GUIDES & RESOURCES

What’s Included In Basic Cover?

If you’re thinking of taking out Basic cover, in this article you’ll learn more about what’s covered, and if it’s suitable for you.
basic cover health insurance

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When it comes to choosing health insurance, you need to do your research. With so many options to choose from, it’s important to know exactly what you’ll be covered for before you make your decision.

What is Basic Cover?

Basic cover is the entry level into private health insurance. It covers you for a limited range of services and usually excludes a wide range of hospital treatments.

These treatments will vary depending on the insurer and type of policy you choose. It’s important to check with your insurer to find out what their basic policy covers. Although basic cover may be cheaper than a Bronze, Silver or Gold policy, the benefits you receive will be less than those paid by other forms of cover. This means you may have more out-of-pocket expenses if you do require treatment down the track.

What does Basic insurance cover?

Private health insurance covers you for a range of out-of-hospital services that are generally not funded by Medicare1. These can include:

  • Ambulance
  • Home nursing (in some cases)

If you take out Basic hospital cover, you’ll also have access to the following treatments as a minimum requirement2. However, remember that restrictions may apply, meaning these might only be covered as a private patient in a Public Hospital, ie: you would be in a shared room and still be subject to public hospital waiting lists:

  • Rehabilitation
  • Hospital psychiatric services
  • Palliative care

A Basic health insurance policy won’t offer you the same level of protection as the Bronze, Silver or Gold tiers, however, your insurer can offer you cover for additional treatments if they choose to3. These policies are known as basic plus [+] policies.

What is not included in Basic Cover?

Before you decide on the type of health insurance cover that’s right for you, you need to know exactly what’s not covered by a basic policy. Here are the types of treatments that could be excluded or only covered at a restricted level (private patient in a Public Hospital) if you take out a standard basic Hospital policy:

  • Brain and nervous system
  • Eye
  • 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, radiotherapy, and immunotherapy for cancer
  • Pain management
  • Skin
  • Breast surgery (medically necessary)
  • Diabetes management (excluding insulin pumps)
  • Heart and vascular system
  • Lung and chest
  • Blood
  • Back, neck, and spine
  • Plastic and reconstructive surgery (medically necessary)
  • Dental surgery
  • Podiatric surgery (provided by an accredited podiatric surgeon)
  • Implantation of hearing devices
  • Cataracts
  • Joint replacements
  • Dialysis for chronic kidney failure
  • Pregnancy, and birth
  • Assisted reproductive services
  • Weight loss surgery
  • Insulin pumps
  • Pain management with device
  • Sleep studies

Who is Basic Cover suitable for?

Basic cover may be suitable for younger people who are fit and healthy, and are unlikely to need hospital treatment in the near future. If you have a family or you are older, you may prefer to choose a higher level of cover, as this will give you access to a wider range of hospital services.

Basic cover is also a good option if you’re on a tight budget, or are taking out hospital cover to avoid the Medicare Levy Surcharge (MLS)4, or Lifetime Health Cover loading (LHC).

When will Basic Cover be introduced?

Basic cover will come into effect on April 1st 20192, and will form part of the government’s new four-tier hospital cover classification system.

The aim of the new product tiers is to provide you with clearer information regarding health insurance, and make it easier for you to compare hospital treatment products, and find the one that suits your needs. If you’re new to health insurance, or are looking to find a policy which better meets your needs, remember to compare policies with iSelect.

What are the requirements for Basic Cover?

The requirements for basic cover - and each hospital product tier - are minimum standards. Your insurer may choose to offer upgrades to policies that include restrictions or exclusions3. These products will feature the name of the policy, along with a ‘plus’ sign - basic plus [+].

How can I compare Basic Cover policies?

Finding the right health insurance cover can be stressful and time-consuming. While lower levels of cover may be more affordable, they also come with a wide range of restrictions and exclusions that may end up costing you more in the long run.

Before you sign up for a new policy, it’s important to ask the right questions so you know exactly what your policy covers and the level of protection you need. At iSelect, we work closely with you to find the perfect cover to suit your health and lifestyle needs.

To find out more about private health insurance, call 13 19 20 to speak to one of our expert health advisors.

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Sources:
1. http://www.health.gov.au/internet/main/publishing.nsf/Content/Frequently+Asked+Questions-1#does
2. http://www.health.gov.au/internet/main/publishing.nsf/Content/private-health-insurance-reforms-fact-sheet-gold-gilver-bronze-basic-product-categories
3. http://www.health.gov.au/internet/main/publishing.nsf/Content/private-health-insurance-reforms-transition-fact-sheet
4. http://www.health.gov.au/internet/main/publishing.nsf/Content/private-1

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