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:
- Bone, joint and muscle
- Brain and nervous system
- Breast surgery (medically necessary)
- Chemotherapy, radiotherapy and immunotherapy for cancer
- Diabetes management (excluding insulin pumps)
- Digestive system
- Ear, nose and throat
- Eye (not cataracts)
- Gastrointestinal endoscopy
- Gynaecology
- Hernia and appendix
- Joint reconstructions
- Kidney and bladder
- Male reproductive system
- Miscarriage and termination of pregnancy
- Pain management
- Skin
- 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:
- Rehabilitation
- Hospital psychiatric services
- Palliative care
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.
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