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Basic hospital cover
Basic hospital cover
Written by
Madeline Pettet
Edited by
Ellie Garran
Reviewed by
Andres GutierrezCheck out our range of private health funds
iSelect does not compare all providers in the market or all policies offered by our partners in your area. Not all policies or special offers are available to all customers and some may only be available over the phone or on the website. Learn more.
What’s basic hospital cover?
Basic cover is the first of 4 tiers of hospital cover that you can buy; with it, you can have some of your out-of-pocket costs handled by your insurer for covered hospital treatment as a private patient.
Basic hospital cover offers some coverage, but it has its fair share of exclusions, too. It’s like dipping your toes into the hospital insurance pool instead of jumping off the 10-metre diving board. True, you only get cover for a small number of hospital treatments, but the price usually reflects this. You can always look for a basic plus policy as well if you want a little more cover, or head on up a tier.
FYI, hospital cover is different from extras cover. The clue is in the name, but hospital cover only handles medical services you need to go to hospital for.
Who is basic private health insurance suitable for?
Basic hospital cover suits people who are unlikely to need elective surgery in the near future but want hospital cover for tax purposes or other benefits. It can also be an option for people who only want a little bit of cover rather than a host of clinical categories.
If you’re young and healthy, taking out a cheap basic cover policy could net you an age-based discount (if you’re under 30) to your hospital insurance until you turn 41. Similarly, having hospital cover helps you avoid Lifetime Health Cover loading from 1 July after you turn 31.
However, if you think you’ll need elective surgery in the near future, basic private hospital cover might not be the right choice for you. It depends on your situation.
Want to know about the other tiers of hospital cover?
What does a basic health insurance policy cover?
Basic hospital insurance includes restricted cover for rehabilitation, hospital psychiatric services and palliative care. Basic plus cover can include additional cover, but it varies between policies and insurers. This additional cover would also have restrictions.
Some basic hospital policies come with ambulance cover, too. If you live in a state that doesn’t automatically cover the cost of an emergency ambulance for residents or you don’t qualify for subsidised emergency ambulance services, this kind of cover might come in handy.
When restrictions apply on your basic hospital cover, it means you’ll only be covered as though you are being treated as a private patient in a public hospital. This means you could still end up on a potentially long public hospital waiting list. You’re also less likely to have a private room and more likely to have out-of-pocket costs.
With restricted cover, you can still check into a private hospital as a private patient, but your health fund won’t cover all of your hospital accommodation fees, or your theatre fees. It might mean paying significantly more out of pocket, but it could also mean a shorter wait and no shared room. You’ll need to weigh up what works for you.
| Included (with restrictions) | ||
 Rehabilitation | Hospital psychiatric services | Palliative care |
| Excluded | ||
 Brain and nervous system | Eye (not cataracts) | Ear, nose, and throat |
| Kidney and bladder | Male reproductive system | Digestive system |
| Miscarriage and termination of pregnancy | Chemotherapy, radiotherapy, and immunotherapy for cancer | Pain management |
| Heart and vascular system | Lung and chest | Blood |
| Podiatric surgery (provided by a registered podiatric surgeon) | Implantation of hearing devices | Cataracts |
| Assisted reproductive services | Weight loss surgery | Insulin pumps |
| Tonsils, adenoids, and grommets | Bone, joint, and muscle | Joint reconstructions |
| Hernia and appendix | Gastrointestinal endoscopy | Gynaecology |
| Skin | Breast surgery (medically necessary) | Diabetes management (excluding insulin pumps) |
| Back, neck, and spine | Plastic and reconstructive surgery (medically necessary) | Dental surgery |
| Joint replacements | Dialysis for chronic kidney failure | Pregnancy and birth |
| Pain management with device | Sleep studies | |
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Share some basic details about yourself or your household and the type of policy you’re looking for
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Helpful tip
Unlike the other tiers of hospital insurance, which cover a wide range of treatments, basic cover takes a minimalist approach.
It might not offer much cover, but it can be a good choice if you’re looking to avoid the Medicare Levy Surcharge. The more affordable premiums of basic cover can be enticing. However, if you want to be covered for certain medical conditions, please make sure to check out the higher-level policies before making a decision.
Dr. Jill Gamberg
GP, Coach, and Lifestyle Medicine Physician
How much does basic hospital cover cost?
The average monthly basic hospital insurance premiums for iSelect customers ranged from $113 to $115 for singles in 2025–2026 financial year.
Typically, policies that covered more adults, like couple and family policies, were roughly double those with only one adult covered. This makes sense as private health cover works on a ‘community rated’ basis, which means everyone, regardless of age or health history, pays the same base price for the same policy. So, health cover for 2 adults typically costs about twice as much as cover for just one.
However, health insurance premiums tend to change a bit between states and territories. It’s down to different hospital costs and medical costs in each place. As if Australian cities didn’t have enough to argue about when it comes to where the best place to live is!
