Gold, Silver, Bronze and Basic: Private health insurance tiers explained

Not sure which tier of Hospital cover is right for you? Let's explore the differences between Gold, Silver, Bronze and Basic Hospital cover.

What are private health insurance tiers?

With so many options to consider, finding the right health cover can feel overwhelming. That’s why the Australian Government standardised the options for Hospital cover to make it simpler and easier to choose, by separating them into Gold, Silver, Bronze and Basic levels, or 'tiers'.¹ Each tier includes a minimum number of clinical categories, with each higher level including more than the one before.

Let’s break down what each tier offers and how to compare them to find the right cover for your health needs. The key difference between Hospital cover tiers is the minimum clinical categories they include. The tiers are separated as:

Basic Hospital cover

Entry-level Hospital cover with minimal clinical inclusions.

Bronze Hospital cover

Lower-level Hospital cover with standard clinical inclusions.

Silver Hospital cover

Hospital cover with a wider range of clinical inclusions.

Gold Hospital cover

Comprehensive Hospital cover with all clinical inclusions.

Alway read the cover summary of product disclosure statement (PDS) carefully before choosing your new health cover.

What does Hospital cover 'Plus' mean?

Health funds can differentiate their hospital products by adding extra clinical categories in addition to what’s required by each tier. That’s where Plus policies come in – they offer extra inclusions beyond the standard tiers. However, Gold can’t be a Plus policy since it already includes all clinical categories.

For example, a Bronze Plus policy includes the minimum clinical categories for the Bronze tier, plus some from the Silver and/or Gold categories. The extra clinical categories included in Plus policies can vary between health funds.

When to consider each tier

When should you consider Gold Hospital cover?

Gold Hospital cover is the most comprehensive of all the tiers. It pays benefits towards several clinical categories typically not included with lower tier covers.

Don’t need top tier Hospital cover? The main difference between Medibank Gold Protect (one of our highest Hospital covers) and Medibank Silver Plus Secure (one of our highest Hospital covers in the Silver tier) is that Medibank Gold Protect pays benefits towards:

Weight loss surgery
Pregnancy and birth
Assisted reproductive services
Hospital psychiatric services are included rather than restricted.

So, if you expect you’ll need any of these in the near future, Gold cover may be a suitable choice.

When should you consider Silver Hospital cover?

You might consider Silver Hospital cover if you don’t need all the inclusions of Gold cover, to help you feel more in control of your health than with Bronze or Basic cover.

Silver includes more clinical categories than lower-level covers, so if you want support for things like heart & vascular, lung & chest or implantation of hearing devices but don’t want to start or expand your family any time soon, Silver cover could be right for you.

Want more options during an emergency? You could get added support from a Private Emergency Department Benefit^> available on Silver Plus Support, Silver Plus Secure and Gold Protect Hospital covers.

When should you consider Bronze Hospital cover?

Bronze Hospital cover may be suitable for people who are looking for a lower level of Hospital cover at a lower price. It includes a range of more common procedures, such as:

Gastrointestinal endoscopy
Chemotherapy, radiotherapy and immunotherapy for cancer
Bone, joint and muscle
Gynaecology
And more…

Bronze Hospital cover could also be right for you if you need support for common kids’ treatments, like tonsil or grommet removals.

Overall, it may be a suitable level of cover to consider for younger families or single people who want simple cover without the higher premiums of silver or gold cover. With Medibank, you’ll also have one less worry with no hospital excess for kids on all family covers.^@

When should you consider Basic Hospital cover?

Basic cover may be suitable for the young and healthy, who don’t anticipate needing hospital treatment.

At Medibank, our Basic Plus Healthy Start includes joint reconstructions, dental surgery, hernia and appendix and more to support the young and healthy for treatment they may need like wisdom teeth surgery or removing the appendix.

It’s important to note that you could save money on tax with Hospital cover if you earn more than $97k as a single or $194k as a family, couple or single parent. You could be paying an additional tax surcharge of 1% (up to 1.5%) of your income if you or any of your dependents don’t hold an appropriate level of Hospital cover for the full financial year.*

You can use our Medicare Levy Surcharge Calculator to find out how much extra tax you could be paying without Hospital cover.

Remember, there are 12-month waiting periods for pre-existing conditions across all tiers as well as pregnancy and birth services.

Finding the right Hospital cover for you

Ultimately, choosing the right level of Hospital cover for you depends on your health needs, your life stage, and your budget. To make an informed decision, review and compare the services included in each tier, and consider Plus policies if you need additional services, as any admission for an excluded service will mean you’re faced with significant out-of-pocket costs.

Explore our hospital cover options

If you have questions about a Medibank cover, our friendly team is available to talk to you. Request a call back, message us online, or visit us in store.

More than just health insurance

Eligible Medibank members with Hospital cover can access a range of programs designed to manage their health conditions and provide access to more affordable care options.

View our health programs

Back to Health Insurance Basics

Why consider Medibank?

Accident Cover Boost

If you have an Accident, you’ll have access to all clinical categories included in Gold level Hospital cover, no matter what level of Hospital cover you have, thanks to our Accident Cover Boost.⁺

Unlimited Emergency Ambulance

No matter which Hospital or Extras policy you choose, you'll have the peace of mind that comes from knowing that your cover includes unlimited emergency ambulance.^

Medibank Member perks

Explore an abundance of rewards, discounts, offers, services, and health programs that can help you live better.

Get a quote View current offers

Want to discuss your options?

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Things you should know

¹ Australian Government: Department of Health and Aged Care; Private health insurance reforms; retrieved March 2025.

^> Two month waiting period applies. We'll pay a benefit up to an annual limit per membership towards any admission fee ("facility fee") charged by the Private Hospital for patients attending a Private Accident and Emergency Department. The fee amount varies by Private Hospital and does not include medical and other charges (such as charges for diagnostic imaging or pathology), so out of pocket expenses may still apply. Only available at Private Hospitals with an Accident and Emergency Department. Members will need to submit a claim to receive the benefit and may have to pay upfront.

^@ Other out–of–pocket expenses may apply.

* The single parent/couple/family income threshold is increased by $1,500 for each MLS dependant child after the first child. 'Income’ and 'dependants' have a specific meaning for Medicare Levy Surcharge purpose. Learn more.

⁺ For Accidents that occur in Australia after your cover starts. Must seek medical treatment within 7 days, and receive hospital treatment within 12 months of the Accident occurring. Excludes Private Emergency Department Benefit, hospital bonus, claims covered by third parties and our Private Room Promise. Out-of-pocket costs may apply.

^ Waiting period applies. For ambulance attendance or transportation to a hospital where immediate medical attention is required and your condition is such that you couldn't be transported any other way. TAS and QLD have State schemes that provide ambulance services for residents of those States.