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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 will allow 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.

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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 what's covered by a Gold policy and roughly 70% of the minimum requirements for the Silver tier. As a minimum, a Bronze tier hospital policy will include:

  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 cover may also offer cover for the following clinical categories on a restricted basis:

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 will now be 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, you'll get 10% off your hospital premiums until you turn 40.

When are these changes happening?

The new tiered system is officially coming into effect on 1 April 2019 and health funds have until 1 April 2020 to make sure all their products are compliant with these tiers.

Picture: Unsplash

Richard Laycock

Richard Laycock is Finder's insurance editor and has been wrangling insurance product disclosure statements for the better part of five years. His musings on insurance can be found across the web including on Money Mag, Yahoo Finance, and Travel Weekly. When he’s not helping Aussies make sense of insurance fine print, he is testing the quality of cocktails in his newfound home of New York. Richard studied Media at Macquarie University and The Missouri School of Journalism and has a Tier 1 Certification in General Advice for Life Insurance.

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