Something else to keep in mind is that your excess also affects your premium. Essentially, an excess is an-out-of-pocket expense. Before you’re properly admitted to hospital, you’ll need to pay your excess if you want your insurance to swoop in and save the day. The good news is that the higher your excess, the lower your monthly or annual premiums will usually be. It’s all a matter of striking the right balance between your needs and your budget.
| Policy membership type | Average monthly premium |
|---|---|
| Single female | $115.17 |
| Single male | $112.92 |
| Single parent | $176.33 |
| Couple | $238.00 |
| Family | $228.25 |
Note: These figures reflect indicative basic hospital insurance monthly premiums sold to iSelect customers in 2025–26 financial year, including age-based discounts, Lifetime Health Cover loading and private health insurance rebates, based on internal iSelect sales data and rounded where appropriate. Estimates include internal iSelect calculations. Actual costs may vary depending on your unique situation, including chosen policy. Data based on 1 July 2025 to 31 June 2026, data retrieved September 2026.
How does basic hospital cover compare to other hospital cover tiers?
Basic hospital cover has the lowest number of mandatory clinical categories covered, with each tier above progressively covering more clinical categories of treatments. That means basic hospital cover has the lowest number of mandatory clinical categories coverage while gold has the highest.
The mandatory minimum number of clinical categories for each tier are as follows:
- basic hospital cover: 3 (restricted cover only)
- bronze hospital cover: 21
- silver hospital cover: 29
- gold hospital cover: 38.
There are specific clinical categories each tier of hospital cover needs to cover, with more needing to be included as the tiers go up. Additionally, once you get above basic hospital insurance, most mandatory clinical categories are restriction free, too.
Plus policies, like basic plus and silver plus, include those mandatory clinical categories plus an additional clinical category or more. If you’re generally happy with a tier’s level of cover but want cover for a specific clinical category from a higher tier, searching plus policies can be a good move.
Is basic hospital cover worth it?
Basic hospital cover could be worth it for people interested in benefits like avoiding Lifetime Health Cover (LHC) loading and Medicare Levy Surcharge more than having lots of elective surgery cover. Ultimately, it depends on your circumstances and what you’d like to get out of your health insurance.
For instance, if you’re young and healthy but want to be prepared for the future, taking out basic cover now can mean you avoid any LHC loading added to your hospital premiums in the future. This is an extra amount you’ll need to pay if you only take out a hospital insurance policy after the 1 July following your 31st birthday. It could end up being one of the worst birthday gifts you receive – for every year you’ve gone without hospital cover, you’ll have an extra 2% to pay in premiums once you do have a policy (up to a max of 70%).
However, if you sign up for hospital cover before that 1 July date and you maintain your cover, you won’t need to pay LHC loading on your policy after you turn 31. Nice!
Similarly, holding basic hospital cover can prevent you being taxed up to an additional 1.5% of your eligible income through the Medicare Levy Surcharge (MLS). However, this is only a concern if you earn over the income threshold: for 2026–27 financial year, the income threshold is $105,000 for singles and $210,000 for couples and families. If you earn under the threshold and don’t have hospital cover, basic or otherwise, you won’t be charged the MLS.
Frequently asked questions
Can basic hospital cover help avoid the Medicare Levy Surcharge?
Basic hospital cover helps you avoid the Medicare Levy Surcharge (MLS) if you earn over $105,000 as an individual or $210,000 as a couple or family for the 2026–27 financial year. Otherwise, you can have to pay up to an additional 1.5% of your eligible income in tax. Depending on your situation, basic cover can be a cost-effective way to avoid this surcharge.
Keep in mind that for your basic hospital cover to be eligible, it needs to have an excess of no more than $750 if it’s a singles policy, or an excess of $1,500 or less if you have a couples or families policy.
What are the waiting periods for basic private health insurance?
The maximum waiting periods for basic hospital cover are 2 months for most kinds of cover, while pre-existing conditions (excluding psychiatric treatments, rehabilitation or palliative care) and pregnancy and obstetrics have waiting periods of a maximum of 12 months (although you won’t find cover for pregnancy and obstetrics on a basic hospital policy). These are the same waiting periods as for other levels of hospital cover.
If you’ve already served waiting periods on another hospital policy, you won’t need to serve them again for the same or lower level of cover if you change policy. This means you could move from a bronze hospital cover policy to a basic cover one without waiting periods, as long as you haven’t had much of a break between cover (different funds have different rules for this).
What is basic plus hospital cover?
Basic plus hospital cover is a basic hospital cover policy with additional coverage outside the 3 mandatory restricted clinical categories. So, a basic plus hospital cover includes cover for more than just palliative care, hospital psychiatric care and rehabilitation (all with restrictions). This can be a handy option if basic offers most of what you want but you’d like a little further cover.
However, those extra categories can come with restrictions, so always read your policy brochure to make sure you understand what you are covered for.
It’s worth keeping in mind, too, that a basic plus policy is unlikely to be the cheapest basic hospital cover around. Those extra inclusions tend to come at a cost.
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Health Insurance & Tax
Tax Implications on Health Insurance
How to save on Health Insurance
About the Medicare Levy Surcharge
About the Life Time Health Cover Loading
Government Rebate & Means Testing
iSelect does not compare all health insurance providers or policies in the market. The availability of policies will change from time to time. Not all policies available from its providers are compared by iSelect and due to commercial arrangements, your stated needs and circumstances, not all policies compared by iSelect are available to all customers. Some policies and special offers are available only from iSelect’s contact centre or website. Click here to view iSelect’s range of providers