Bronze cover: What is covered by the third-highest tier of hospital insurance policies?
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|
|Starter Bronze||$86.80||Go to Site|
|Bronze Starter Hospital Plus||$87.45||Go to Site|
|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:
- 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
- Hernia and appendix
- Joint reconstructions
- Kidney and bladder
- Male reproductive system
- Miscarriage and termination of pregnancy
- Pain management
- 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
- 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:
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.
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.