What is the simplified tiered system?

A new system for categorising hospital products was introduced from 1 April 2019.

To make it easier for everyday Australians to identify, compare, research and take out health insurance, a tiered system for hospital cover is now mandatory for all insurers. 

What does this mean?

Essentially this means that Hospital products are simplified for members by creating easily understood tiers of cover. There are four tiers of hospital products – Gold, Silver, Bronze and Basic. These product tiers were introduced from 1 April 2019. HIF will be able to offer additional coverage in the Basic, Bronze and Silver tiers. Minimum requirements for each tier of cover are outlined in the Private Health Insurance (Reforms) Amendment Rules 2018.

Why is this important?

Private health insurance is an important issue to many Australians, with 55% of the population covered by some form of private health insurance. However, the Government’s consultations identified that Members find hospital insurance products complex and difficult to understand and there's confusion when comparing private hospital insurance products. Members have also advised they find it difficult to understand what services different products do, and do not, cover.

Who will benefit?

By introducing the simplified product tier system, this will give Members greater certainty about the services covered by each type of hospital treatment product. The changes will make it easier to shop around and compare different hospital treatment products to find one that meets your individual needs and circumstances. In particular, the changes will benefit women with breast cancer, as all medically necessary breast surgery will now be included in all Bronze tier hospital treatment products and above. Women will also have access to gynaecology in these products.

Hospital Treatment Product Tiers Table - Gold, Silver, Bronze and Basic

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