We get it – our older members will (understandably) question why they can’t remove Pregnancy and Birth from their Gold Top Hospital Cover. Meanwhile, other members will ask to remove clinical categories such as Gynaecology or Male reproductive system from their Hospital Cover, explaining they are absolutely certain they will never need these services. It’s not just HIF members asking these questions. Why? Because the clinical categories included on your Hospital Cover have been pre-determined by the Australian Government and are consistent across the entire Australian Private Health industry.
What does that mean?
Since 1 April 2019, it has been compulsory for all Hospital Cover products in Australia to be classified as Basic, Bronze, Silver, or Gold.
Each tier has a minimum requirement of specific clinical categories that must be included.
Funds can choose to include additional clinical categories, but they can never cover less than the minimum requirement.
Example: You will always be covered for both Gynaecology and Male Reproductive System when you maintain Bronze Hospital Cover, regardless of which fund you hold that Hospital Cover with
View the Private Health Insurance Reforms to see the services that must be covered under each tier.
Who does this benefit?
The Government’s consultations identified that Members find hospital insurance products difficult to understand and compare. Members have also advised they find it difficult to understand what services different products do, and do not, cover.
Introducing the simplified product tier system offers Members greater certainty about the services covered by each type of hospital treatment product, making it easier to shop around and compare different hospital treatment products to find one that meets your individual needs and circumstances.
I thought I had freedom to choose?
To ensure there is still some ability for insurers to differentiate themselves in the market, health funds are allowed to introduce ‘Plus’ products. These ‘Plus’ products offer more choice to members who may want a little more cover than what one tier of Hospital Cover offers, but don’t want to pay for all the extra categories included in the next tier. We’ve kept it pretty simple here at HIF, and named ours Basic Plus, Bronze Plus and Silver Plus.
View the Hospital cover comparison table see a side-by-side comparison of the services included on all levels of domestic Hospital Cover at HIF.
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