What changes to health insurance mean for women’s health
From breast cancer to fertility treatments, here’s what the changes to health insurance mean for women’s health.
Medibank is rolling out all of the Government’s health insurance reforms to help make health insurance easier to understand and more affordable. One of the key changes is categorising all hospital covers as Gold, Silver, Bronze and Basic.
Read on to find out which services are included in each classification from a women’s health perspective. The changes may be good news for those looking for a cost-effective option that includes gynaecology and breast cancer treatment.
Understanding Gold, Silver, Bronze and Basic cover
Under the new system, hospital cover will be categorised as Gold, Silver, Bronze or Basic.
Each product classification will include the same minimum set of hospital services (called standard clinical definitions or clinical categories) and health insurers across the industry will talk about them in the same way. For example, no matter which health fund you are with, Bronze hospital covers will include joint reconstructions, while all Gold hospital covers will include pregnancy and birth services.
Keep in mind that waiting periods apply to hospital services including a 12 month waiting period for pregnancy and birth services and any pre-existing health conditions. And if you are going to hospital, don’t forget to give your health insurer a call to check what’s included in your cover, and whether any out of pocket expenses may apply.
What do the new classifications mean for women’s health services?
Bronze health insurance includes treatment for breast and ovarian cancer
All Bronze hospital covers will include treatment for cancer treatment, including chemotherapy, radiotherapy and immunotherapy of cancer or benign tumours.
Bronze hospital cover also includes gynaecology and medically necessary breast surgery, which means you can claim benefits towards breast or ovarian cancer surgery.
One of the key benefits of having your cancer treatment in a private hospital is having more choice about your specialists and hospital.
Bronze hospital cover includes gynaecology services
A range of gynaecological hospital treatments will be included in all Bronze hospital covers. This includes the investigation and treatment of conditions like endometriosis, polycystic ovaries, cervical cancer, prolapse of the uterus or fibroids.
If you access gynecological services through private health insurance you may have the option to choose your preferred specialist. If it’s elective surgery and there is a waiting list in the public system, you may also be able to have your surgery sooner in a private hospital.
Silver health insurance includes medically necessary plastic and reconstructive surgery
Silver hospital cover includes medically necessary reconstructive surgery, for example, breast reconstruction following a mastectomy. If there is a waiting list in the public system, you may also be able to have your surgery sooner in a private hospital and have more choice over your surgeon.
READ MORE: Find out more about what is included under Gold, Silver, Bronze and Basic hospital covers here.
Gold health insurance includes pregnancy and birth support, and assisted reproductive services like IVF
Gold hospital cover is the only classification that includes all 38 clinical categories that have been set out by the Government. It includes all of the services from Silver and Bronze hospital cover, like gynaecology and cancer treatment, as well as pregnancy and birth services.
Gold hospital cover also includes assisted reproductive services. This means you can claim towards hospital treatments involved in in-vitro fertilisation (IVF).
It’s important to remember, a 12 month waiting period applies for pregnancy and birth services. And if you’re experiencing fertility issues, you will have to wait 12 months after taking out Gold hospital cover to claim for assisted reproductive services. This is because it is considered a pre-existing condition.
Gold, Silver, Bronze, or Basic: what’s right for me?
If you're looking for hospital cover — or your hospital cover has changed to align with the new classifications — you may be thinking about whether Gold, Silver, Bronze or Basic cover is right for you.
Thanks to the changes to health insurance, women with a family history of cancers or gynecological issues — or those who may be at risk of these conditions — can have peace of mind knowing that Bronze hospital cover may be a suitable option..
However, most women’s health needs go beyond cancer and gynaecology, so it’s still important to carefully compare what’s included in Gold, Silver, Bronze and Basic and check for other services you might need.
Read more about Gold, Silver, Bronze and Basic here.
New health insurance classifications explainedRead more
The changes will mean different things for different peopleRead more
Help navigating the Australian healthcare system.Read more
How everyone gets a fair go at health insurance.Read more