Gold and Silver hospital cover: what's the difference?

There’s a lot to consider when you’re choosing between Gold and Silver hospital cover. Here, we examine the main differences to help you decide.

Choosing between Silver and Gold hospital cover feels like it should be a no-brainer but it can be confusing as they are both comprehensive options that can pay benefits towards a wide range of services. Your ideal cover depends on your individual health needs and budget, not just the policy’s tier.

To help you decide, it helps to understand the tier system first. In Australia, private health insurance policies fall into one of 4 different tiers: Gold, Silver, Bronze and Basic. 

Gold and Silver health insurance policies – which include clinical categories like joint replacements; cataracts; implantation of hearing devices; and heart and vascular – tend to be most suitable for people who need more comprehensive cover. 

Here, we look at what’s included in both Silver and Gold hospital cover to help you decide which is right for you.

What does Silver hospital cover include?

Silver hospital cover is a mid-level option, paying benefits towards 26 clinical categories of services, including heart and vascular; chemotherapy, radiotherapy and immunotherapy for cancer; and implantation of hearing devices.

Silver hospital cover offers more benefits than Bronze hospital cover, which includes the categories ear, nose and throat; diabetes management (excluding insulin pumps) and pain management.

Hospital cover doesn’t include non-hospital treatments like dental, physiotherapy and optical. You’ll need extras cover to get benefits for these services.

What does Gold hospital cover include?

Gold hospital cover is top-tier cover – the highest level available in Australia. It offers comprehensive cover for treatments and procedures not on the lower tiers.

It includes benefits for all 38 clinical categories including rehabilitation, palliative care, cataracts, joint replacements, weight-loss surgery, dialysis for chronic kidney failure and insulin pumps.

Comparing the costs: Gold vs Silver hospital cover

What’s the difference between Gold and Silver cover when it comes to cost? Because Gold cover typically offers a higher level of inclusions, these policies tend to come with higher premiums. Silver cover offers a balance between benefits included and affordability for older people who are generally in good health – and the costs reflect this. 

Once you hit 65 you may be eligible for a greater rebate from the government depending on your income, which would lower the price of your policy.

Whether you choose Gold or Silver cover, private health insurance offers good value as you get older. Your body requires more attention and care, and you’re more likely to need treatment in a hospital once you’re over 65, according to the Australian Institute of Health and Welfare.

Medibank Hospital cover allows you to avoid long public hospital waiting lists for many elective procedures; choose your doctor; boost your chances of a private room, and access a range of Medibank programs. For example, Medibank’s Better Knee, Better Me program helps eligible members with osteoarthritis knee pain, to improve their quality of life. 

How to choose between Gold and Silver hospital cover

To decide between Gold and Silver cover, it’s important to carefully consider your healthcare needs and your budget. Other considerations include if you have specific health concerns or are planning for future surgeries that are included in the higher tiers of cover.

But if you’re seeking a more affordable cover, Silver cover is a great middle ground, providing essential care without the higher premium.

Ultimately, choosing the right cover depends on balancing your health needs, long-term care plans and what fits with your financial situation.

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