The Four Government-Standard Hospital Tiers
Since 2019, every hospital policy in Australia must fall into one of four standardised tiers — Basic, Bronze, Silver or Gold — so you can compare tiers across insurers and know roughly what's covered, regardless of the insurer's own marketing name for the product.
Gold
The highest level, covering all 29 clinical categories, including pregnancy and birth, joint replacements, cataracts, and weight loss (bariatric) surgery. If you're planning a family or likely to need major surgery, Gold is the tier that guarantees cover without gaps.
Silver
Covers 24 required clinical categories, including heart and vascular system, lung and chest, back and spine, and dental surgery — a strong mid-tier option, though some categories remain optional for the insurer to include or exclude even within Silver.
Bronze
Covers 16 mandatory clinical categories — standard procedures like bone and joint issues and gastrointestinal treatment — but excludes higher-tier treatments like joint replacements and pregnancy care entirely.
Basic
The entry-level tier, with only three mandatory categories: rehabilitation, hospital psychiatric services, and palliative care. Most other treatment categories are optional or restricted, and Basic exists mainly to satisfy the Medicare Levy Surcharge exemption at the lowest possible premium, not to provide broad cover.
Why the Tier Name Alone Isn't Enough
Insurers can add extra categories within a tier beyond the mandatory minimum (a 'Silver Plus', for instance), so two Silver policies from different insurers can genuinely cover different things. Always check the Standard Information Statement's category list, not just the tier name.
This page is for educational purposes and isn't personalised financial or medical advice. Premiums, rebates, thresholds and eligibility vary by insurer, policy and individual circumstances — always check the Standard Information Statement and Product Disclosure Statement before buying.