6.2 million Aussies in the dark about hospital cover

7 March 2019, Sydney, Australia - Millions of Aussies are signed up to hospital cover without knowing what it provides, according to research from Finder, Australia's most visited comparison site.

The survey of 1,217 Australians with hospital cover found 55% – equivalent of 6.2 million policyholders – aren't across the details of their policy.

The biggest source of confusion was over which procedures are included, with one in five (22%) admitting they have no idea about what they would be covered for.

To make private health insurance simpler, the Australian government has announced reforms including Gold, Silver, Bronze and Basic product tiers for hospital cover.

With these reforms coming into effect as early as 1 April, Sophie Walsh, insurance specialist at Finder, says this is the perfect time to reevaluate your policy.

"The reality is health insurance often falls into the 'set and forget' basket. Many of us signed up years ago, so it's understandable we don't remember all the ins and outs of hospital cover."

"Now is the time to pay attention to your hospital policy. Take a closer look at not just the cost but also the restrictions and any exclusions."

A further 18% are unsure about cover limits for certain procedures and don't know how much of a payout they'd receive for claims.

Disturbingly, one in six (16%) said they have absolutely no idea what their hospital policy actually covers.

"Not knowing what you're covered for could leave you with a rejected claim, and a big bill to pay. Invest a few moments of your time reading the PDS and if you aren't sure about anything give your health fund a call to get the facts straight from the horse's mouth."

Baby Boomers are by far the most informed generation, with 68% of older policyholders saying they understand the fine print of their hospital cover.

Unsurprisingly, the younger generations are the least in tune, with only 34% of Generation Y understanding their cover.

How to decide which tier is right for you
Here's a breakdown of which tier and what it typically includes

• Gold: As its name suggest, Gold is the highest tier for hospital insurance. It provides a range of services that aren't covered in other tiers. This is the policy to be on if you're starting a family and you want to have a private room. It's also a good option for seniors as benefits for cataracts and joint replacements are only available on Gold.
• Silver: Silver health insurance will cover about 68% of the procedures that are offered by a Gold tier hospital policy. If you're not planning to start a family in the near future but still want reasonable coverage, then a Silver policy might be a good choice.
• Bronze: If you're not after comprehensive cover but want to cover the basics, Bronze will cover roughly 48% of what's covered on a Gold policy. If you're after a hospital policy that offers a baseline of cover without breaking the bank, a Bronze policy may be for you.
• Basic: Basic hospital provides a limited range of cover for bare essential medical services at an affordable price. It's a good choice if you're young or if you're a high income earner wanting to avoid the Medicare Levy Surcharge.