Get Top Private Health Insurance With Gold Hospital Cover
Confused about which hospital cover is best for you? Don't worry, we've got you covered! In Australia, there are four levels of hospital cover to choose from based on your budget and healthcare requirements.
At the very top is Gold, providing the most extensive coverage across all 38 clinical categories. If you’re looking for the best of the best hospital insurance for the ultimate peace of mind, you can’t go past gold hospital cover.
In this guide, we'll simplify Gold hospital insurance for you. From understanding hospital costs to out-of-pocket costs, we'll walk you through all the essential information you need to find the perfect level of cover and health fund provider for your needs.
What is Gold Health Insurance?
When it comes to health insurance, the Gold tier is like having the VIP pass. It's the highest level of cover you can get, offering you comprehensive protection for in-hospital procedures. Whether you choose a private or public hospital, you'll be covered for all the treatments listed on the Medicare Benefits Schedule (MBS) as a private patient.
Here's how it works:
When you go in for treatment, your health fund may cover 25% of the MBS fee, along with other hospital charges like accommodation, theatre fees, medicines, and dressings. The remaining 75% of the MBS fee is covered by Medicare. Keep in mind that if your doctors decide to charge more than the MBS fee, you may have to pay the difference out of pocket.
Now, depending on where you live, your Gold hospital insurance might also include coverage for ambulance services. In QLD for example, ambulance services are covered by the state government, so you don't need to worry about it. However, if you're in another state like NSW, it's a good idea to consider a policy that includes ambulance cover, as it's not covered by the state government there.
With Gold hospital insurance, you'll have peace of mind knowing that you have extensive coverage, making it a top choice for many Australians.
What Does Gold Health Insurance Cover?
When you have Gold health insurance, you can rest assured that you're covered for a wide range of medically necessary inpatient hospital treatments.
Here's what's included within the 38 clinical categories:
- Hospital psychiatric services
- Palliative care
- Brain and nervous system treatments
- Eye treatments (excluding cataracts)
- Ear, nose & throat procedures
- Tonsils, adenoids, and grommets
- Bone, joint, and muscle treatments
- Joint reconstructions
- Kidney and bladder procedures
- Male reproductive system treatments
- Digestive system procedures
- Hernia and appendix surgeries
- Gastrointestinal endoscopy
- Gynaecology treatments
- Prostheses (not including external prostheses like prosthetic limbs or external breast prostheses)
- Miscarriage and termination of pregnancy services
- Chemotherapy, radiotherapy, and immunotherapy for cancer
- Colonoscopy procedures
- Pain management options
- Skin treatments
- Intensive care
- Medically necessary breast surgeries
- Diabetes management (excluding insulin pumps)
- Heart and vascular system treatments
- Lung and chest procedures
- Blood-related services
- Back, neck, and spine treatments
- Medically necessary plastic and reconstructive surgeries
- Dental surgeries
- Podiatric surgeries (provided by a registered podiatric surgeon)
- Implantation of hearing devices
- Cataract procedures
- Joint replacements
- Dialysis for chronic kidney failure
- Pregnancy and birth services
- Assisted reproductive services
- Weight loss surgeries
- Insulin pumps
- Pain management with devices
- Sleep studies
With Gold health insurance, you can have peace of mind knowing that you have coverage for a comprehensive range of treatments and services.
How Does Gold Cover Compare to Silver and Bronze?
When it comes to health insurance, Gold is the ultimate level of coverage you can get. It goes above and beyond by covering all 38 clinical categories for hospital services and treatment. That's a whopping 9 more categories than what's covered by Silver policies and a generous 17 more categories than Bronze policies.
One of the great things about Gold health insurance is that it must provide total and unrestricted* cover for all these categories, ensuring you have comprehensive protection. It even includes unrestricted cover for important services like rehabilitation, hospital psychiatric services, and palliative care. These services may be offered on a restricted^ or unrestricted* basis under lower-level Silver, Bronze, or Basic tiers.
Now, it's worth noting that because Gold health insurance offers such extensive coverage, it tends to be more expensive compared to Silver, Bronze, or Basic policies. But if you prioritize comprehensive coverage and peace of mind, it could be well worth the investment.
With Gold health insurance, you can rest easy knowing that you're getting the highest level of coverage available, giving you access to a wide range of hospital treatments and services when you need them most.
Pros and Cons of Gold Hospital Cover
Comprehensive coverage for treatment in a private hospital.
The only tier that includes coverage for pregnancy and childbirth.
Covers important services like rehabilitation, hospital psychiatric services, and palliative care.
Gold cover can be expensive, often exceeding $150+ per month.
If you don't require certain services like pregnancy coverage, a Gold policy will still charge you for them, making it more coverage than you might actually need.
Doesn't provide coverage for outpatient services unless you have additional extras cover.
Who Will Benefit From Gold Hospital Cover?
Deciding if a Gold plan is right for you depends on your specific circumstances. Here are some scenarios where upgrading to Gold cover might be worth considering:
Starting a family: If you're planning to have a baby and want the comfort of a private room during childbirth, a Gold hospital policy is what you'll need. It provides coverage for pregnancy, birth, and assisted reproductive services like IVF.
Older Australians: As we age, certain conditions become more common. Gold coverage includes treatments that are particularly beneficial for older Australians. For example, cataracts and joint replacements are covered under Gold policies.
