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Gold Health Insurance Cover in Australia
Gold Health Insurance Cover in Australia
Written by
Madeline Pettet
Edited by
Laura Crowden
Reviewed by
Dr Jill GambergCheck 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 is gold health insurance?
Gold hospital policies sit at the very top of the tier system that the Aussie government introduced in 2019 to help make health insurance easier to understand and compare. Policies from this tier offer more protection than any other type of hospital cover.
How does gold health insurance compare to other tiers?
With gold hospital insurance, you’ll get coverage for more in-hospital treatments than on basic, bronze, or silver policies. While each tier has a required minimum level of cover, only gold tier health insurance must cover all 38 clinical categories of hospital treatment. Just remember the more that’s covered, the more expensive your premiums are likely to be.
Want to know about the other tiers of hospital cover?
What does gold health insurance cover?
Gold health insurance covers all treatments included in lower hospital cover tiers. In addition, it also covers:
assisted reproductive services
cataracts
dialysis for chronic kidney failure
hospital psychiatric services with no cover restrictions
insulin pumps
pain management with devices
palliative care with no cover restrictions
rehabilitation with no cover restrictions
sleep studies
How much does gold health insurance cost?
Like all health insurance policies, gold hospital cover options can vary in price. This can be down to a range of factors, including the insurer, your chosen excess, and how many people the policy covers.
Which state you live in can also make a difference. This is due to things like:
- the number of hospitals in your state
- the cost of healthcare in your state
- the age and health of your state’s population, including claiming activity.
The map shows the average monthly gold singles hospital insurance premium in different states in October 2024.
Is there any way to reduce my premiums for gold health insurance?
There certainly is! While you don’t have as much wriggle room here as you might for, say, car insurance, most insurers will still provide some options that can help reduce your premiums.
Increase your excess
Most insurers will charge you an out-of-pocket cost whenever you make a claim called an excess. Selecting a higher excess can result in lower premiums, which can be a great option for those who think they’re unlikely to claim on their policy.
Pay with direct debit
Some health insurers will apply a discount to regular premiums if you pay by direct debit instead of BPAY or credit card. Over time, this could save you quite a bit of money on your policy.
Lock in your annual premium by paying upfront
Typically, 1 April sees health insurance premiums rise. However, you could stick to last year’s lower rate if you pay for 12 months of cover before March ends.
Compare regularly
It can pay to keep an eye out for other policies – especially if you’ve held onto your cover for a while. Just because your gold policy was the cheapest option a few years ago doesn’t mean it will stay that way. It’s a good idea to regularly compare what’s out there and see if another policy offers more value, particularly if your life stage or health needs have changed.
Even if your gold cover costs a bit more than lower level policies, these little strategies can quickly add up and help your money go even further than usual.
Helpful tip:
Gold hospital cover is available for singles, and many insurers also offer this policy for couples and families. This can be especially beneficial if you have young children, as some insurers provide coverage for them at no additional cost until they reach adulthood (typically between 18 and 25, depending on the insurer, as long as they’re single and living at home). In fact, a gold family policy is often priced similarly to a couples’ gold policy, with the added bonus of covering your children. Plus, you’ll enjoy the convenience of having your partner and kids all covered under a single policy, eliminating the need to manage multiple plans.
Dr. Jill Gamberg
GP, Coach and Lifestyle Medicine Physician
Who is gold health insurance suitable for?
Whether or not gold cover is a good fit for you comes down to a whole bunch of factors. It’s about what you want (and need!) out of your health insurance. And since every person’s circumstances are so unique, it’s tricky to give a one-size-fits-all answer.
That being said, there are some people who are more likely to find gold cover suitable.
People planning pregnancy
If you’re planning on getting pregnant and want to give birth as a private patient in a private hospital, and/or have the option of choosing your own obstetrician, then gold cover may be for you. Gold hospital insurance also gives people who are having difficulty conceiving access to in-hospital IVF treatment (as long as it’s medically required).
People with chronic conditions
Gold cover might suit people who have diabetes, osteoarthritis, or other chronic conditions (without needing to comb through silver plus policies with their fingers crossed. The right level of cover can give them the option to get treated in a private hospital and (potentially) skip the public system’s often longer waiting lists. This means they might be able to get treatments like a hip replacement or an insulin pump sooner rather than later.
Older Australians
As you get older, you are more likely to be affected by certain conditions. By the age of 80, most people will have developed cataracts1Healthdirect – Cataracts and around one in 10 Australian adults has signs of chronic kidney disease.2Healthdirect – Chronic kidney disease Having the option to go private for treatment of these conditions might be a priority for you.
Of course, even people who don’t fall into these categories may find gold cover useful. One of the best ways to determine if it’s a good match or not is to simply think about whether you’ll need medical treatment for the additional clinical categories it covers in the foreseeable future. Alternatively, you may prefer just to have the peace of mind extra coverage offers.
But if you don’t think you’ll need this much cover (or if you’re fine with getting treatment as a public patient), then a lower product tier might be worth considering.
Frequently asked questions
Is gold hospital cover worth it?
Everyone’s health needs are different. Gold health insurance could be just what you’re after if lower tiers don’t cater to your health needs.
However, if you’re young, generally healthy, and aren’t planning on starting a family any time soon, a lower tier may be more your speed. For instance, if you’re just looking to pay less tax by skipping the Medicare Levy Surcharge (MLS), and have no health concerns for the time being, a basic policy might do the trick.
How does gold hospital insurance weigh up?
| Pros | Cons |
 covers you for more medical treatments than other tiers of hospital cover |
 typically costs more than other tiers of hospital cover |
| ensures unrestricted cover for every category of in-hospital treatment |
like all hospital-only policies, it won’t insure you for extras like general dental services or chiropractic visits |
| may come with nil excess for same-day treatments |
will usually involve out-of-pocket expenses in the form of an excess if you need to stay in hospital overnight |
What are the waiting periods for gold health insurance?
A waiting period refers to how long you have to hold a policy before you can claim for certain conditions. Gold cover has the same maximum limits for waiting periods as other hospital policies. For hospital cover, the legal requirements are no more than:
- two months for psychiatric care, rehabilitation, or palliative care (even if it’s for a pre-existing condition)
- twelve months for all other pre-existing conditions
- twelve months for pregnancy and obstetrics
- two months for all other conditions and treatments
Insurers can technically offer shorter waiting periods, but it’s honestly quite rare to find a policy that doesn’t apply the maximum limits. Most insurers – big and small – are the same on this front.
Can I get a gold plus policy?
If you’ve already started browsing hospital cover options, you might have spotted that there are more than basic, bronze, silver, and gold policies available – sort of. Insurers who choose to offer more cover than the minimum required amount for a tier can label these policies as ‘plus’ options, like basic plus or bronze plus.
However, given that gold already covers everything under the sun (or at least the 38 private hospital insurance clinical categories), there’s no such thing as a gold plus policy.
If you were after more cover, though, you could look at supercharging your gold hospital insurance with an extras policy. This could give you cover for health services and treatments outside of hospital, like dental or physio.
What excess applies for gold hospital cover?
When it comes to your excess, your options can vary between policies and insurers. Some may offer a range of options, including no (or nil) excess, with no restrictions. Others may only offer no excess for same-day admissions or for dependents under a certain age.
Where can I compare health insurance policies?
You don’t want to be paying more than you need to for hospital cover. Luckily, iSelect can help. You can compare a range of health insurance options online with our comparison tool, or speak with our health comparison experts on 1800 784 772.
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