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Gold Health Insurance
Compare quotes for gold hospital cover insurance from some of Australia’s leading health insurers here through Savvy.
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Gold health insurance is the highest level of hospital cover available in Australia today. It offers full coverage for all eligible treatments as a private patient in a hospital setting. However, the coverage offered by health funds can vary widely, as can the price, which is why it’s important to compare policies before deciding which one is right for your individual circumstances.
Here at Savvy, we make it easy to compare policies offered by health funds. Our partner’s panel of providers include some of the most trusted health funds in Australia. By answering a few simple questions about the insurance you’re after, you can have multiple quotes from health funds delivered online side-by-side. Start comparing gold tier health insurance policies here through Savvy today!
What is gold health insurance?
In 2019, the Australian Government introduced legislation to help Aussies compare health insurance policies. These new laws made it compulsory for insurers to cover a set number of services for each tier of health insurance provided.
There are four tiers of cover available in Australia: gold, silver, bronze and basic. Out of these, gold tier covers the highest number of clinical categories (all treatments available through Medicare), but it is also the most expensive level of cover.
Hospital cover can assist with the cost of treatments received while an inpatient in hospital. It typically covers the following for a hospital stay (either in a private hospital or as a private patient in a public hospital):
- Consultations with doctors, specialists and anaesthetists while an in-patient
- Tests administered prior to surgery or post-op in hospital, such as x-rays, CT and MRI scans while an in-patient
- Theatre fees and hospital accommodation fees
- The cost of surgery or other treatments received as an inpatient
- The cost of providing food and other services as a private patient
- The cost of most medications and pharmaceuticals given to a private patient
- Specified allied health services such as psychiatrists, psychologists, nutritionists and pain management specialists who deliver their services to you as an inpatient
- Ambulance cover*
*Not included in all hospital cover. Ambulance cover differs between states and territories, with some providing free cover to residents for transport within their state or nationally. Check with your state ambulance provider or health insurer for details of any cover offered.
Savvy can help you compare gold tier health insurance policies from a number of leading health funds in Australia right here. Just answer a few simple questions about the type of cover you’re looking for and you can have multiple quotes to compare from our partner’s panel of trusted insurers. If you’re still not sure how health insurance works or what tier would be most beneficial for your health needs, you can ask for a call-back and a health insurance specialist will talk you through your options.
What does gold health insurance cover me for, and what are the exclusions?
Gold tier hospital cover is the only private health insurance level which must provide cover for the following (in addition to the other treatment categories which are covered by basic, bronze and silver policies):
- Joint replacements
- Dialysis for chronic kidney failure
- Pregnancy and birth
- Assisted reproductive services
- Weight loss surgery
- Insulin pumps
- Pain management with device
- Sleep studies
In addition, gold cover is usually the only tier of cover which may provide rebates for laser eye surgery, although not all gold policies offer this coverage, as it’s optional. If you take out a gold tier policy, you can rest assured you’ll have cover for the most comprehensive range of services.
However, even gold tier hospital cover won’t cover you for the following:
- Most MRIs, CT scans and x-rays conducted while you’re an outpatient
- GP visits (which can be at least partially covered by Medicare)
- Breast augmentation or reduction
- Other forms of cosmetic surgery and procedures not considered medically necessary
How do I compare different gold health insurance policies?
There are many different aspects of a health insurance policy to compare when you’re looking at gold tier hospital cover policies side-by-side, including:
Inclusions and exclusions
Each hospital cover policy will come with a private health information statement which details exactly what is and isn’t included in the policy. Compare these details carefully when looking to see which one offers the best value.
Cost
We all want the cheapest health insurance policy, but the cheapest isn’t necessarily the best if it offers an unsuitable level of cover. Compare the total coverage offered by each health fund when choosing between two different gold-tier policies.
Excess cost
This is an amount you may be required to pay if you do have to make a claim on your hospital policy. It can range from zero up to $750 maximum for a single gold policy or $1,500 maximum for a family or couples gold policy. The higher your excess, the lower the cost your hospital insurance may be.
Co-payments
Similar to an excess, a co-payment is an amount you may have to contribute towards the cost of your hospital stay. It can range from zero to $100 a night. By comparing co-payment costs, you may be able to determine which policy will cost you more in out-of-pocket expenses.
