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What private health insurance tier do I need? 

By Trudie McConnochie

If you’re looking for a new Hospital Cover policy or upgrading your current policy, you’ll need to decide what private health insurance tier you need. There are 4 tiers of Hospital Cover: 

  • Basic – the cheapest; covers 3 out of 38 hospital treatments with restrictions 
  • Bronze – covers 21 out of 38 hospital treatments; some may be restricted 
  • Silver – covers 29 out of 38 hospital treatments; some may be restricted 
  • Gold – the most expensive tier; covers all 38 treatments without restrictions. 

Here are the 3 steps to choose your Hospital Cover tier.  

Choose your private health insurance tier in three easy steps. Illustration of stick figure leaping between 1 and 2, with step 3 just above.
Image credit: Shutterstock

Make a list of the hospital services, (known as clinical categories), you might need in the near future – especially if you want the option of being treated privately for those procedures. Take into account any injuries or issues you’ve had in the past, your family history of illnesses, as well as treatments that might reflect your family needs in the future (for example, Assisted Reproductive Services for fertility treatments, or Pregnancy and Birth for childbirth in a private hospital).  

Once you know what hospital services you want covered, work out how much you can afford to spend on your health insurance premium. The cheapest tier of Hospital Cover is Basic, but Basic policies offer minimal cover and may not be useful if and when you need to claim. If you’re not sure how far your budget will stretch, use the healthslips.com.au calculator and choose one of the mid-range tiers, such as Bronze or Silver. Once you see the premiums in your results, you’ll be able to adjust your tier higher or lower to suit your budget.  

What’s the best Basic hospital cover? 

‘Plus’ policies allow you to get more cover within the same tier, without paying the premiums of the higher tier. For example, a Bronze Plus policy will give you more cover than a Bronze tier policy without having to pay Silver premiums. Because you’ll get more cover for slightly more money, Plus policies can sometimes work out better value – especially if you have higher healthcare needs. A Gold tier policy might be out of your budget, for example, but a Silver Plus policy will give you almost as much cover for a lower price. 

Is a Bronze Plus policy better than Bronze? 

Is a Silver Plus policy better than Silver? 

Essential to know

If you’re looking for a treatment that isn’t on Hospital Cover, it might be under Extras Cover, which is for healthcare outside of hospital like physiotherapy, optical, dental and acupuncture. Extras Cover policies don’t have tiers but can include up to 27 treatments. The more treatments covered, the more you will pay.  

Jump onto the healthslips.com.au calculator, answer a few simple questions, choose the tier you want and the treatments you want covered, and calculate your best options. Our calculator compares every health insurer in Australia without commercial bias, and you can search anonymously. You can also compare policies at different tier levels, to make sure you’re getting the best level of cover at the best price for you. Give it a go – search for a new Hospital Cover policy, or compare your current policy to others that are available.  

healthslips.com.au does not provide general or personalised advice. Your particular circumstances are likely to impact the accuracy, completeness and relevance of the information or results. Take this into account before making a decision and talk to an expert for financial advice.  

Trudie McConnochie
Writer and Researcher

Knowledge is power – that’s the guiding principle behind everything Trudie writes, and it’s a philosophy she brings to her work at healthslips.com.au. By breaking down complex information into easy-to-understand blogs and stories, she aims to empower Australians to make the best choices and an informed decision around private health insurance.

Trudie understands firsthand some of the complexity of private health insurance having moved to Australia from New Zealand and having to navigate a vastly different public healthcare system and health insurance structure.

Trudie holds a Bachelor of Communication Studies (journalism major) from the Auckland University of Technology.

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