Gold hospital cover health insurance explained

If you’ve been doing your homework on private health insurance, you’ll already be familiar with all the other tiers available – from Basic to Bronze to Silver. Now it’s time for Gold to take centre stage!

It can be a daunting task to research all of your options and understand the different tiers of cover that will help you make the best decision for your own healthcare needs. You already know that Gold hospital cover is the highest level of protection available, but what does it actually include and who is it best suited for?

Whether you’re considering upgrading your current policy or exploring your options for the first time, here’s everything you need to know about Gold hospital cover in Australia.

At the most basic level, all you really need to know is that Gold hospital cover is the pinnacle of private health insurance in Australia. It gives you the highest level of protection possible and has premiums to match. You’ll get covered for pretty much everything when it comes to medical treatments and services, and that includes both in-hospital and out-of-hospital care.

If you hold a Gold hospital cover policy then you can expect access to private hospital facilities and have the ability to choose your own doctor or specialist for treatment. With this tier you can also expect coverage for major procedures like heart surgery, joint replacements and cancer treatments, as well as support services like rehab and palliative care. Some Gold policies will also include benefits for services not covered by Medicare, whether that be dental surgery, physiotherapy or anything in between.

While Gold hospital cover will come saddled with higher premiums compared to lower tiers, it offers total peace of mind and financial protection against unexpected medical expenses.

This utterly comprehensive level of cover includes a huge range of services – from major surgeries to specialist consultations, diagnostic tests, rehab therapies and more. Whether you’re a single, couple or family, with Gold insurance you can trust that you’ll always have access to private hospital facilities and can choose your own doctor for treatments.

Some of the most sought-after services covered under Gold health insurance policies can include:

• Joint replacements
• Pregnancy and obstetrics
• Cardiac procedures
• Cancer treatments like chemotherapy and radiation therapy
• Organ transplants
• Insulin pumps and other diabetes-management devices
• Rehabilitation services
• Psychiatric care
• Home nursing and palliative care
• Weight loss surgeries

Ultimately, Gold policies are meant to provide the most comprehensive cover for a range of medical needs – you really do get what you pay for. While Gold health insurance premiums are higher compared to other tiers, the peace of mind from having such a financial safety net can make it a worthwhile investment.

While you may be able to find a Gold-tier health insurance policy for as little as $55 per week, it really depends on a few factors, such as the provider you go with (some health funds are restricted to certain industries) and where you're located.

In fact, where you live has arguably the biggest influence on how much your premiums cost. Here are the average monthly premiums for Gold hospital insurance policies:

• NSW/ACT: $219.35
• VIC: $243.24
• QLD: $234.21
• SA: $201.28
• WA: $189.28
• TAS: $211.86
• NT: $137.48

As you can see, it’s a lot cheaper to get comprehensive Gold cover if you live in the Northern Territory or Western Australia compared to Victoria or Queensland. So it’s a good idea to shop around and compare health insurance online to find the best deal for your needs.

No, and if you see somewhere advertising Gold Plus policies, it’s a good idea to steer clear!

The reality is that you can only purchase Gold hospital insurance policies these days. After the government reforms back in 2019, these categories only relate to hospital plans. Also be aware that extras cover plans can no longer use those all-too-familiar ‘stone’ names (i.e. metals or gemstones) in their product titles – you know the ones like ‘Diamond’ or ‘Platinum’ extras policies. Those are a big no-no nowadays.

Nevertheless, you’ll still have access to a complete range of extras policies, if that’s what you’re looking for, including premium extras products. Certain combined policies, which include both hospital and extras coverage, may also be labelled as Gold hospital and extras.

Gold hospital cover is perfect for Aussies who are seeking the most comprehensive health insurance around. It’s the best health insurance for those who want extensive cover and to get access to a wide range of medical services without worrying about out-of-pocket expenses.

This superior level of cover is particularly beneficial for:

• Families planning to have kids: Gold policies should include pregnancy and birth-related services, making them a popular option for those looking to start or expand their family.
• If you have existing health conditions: The extensive cover provided by Gold-tier policies will mean you have access to a broad range of treatments and services.
• Those who are after total flexibility and cover: Gold policies have more benefits and fewer restrictions than other tiers, which means you can choose your preferred healthcare providers and access services with minimal headaches.

Overall, Gold hospital cover is ideal for singles, couples and families who want total healthcare cover and value the peace of mind that comes from knowing they’re well protected against unexpected medical expenses.

While the premiums for Gold policies can indeed be eye-watering – especially if you’re on a tight budget – they offer everything the lower-tier policies simply can’t. For some, that’s worth paying a little bit extra every month. There are also the extensive benefits and minimal out-of-pocket expenses to consider. This might help tip you over the line from a Silver policy to a Gold-tier alternative.

Ultimately, the true ‘worth’ of Gold hospital cover will depend on your own healthcare needs, your family’s living situation, any budget constraints, as well as what you expect out of a health policy. If you’re just after the best, then Gold is usually the way to go!