Special offers
In addition to the compulsory coverage categories, compare what else the gold policy has to offer in terms of added bonuses or special offers. Since health insurance is very competitive in Australia, some funds offer a variety of sweeteners to attract new clients.
You can compare all of these elements of different insurance policies side-by-side through Savvy.
Types of health insurance
This can help you pay for medical treatment if you need to be admitted to hospital. It can help cover the cost of your admission or accommodation and the fees charged by doctors, surgeons and anaesthetists. It can also cover other costs associated with a stay in a private hospital.
This helps cover the costs of health care treatments outside a hospital setting which aren’t covered by Medicare. This can include major and minor dental treatment, orthodontics, hearing aids, physiotherapy, glasses, contact lenses and podiatry (in most cases with annual limits).
This is a standard health insurance policy designed for a single person, rather than being tailored to cater to the needs of a couple or family. It may include hospital cover plus extras, or either of these types of insurance on their own, depending on what you're after for your health cover.
A family health insurance policy is designed for a family unit including dependent children who may reach up to 31 years of age with some insurers. It offers private health insurance suitable for the whole family and may include shared limits for all members included in your policy.
A health insurance policy aimed at seniors is designed to appeal to people who are in the second half of their life. These are often specific Silver Plus policies that offer the same cover as other health insurance policies, with the exception that pregnancy and childbirth cover may not be included.
Visitors who are in Australia on a temporary basis for travel, work or study may be able to take out Overseas Visitors Health Cover (OVHC). Many visas issued in Australia come with a requirement to take out this type of insurance, which covers visitors who may not be covered by Medicare.
Ambulance cover is generally available either packaged into your private health insurance or on its own as a separate policy or subscription. By having this protection, you could be covered for all eligible ambulance travel in Australia (subject to your insurer's terms and conditions).
The cheapest and most barebones form of private hospital insurance, this can include cover for rehab, in-hospital psychiatric services and palliative care. Having this policy will enable you to avoid paying the Medicare Levy Surcharge (MLS) and Lifetime Health Cover (LHC) loading.
Bronze hospital cover is a step up from basic insurance, including 18 further clinical categories such as ear, nose and throat, bone, joint and muscle, digestive system, joint reconstructions, gynaecology and chemotherapy, radiotherapy and immunotherapy for cancer.
Silver hospital cover is the second-most expensive type of policy and offers the second-most clinical categories. On top of what's offered by basic and bronze cover, it also includes heart and vascular system, lung and chest, blood, hearing device implantation and dental surgery.
The highest level of private hospital insurance available in Australia, gold policies can offer cover for pregnancy and birth, weight loss surgery, assisted reproductive services and insulin pumps on top of all the categories provided by silver, bronze and basic hospital insurance.
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More of your questions about gold hospital cover health insurance
The cost of your gold hospital cover policy will depend on which insurance fund you choose to buy from and the rebates or reductions you may be eligible for. It may also depend on whether you also have an extras policy with the same insurer, or if you choose to buy a combined hospital and extras policy. The rebates you may be entitled to on the cost of your health insurance could include:
- A 2% reduction on the cost of the hospital policy per year for each year that you’re under 30 years of age (capped at a 10% reduction for 18 to 25-year-olds)
- if you earn under $90,000 p.a., a 24.60% health insurance rebate from the Australian Government*
*Figures correct as of February 2023, but subject to change
The standard waiting periods for a gold tier hospital cover policy are:
- 12 months for pre-existing conditions
- 12 months for pregnancy cover
- 2 months for psychiatric care, rehabilitation, and palliative care
- 2 months for all other conditions
No – extras cover is not as tightly controlled or regulated as hospital cover in Australia. Therefore, there are no specific pre-defined levels of cover that have to be offered with certain tiers of extras cover. However, extras cover is often sold at different levels, ranging from the cheapest, most basic policies to the most expensive. The most expensive extras policy could be considered as that fund’s gold-equivalent extras offering.
No – the private health insurance rebate isn’t dependent on the level of cover you buy, but rather on your income and whether you had any hospital cover health insurance at all in the past financial year. So the level of cover you buy won't affect the rebate you’re entitled to, however the premiums may, as the health insurance rebate is paid as a percentage of your premiums.
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Read one of our helpful guides on a range of different ailments and potential hospital or extras treatments to help you find out if they're covered.
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