In Australia, there are four tiers of Private Hospital Insurance – Gold, Silver, Bronze, and Basic – dictated by the Australian Government. All Health Insurers have to stick to these tiers, and each tier includes specific minimum requirements.1
Bronze Cover is the second lowest of the four tiers of Hospital Cover. It’s generally a more affordable option than Silver or Gold, but also provides fewer benefits, so it’s really important that you are absolutely clear on what a Bronze Policy will cover you for, and just as importantly, what it won’t.
To put it into perspective, Basic, the lowest tier, is only required to include cover as a private patient in a public hospital for rehabilitation, hospital psychiatric services, and palliative care – and that’s it.
Bronze Cover is a decent step up from Basic. Bronze includes those three categories as well as 18 others, including joint reconstructions, gynaecology, chemotherapy, diabetes management, brain and nervous system, eyes, and tonsils.
The Silver and Gold tiers cover an even wider range of treatments. A Silver policy will include all the services you’ll find on a Bronze policy, along with more complex services like treatment for the heart and vascular system, and back, neck and spine.
The Gold tier is the bells and whistles of hospital cover, and includes all of the previously mentioned services and more, such as joint replacements, weight loss surgery, pregnancy and birth.2
While insurers have a minimum list of services they must include under each policy tier, they are welcome to add extra services at their discretion. If they add several extra services, then they’ll generally add a ‘plus’ to the policy name.
Some insurers offer such a level of cover in between Bronze and Silver, called Bronze Plus. Because there are no rules about which additional treatments insurers can include, what’s covered under Bronze Plus with one fund could be quite different from what’s covered by another.3
AHM’s Core Bronze Plus, for example, covers all the minimum Bronze treatments, plus additional procedures like back, neck and spine, and lung and chest.4 Bupa’s Bronze Plus Simple Hospital, on the other hand, doesn’t cover back, neck and spine, but it does include sleep studies.5
Because Bronze Cover doesn’t include many treatments, it’s not going to suit everyone. If you're young and healthy (lucky you!) and want some peace of mind, but you’re more concerned about budget than high coverage, then Bronze could be a great choice. It has provisions for some conditions you might want to be prepared for just in case, like tonsilitis and joint reconstructions.6 But if you have health needs that are a little more complex, like asthma or scoliosis, Silver could be a better fit for you.7
Different Insurance Providers have different prices for their Bronze Cover. As a rule of thumb, a Bronze policy from a particular provider will cost more than their Basic policy and less than their Silver policy. There’s a good reason for this, though – the more expensive the tier, the more treatment categories it covers. And so by the same logic, a Bronze Plus policy will generally cost more than a straight Bronze policy.
But remember, the price of Bronze policies between insurers can vary quite a bit, which is why it pays to shop around! And there are a bunch of things that can change how much you’ll pay for a Bronze policy, such as which state you live in, how old you are and your taxable income.
As you can see in the table below, Basic Cover only has to includes three categories, while Bronze includes several more, and Silver and Gold more again. The categories are either marked as unrestricted, which means you’ll be treated as a private patient in a private hospital and most or all of your treatment will be covered, or restricted, which means you’ll have some out-of-pocket expenses and you’ll usually be treated as a private patient but in a public hospital.8
If categories are marked as optional, that means an insurer has the option to cover them but doesn’t have to in that level of cover.
|Hospital treatment by clinical category||Basic||Bronze||Silver||Gold|
|Rehabilitation||Yes (restricted)||Yes (restricted)||Yes||Yes|
|Hospital psychiatric services||Yes (restricted)||Yes (restricted)||Yes||Yes|
|Palliative care||Yes (restricted)||Yes (restricted)||Yes||Yes|
|Brain and nervous system||Optional (restricted)||Yes||Yes||Yes|
|Eye (not cataracts)||Optional (restricted)||Yes||Yes||Yes|
|Ear, nose and throat||Optional (restricted)||Yes||Yes||Yes|
|Tonsils, adenoids and grommets||Optional (restricted)||Yes||Yes||Yes|
|Bone, joint and muscle||Optional (restricted)||Yes||Yes||Yes|
|Joint reconstruction||Optional (restricted)||Yes||Yes||Yes|
|Kidney and bladder||Optional (restricted)||Yes||Yes||Yes|
|Male reproductive system||Optional (restricted)||Yes||Yes||Yes|
|Digestive system||Optional (restricted)||Yes||Yes||Yes|
|Hernia and appendix||Optional (restricted)||Yes||Yes||Yes|
|Gastrointestinal endoscopy||Optional (restricted)||Yes||Yes||Yes|
|Miscarriage and termination of pregnancy||Optional (restricted)||Yes||Yes||Yes|
|Chemotherapy, radiotherapy and immunotherapy for cancer||Optional (restricted)||Yes||Yes||Yes|
|Pain management||Optional (restricted)||Yes||Yes||Yes|
|Breast surgery (medically necessary)||Optional (restricted)||Yes||Yes||Yes|
|Diabetes management (excluding insulin pumps)||Optional (restricted)||Yes||Yes||Yes|
|Heart and vascular system||Optional (restricted)||Optional||Yes||Yes|
|Lung and chest||Optional (restricted)||Optional||Yes||Yes|
|Back, neck and spine||Optional (restricted)||Optional||Yes||Yes|
|Plastic and reconstructive surgery (medically necessary)||Optional (restricted)||Optional||Yes||Yes|
|Dental surgery||Optional (restricted)||Optional||Yes||Yes|
|Podiatric surgery (provided by a registered podiatric surgeon)
|Implantation of hearing devices||Optional (restricted)||Optional||Yes||Yes|
|Joint replacements||Optional (restricted)||Optional||Optional||Yes|
|Dialysis for chronic kidney failure||Optional (restricted)||Optional||Optional||Yes|
|Pregnancy and birth||Optional (restricted)||Optional||Optional||Yes|
|Assisted reproductive services||Optional (restricted)||Optional||Optional||Yes|
|Weight loss surgery||Optional (restricted)||Optional||Optional||Yes|
|Pain management with device||Optional (restricted)||Optional||Optional||Yes|
|Sleep studies||Optional (restricted)||Optional||Optional||Yes|
While the Bronze tier includes many more treatments than Basic, it doesn’t cover as much as a Silver or Gold policy.
Bronze doesn’t usually include:9
Insurers have the option to include additional treatment categories in a Bronze policy if they want to, but they’re not required to.10
When it comes to finding the right Health Insurance to suit your needs, it’s worth doing your research. Lower levels of cover might appear to be more affordable, but they also come with a wide range of restrictions and exclusions that could end up costing you more in the long run.
Before you decide on the type of cover you need, you’ll probably want to ask questions, learn what each level of cover offers and get good advice.
1 Privatehealth.gov.au – Product tiers
2 As above
3 Department of Health and Aged Care – Hospital cover and product tiers
4 AHM – Core bronze plus
5 Bupa – Bronze Plus Simple Hospital
6 Privatehealth.gov.au – Product tiers
7 As above
8 As above
9 As above
10 As above
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