A guide to bronze tier hospital cover

Health insurance has two main components: Hospital cover. Extras cover. Extras cover is for out-patient health care services like consultations, therapies, and treatments like dental check-ups, remedial massages, and physiotherapy. Hospital cover includes your emergency care such as ambulance services, and your same day and overnight hospital visits. Hospital cover is offered across four tiers:

• Gold

• Silver

• Bronze

• Basic.

NOTE: The four tiers of health cover only apply to hospital cover.

What is the health insurance tier system?

The federal government implemented a series of reforms in order to make health insurance easier to understand and shop for. These reforms are also intended to combat the ongoing rise in cost for health insurance policies. The new tier system simplifies hospital cover products, so you know what's covered by each tier.

Health funds will now put their hospital policies into tiers: Basic, Bronze, Silver, and Gold. The tiers do not apply to extras cover. Each policy must meet minimum coverage requirements to be classified as a certain tier. Health funds can offer cherry-picked additional benefits if they choose to, but it's not required. These 'in-between' tiers are known as 'Plus': Basic Plus, Bronze Plus, and Silver Plus.

What is Bronze tier health insurance?

Bronze hospital cover is the second lowest tier of hospital cover you can buy. That’s not to say that Bronze cover doesn't have ample cover. Compared to the Basic tier, Bronze is a huge step up.

You will receive the same Basic care of rehabilitation, hospital psychiatric services, and palliative care and a long list of other benefits. Note that these three clinical categories - Rehabilitation, hospital psychiatric services, and palliative care - can be offered on a restricted basis. There must be some level of cover for these categories, but the level of benefits can be set by the fund and may vary.

Below are 3 relevant Bronze policies for a Single, living in NSW, aged 35 with an annual income of $97,001-$108,000 (Tier 1)

*Policies accurate as of 07-08-2024

All Bronze policies above contain cover for the following bronze level treatements:

• Brain and Nervous System

• Eye (not cataracts)

• Ear, Nose and Throat

• Tonsils, Adenoids and Grommets

• Bone, Joint and Muscle

• Joint Reconstructions

• Kidney and Bladder

• Male Reproductive System

• Digestive System

• Hernia and Appendix

• Gastrointestinal Endoscopy

• Gynaecology

• Miscarriage and Termination of Pregnancy

• Chemotherapy for Cancer

• Pain Management

• Skin

• Breast Surgery

• Diabetes Management

You will likely see some health funds offering procedures like lung and chest, heart and vascular system, or others that are usually found in the Silver policies.

These will probably be considered 'Bronze Plus' policies.

The graphic above shows the minimum requirements for a Bronze plan, but providers can offer other benefits to attract new customers.

Who is the Bronze tier cover best for?

Bronze tier hospital cover is a good option if you’re seeking budget-friendly health cover. While the Bronze tier does offer cover for a range of service and procedures, this typically comes with more limitations compared to the higher hospital insurance tiers. However, if the cost of your cover is your first priority, and you’re willing to accept a more restricted cover, Bronze tier can be a good option - especially if you live a predominantly fit and healthy lifestyle, with few overall health concerns.

What does the Bronze tier cover include?

Generally, Bronze hospital cover includes your hospital stays and associated costs for covered services. Covered services may included

• In-hospital accommodation costs.

• Operating theatre fees.

• Intensive care services if required.

• A range of medically necessary treatments and procedures.

• Surgically implanted prostheses (e.g. after a mastectomy).

While the above inclusions provide good foundational cover, Bronze tier hospital cover may not include certain treatments or services covered by higher-tier plans. Bronze health insurance also offers restricted cover for:

• Rehabilitation

• Hospital psychiatric services

• Palliative care.

NOTE: The three clinical categories above are usually offered on a restricted basis under the Bronze (and Basic) tiers of cover. This is because the Government mandated that there must be some level of cover for these categories in all hospital policies, but the level of benefits can be set by your fund, so this varies across the tiers as much as it does across insurers.

What is Bronze Plus?

Bronze Plus cover is a little more than the usual Bronze tier offering, and a little below the Silver tier. Bronze Plus covers a few additional procedures normally found in Silver tier, and may include:

• Dental surgery.

• Lung and chest procedures.

• Blood procedures.

• Sleep studies.

• Podiatric surgery.

• Palliative care.

Your Bronze Plus policy may not offer all of these additional services. You may be required to decide which procedures you’d like included, and which you’re okay with leaving out.

For the funds that include some of these additional procedures in their Bronze Plus tier, this is a way you’re able to access some parts of the Silver tier cover, without paying for the higher Silver premium. Bronze Plus cover does come at a higher priced premium than Bronze cover, but it is still cheaper than a Silver or Gold tier.

Who is Bronze tier health insurance best for?

Bronze is an excellent level of coverage for healthy, active individuals, providing you with protection from common accidents and health problems, but with a lower premium cost than Gold or Silver tier policies. Bronze tier policies are best for Australians who want to protect themselves from general injuries or common diagnoses. It’s likely to suit:

• Active individuals.

• Adults who don’t plan to have a family any time soon.

• Athletes and those who enjoy sports - especially extreme or contact sports.

• Those who need general health procedures (such as cyst removals, or chemotherapy treatments) on a semi-regular basis.

NOTE: Bronze tier cover doesn’t include any rebate or subsidy for insulin pumps. You’ll find these covered under your Gold tier policy. The Bronze tier might be the second lowest level of health insurance, but it covers you for a range of services and procedures. Bronze is a huge step up from Basic, and the benefits that come along with it are valuable. That said, Bronze isn't for everyone. Always check your policy details for a comprehensive understanding of any inclusions and exclusions.

Are you ready to start shopping for health insurance under the new system? Get started today.

Frequently asked questions:

Bronze vs Silver vs Gold health insurance - what is best? Choosing between hospital cover tiers depends on your individual healthcare needs as much as your personal budget considerations. Silver and gold tiers of cover offer more comprehensive protection, making them preferable for those prioritising more complete health insurance.

Bronze tier hospital cover offers limited benefits compared but this may suit you best if you’re seeking a more affordable premium. Bronze may come with narrower cover but this may not be as much of a concern for active young Australians.

Chris Stanley is the sales & operations manager of health insurance at Compare Club. With extensive experience and expertise, Chris is a trusted leader known for his deep understanding of health insurance markets, policies, and coverage options. As the sales & operations manager of health insurance, Chris leads a team of dedicated professionals committed to helping individuals and families make informed decisions about their health insurance needs.

Meet our health insurance expert, Chris Stanley

Chris's top health insurance tips

• 1

  Australia’s public health system is world-class, but wait times for public hospitals can be long, inconvenient - and leave you living in constant pain while you wait.

• 2

  An appropriate private health insurance policy can speed up your surgery, relieving your pain sooner.

• 3

  Family health cover means your children are covered under the same policy as you.

• 4

  Many health insurance policies come with a 12-month waiting period for pregnancy-related cover, so it’s a good idea to get a family policy organized well before starting your family. This means your child will be covered from birth until at least their early twenties (depending on which health fund you select).