but usually at a slightly cheaper cost.

They're quite often designed with certain life stages in mind. For example some Silver Plus policies may include pregnancy cover but may strip out items that would be more useful to older Australians such as joint replacements, and vice versa.

Gold, Silver, Bronze, Basic Hospital cover: which one to pick?

Australians take out hospital cover for a variety of reasons. 

  1. Some couples get it for pregnancy and obstetrics treatments. 

  2. Older Aussies want it in case of surgeries and common health issues as they age. 

  3. Some people may want coverage for a specific condition, such as chemotherapy if they have a family history of cancer.

  4. And some people just want to avoid paying the Medicare levy surcharge. 

Here’s a quick breakdown of what you can expect from the four main hospital cover tiers:

🥇Gold cover

  • It's expensive. You'll be paying top dollar for the gold tier. Is it the best cover? That's debatable.

  • Pregnancy & IVF, weight loss, in-patient psychiatric treatment, joint replacements, cataracts, insulin pumps, palliative care, pain management, dialysis, and sleep studies are all covered here.

Yes, but... A lot of the items such as joint replacements and cataracts can be found in Silver Plus policies, so don't immediately assume you need top tier cover.

Go deeper: read our guide to everything you need to know about Gold hospital cover.

🥈Silver cover 

  • Think of this as mid-tier. You get what you pay for with Silver and Silver Plus policies.

  • Items that sit in Silver but not Bronze include heart and vascular surgery, lung and chest, dental surgery (like wisdom teeth removal), podiatric surgery, and back, neck and spine treatment.

  • Look out for Silver Plus policies. They may include items that normally sit in Gold cover.

Be aware: there are a lot of different Silver and Silver Plus policies on the market. You'll need to do a bit of comparison to check if it covers a lot of items you need and fewer of those you don't (or you could get a Compare Club expert to help).

Go deeper:everything you need to know about Silver Hospital Cover is in our guide.

🥉Bronze cover

  • Bronze is a lot more affordable than Silver or Gold. It tends to be more popular with younger Aussies or those on a tight budget.

  • It covers a lot of common hospital treatments that are used by all ages.

  • Hernias, appendix, tonsil removal, ear grommets, cancer treatments, gynaecology, miscarriages and endoscopies (sticking a tube down your mouth so the doctor can look into your stomach) are some of the common items in this level of cover.

Be smart: there are often some exceptionally good value Bronze Plus policies on the market that include some of the usually pricier items found under Silver cover.

Go deeper:read our guide to find our everything that's covered under Bronze.

🪙 Basic cover

  • The cheapest kind of hospital cover. If you're just looking to avoid paying the Medicare Levy Surcharge then most Basic policies will do just that.

  • You'll likely get ambulance cover as well - although Queensland residents won't need this. Your state government has you covered for ambulance rides and call outs.

  • It'll also help you avoid or reduce your Lifetime Health Cover loading (this gets a bit complicated, so read our guide on how LHC works). 

Be aware: you get what you pay for. Which is to say, not very much except a tax saving if you earn over $90k or $180k as a couple.

Be smart: Bronze hospital cover is often just a few dollars a week more.

Go deeper: if you really want to know more about Basic cover, we have a guide for that.

How to choose the right level of hospital cover

While having lots of choice is generally a good thing, it can get overwhelming when you are trying to decide which health cover to get. 

🤓 You’ll want to do a bit of research and pick the product that suits your lifestyle, your family’s needs and your current health status. 

Here are 5 suggestions to help you pin down the right health tier:

  1. Pick services you NEED: look for a policy where you'll actually use or think you'll need the majority of items covered.

  2. Check waiting periods: You'll need to wait between 2 and 12 months before you can make a claim on hospital cover. Plus pre-existing conditions are usually 12 months as well. Be smart: if you're switching to equivalent or a lower tier cover and you've already served waiting periods, you won't be hit with any new ones. So you can use your cover right away.

  3. See if you are eligible for discounts: Australians aged under 30 years old can get up to 10% discount on their private health premiums? You might also be eligible for the private health insurance rebate, which is based on your age and income.

  4. Customise your policy: Choosing a higher excess will lower your premiums - although you'll have to pay more out-of-pocket if you do make a claim. 

  5. Compare and switch regularly: Don’t wait for your premiums to get more expensive. It may be more cost-effective to shop around and switch to a better health policy or tier every couple of years.

The bottom line – it pays to be picky

Just because you take out a health insurance policy with a particular provider, that doesn’t mean you are stuck with them for life. 

🙏 Yes, life admin is annoying and time-consuming, but you’ll be thankful you spent time researching the right level of cover when you actually need it!

⏲️ Choose a health tier that meets your needs right now. Don’t spend extra on cover that includes pregnancy services if you won’t be using them. That’s just money down the drain!

🛒 If you feel like you are paying too much or aren’t getting the level of cover you need, compare health insurance policies online and find a more suitable tier for your lifestyle. It’s quick, easy and cost-effective!

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The information contained on this web page is of general nature only and has been prepared without taking into consideration your objectives, needs and financial situation. You should check with a financial professional before making any decisions. Any opinions expressed within an article are those of the author and do not specifically reflect the views of Compare Club Australia Pty Ltd. 

#Compare Club compares selected products from a panel of trusted insurers. We do not compare all products in the market.