Complex needs: Some individuals may require treatments that are only covered by Gold-tier health insurance. If you have complex medical needs, here are a few Gold treatments that could be relevant to you: dialysis for chronic kidney failure, weight loss surgery, insulin pumps, pain management devices, and sleep studies.
Remember, these are just a few examples to help you understand the potential benefits of Gold cover. It's important to assess your individual needs and consider whether the additional coverage and higher cost of a Gold plan align with your specific requirements.
Is Gold the Best Health Insurance Option?
When it comes to covering a wide range of clinical categories and hospital treatments, Gold is considered the top tier of health insurance for hospitals. However, don't worry if Gold seems overwhelming or too expensive for you. There are other options available too!
You can also find health insurance policies with 'Plus' or '+ ' tiers. These policies offer some of the benefits of higher-level tiers without the full price tag. So, it's worth exploring all your options and comparing what each policy offers. Consider things like what's included, any restrictions or exclusions, and the premiums you'll need to pay. Your ideal coverage will depend on your specific needs and budget, so take your time to find the best fit for you.
Is Gold Hospital Cover Worth it?
Gold health insurance can be a great investment if you'll benefit from the extra coverage it provides. For example, if you're planning to start a family or need joint replacements, Gold can offer the comprehensive coverage you're looking for.
But, keep in mind that if Gold is beyond your budget or includes coverage you don't need (like pregnancy-related services for older Australians), there are other options to consider. You might find that a Silver Plus or Bronze Plus policy suits you better. These policies can still offer coverage for some treatments found in Gold, and they may even be more affordable.
For instance, if you're concerned about future knee replacement surgery, you might discover a Silver Plus policy that covers 'Joint replacements'. It's a way to get the coverage you need without straining your finances. Remember, finding the right health insurance is about finding the best match for your needs and budget.
Is Silver Plus Health Insurance a Better Option for You?
If the comprehensive coverage of Gold health insurance feels like too much or exceeds your budget, you might want to consider a Silver Plus policy instead. It's a step below Gold, but it can still provide the coverage you need while potentially saving you some money.
Silver Plus policies include all the 26 services covered by Silver-level health insurance in private hospitals, and on top of that, they offer one or more services from the Gold level. This means you can get specific coverage without paying for all the extras that come with Gold.
For instance, if you're specifically looking for pregnancy-related coverage, a Silver Plus policy might be a perfect fit. It can include pregnancy and birth, including fertility treatments like IVF. And the best part? It could be more affordable than a Gold policy that offers a full range of services.
What's Included in Silver Plus?
With a Silver Plus policy, you get everything covered by Silver policies, plus at least one of the following additional services:
- Pregnancy and birth, including fertility treatments like IVF
- Joint replacements
- Rehabilitation in a private hospital
- Hospital psychiatry in a private hospital
- Palliative care in a private hospital
- Gastric banding and obesity surgery
- Insulin pumps
- Sleep studies
- Pain management with a device (such as a surgically implanted device to manage pain caused by heart disease)
By choosing a Silver Plus policy, you can customise your coverage to meet your specific needs while keeping costs in check. It's all about finding the right balance for you.
What are the different tiers of hospital insurance?
The Australian Government introduced reforms in 2019 to make private health insurance simpler. As a result, hospital policies are now divided into four tiers: Basic, Bronze, Silver, and Gold health insurance.
Do waiting periods apply to Gold tier policies?
Waiting periods work the same way for Gold tier policies as they do for all hospital insurance policies, as they are regulated by the government.
If you upgrade to a Gold tier hospital insurance policy, you'll only need to serve waiting periods for the services that are newly added to your cover. You won't have to re-serve any waiting periods you've already completed.
Can I get a Gold Plus policy?
No, Gold Plus health insurance policies are not available. Gold is already the highest tier, covering all clinical categories.
However, you can find 'plus' policies in the Silver, Bronze, or Basic tiers. These 'plus' policies may offer coverage for treatments typically found in higher-level tiers, but they might come with additional premiums.
Can I get a Gold extras health insurance policy?
Gold health insurance policies are specifically for hospital coverage. Extras cover policies are no longer categorised using metal or gemstone names like 'Diamond' or 'Platinum.' However, you can still find a wide range of extras policies, including top-level options. Some combined policies may be named Gold hospital and extras, offering both hospital and extras coverage.
How much does Gold health insurance cost?
Gold health insurance generally comes with a higher price tag compared to Silver or Bronze options, although the actual cost can vary. The price of your Gold health cover depends on the specific inclusions of your policy and the health fund you choose.
Keep in mind that factors such as the Australian Government Rebate, Lifetime Health Cover loading, Medicare Levy Surcharge, and age-based discounts can impact your total premiums. It's important to consider these factors when selecting a policy.
Can I take out gold hospital cover with a pre-existing condition?
Yes, you can take out Gold hospital cover even if you have a pre-existing condition. The government regulations for health insurance policies, including Gold tier policies, allow coverage for pre-existing conditions.
Ready to Take Out Gold Hospital Cover?
Looking for the right hospital and extras cover policy can feel overwhelming, but we're here to help! We understand that cost is just one factor to consider - finding a policy that meets your unique healthcare needs is essential.
That's why we've developed an easy-to-use online comparison tool that's designed to save you time and effort. With just a few clicks, you can compare different policies and find the one that suits you best.