Simplifying levels of cover

It’s about to become simpler to find the health insurance coverage that suits your needs.

One of the major changes introduced as part of the Australian Government’s private health insurance reforms is the introduction of a consistent tiered system for hospital cover across every health fund. This change is designed to help members better understand their existing products and also compare more easily between health funds.

This will mean that all Hospital and Combination products will fall under one of a series of new product tiers – Gold, Silver, Bronze and Basic.

What are the Gold, Silver, Bronze and Basic tiers of cover?

In order to make choosing hospital cover simpler and more transparent, each of the new tiers will contain a minimum set of included services and use a set of standardised clinical categories, making it clearer what is (and isn’t) covered by each policy.

Each tier will be defined consistently across the industry. This means, if you are looking at a “Silver” level of cover at one fund, you can be assured that it will include the same services across all funds. If there are additional services above the minimum are included, the name will include a ‘Plus’ or ‘+’, for example ‘Silver Plus’.

Why are our covers changing?

Being reforms that are put in place by the Federal Government, these tiers and their minimum clinical categories will apply to all private health insurance hospital products across Australia.

What it means for you is that if you have hospital cover, it will fall under one of the new health insurance product tiers and the name of your product will also change to reflect this.

When will these changes be happening?

As part of the Government reforms, all health funds have been granted a 12-month transitional period to implement the tiering system, with all Hospital and Combination products to be categorised under the four new tiers by 1 April 2020.

Australian Unity will be implementing the tiering system by 1 July 2019 and have recently contacted members to advice of the specific changes to their existing policies.

Additional information

View the new Hospital tiers and the minimum clinical categories included for each

View a definition of each of the clinical categories