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Bronze tier hospital insurance

Bronze cover: What is covered by the third-highest tier of hospital insurance policies?

The health insurance industry is being shaken up by a range of reforms and one of those reforms is the introduction of a new tiered system for hospital policies: Gold, Silver, Bronze and Basic.

What is the Bronze tier hospital cover?

A Bronze policy is a step up from basic, which under the new system is the lowest level of hospital cover. A Bronze policy gives you unrestricted access to benefits for 18 clinical categories, with access to a further 3 clinical categories on a restricted basis.

However, under the new tiered system, health funds can provide "Plus [+]" options, in this case a Bronze Plus [+] policy, which would provide coverage that is above the minimum requirements of the Bronze tier.

Fund Policy Name Cost per month Apply
ahm logo Starter Bronze $86.80 Go to Site
nib helath insurance logo Bronze Starter Hospital Plus $87.45 Go to Site
HCF health insurance Bronze Plus $91.60 Go to Site

price is for a single individual in NSW with $500 Excess

What does the Bronze hospital tier cover?

If you're not after comprehensive cover and only want cover for the basics, a Bronze policy might be right for you as it offers about 48% of the treatment categories covered by a Gold policy and roughly 70% of the treatment categories for the Silver tier. At a minimum, a Bronze tier hospital policy includes:

  1. Bone, joint and muscle
  2. Brain and nervous system
  3. Breast surgery (medically necessary)
  4. Chemotherapy, radiotherapy and immunotherapy for cancer
  5. Diabetes management (excluding insulin pumps)
  6. Digestive system
  7. Ear, nose and throat
  8. Eye (not cataracts)
  9. Gastrointestinal endoscopy
  10. Gynaecology
  11. Hernia and appendix
  12. Joint reconstructions
  13. Kidney and bladder
  14. Male reproductive system
  15. Miscarriage and termination of pregnancy
  16. Pain management
  17. Skin
  18. Tonsils, adenoids and grommets

In addition to these 18 clinical categories, Bronze tier also offers cover for the following clinical categories on a restricted basis:

What is bronze plus (+)?

From 1 April 2019 the health insurance reforms mean that health funds can offer a "Plus [+]" option for policies outside the gold tier, in this case a Bronze Plus [+] policy.

What this means is a policy with Plus [+] provides cover above the minimum requirements of the bronze tier. For example, ahm offer a bronze plus policy that in addition to the minimum benefits required for a bronze tier policy, ahm core bronze plus (Bronze Plus) offers benefits for:

  • Lung and chest
  • Blood
  • Back, neck and spine
  • Plastic and reconstructive surgery (medically necessary)
  • Dental surgery
  • Podiatric surgery (provided by a registered podiatric surgeon)
  • Implantation of hearing devices

Who can benefit from Bronze hospital insurance?

If you're looking for a hospital policy that offers a baseline of cover without breaking the bank, a Bronze policy may be for you. Those who may find benefits from a Bronze policy include:

Women

As part of the reforms to the private health insurance system, women are now able to claim for a range of services on Bronze tier cover and above including for:

  • Breast and ovarian cancer treatment
  • Breast reconstruction
  • Gynaecological services

However, it's worth pointing out that if you want cover for pregnancy and treatments such as IVF, you're going to need to get a Gold policy.

Young people

If you're fit, healthy and don't plan on having children anytime soon, a Bronze policy should provide you with adequate cover. And to sweeten the deal, if you're aged between 18 and 25, insurers can now start offering you 10% off your hospital premiums until you turn 40.

When are these changes happening?

The new tiered system came into effect on 1 April 2019 and many insurers have already begun rolling out Gold, Silver, Bronze and Basic policies. However, health funds have until 1 April 2020 to make sure all their products are compliant with these tiers.

Picture: Unsplash

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