Gold Hospital Cover

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.

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.

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 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.

FAQs

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.