Compare Basic Health Insurance quotes

Basic health insurance policies are only required to include restricted hospital cover for hospital psychiatric services, rehabilitation and palliative care. Having restricted cover means your policy will only provide limited benefits or partial payment towards a specific treatment or service. Any remaining expenses will need to be paid by you out of pocket.

Here is what these 3 restricted clinical categories cover:

• Hospital psychiatric services: Hospital treatment and care for patients with psychiatric, mental, addiction or behavioural disorders, including psychoses like schizophrenia, mood disorders like depression, eating disorders and addiction therapy.
• Rehabilitation: Hospital treatment for physical rehab of a patient related to surgery or illness, including inpatient/admitted day patient rehab, stroke recovery and cardiac rehabilitation.
• Palliative care: Hospital treatment for quality-of-life care for a patient with a terminal illness, including treatment to alleviate and manage pain.

In some states, Basic level hospital policies may also come with ambulance cover, which can pay towards emergency ambulance services if your state government does not already cover you.

A Basic Plus policy is a tier of health insurance that provides the same cover as a basic policy, plus an additional one or more clinical categories. Usually, the health fund will decide what this additional clinical category will be. Basic Plus policies can include additional restricted or unrestricted cover for one or more of the remaining 35 clinical categories that are usually only found in higher-tiered policies.

This means a Basic Plus policy may cost more than a standard Basic policy. Depending on your health insurance needs, you may get more benefit from a Bronze hospital policy, which will provide you 18 more clinical categories, giving you much more hospital cover.

Basic health insurance doesn’t typically include any clinical categories except restricted cover for rehabilitation, hospital psychiatric services and palliative care. The exception to this is Basic Plus, policies which provide some additional private health cover. Compared to higher tiers, Basic hospital cover in Australia includes the fewest clinical categories and therefore pays a benefit towards the fewest hospital services. The hospital cover provided by a Basic-tier policy is also restricted, meaning your fund will only pay a partial benefit towards your treatment. This will likely mean higher out-of-pocket costs for you.

A standard Basic policy is only required to include restricted private hospital cover for 3 clinical categories out of 38 total. This is 18 fewer clinical categories than the Bronze tier and 26 fewer than the Silver tier. Meanwhile, Gold tier policies include cover for all 38 clinical categories.

Restricted cover means limited or partial cover for a treatment, whereas unrestricted cover means your health fund will pay benefits for treatment a private patient in either a private or public hospital. Standard Basic policies will only offer restricted cover on 3 clinical categories, meaning they provide little actual hospital cover.

With restricted cover, your fund will only pay a limited amount towards your treatment.

• As a private patient in a public hospital, your health fund will cover your accommodation in a shared room up to the government-set fee. If your hospital charges more than the government-set fee, you’ll need to pay the difference out of pocket. Your theatre fees will be covered as they would be if your cover was unrestricted.
• As a private patient in a private hospital, you’ll only receive a small benefit towards your accommodation fee, and you won’t receive any benefits at all towards your theatre fees. As a result, you will have to pay substantial out-of-pocket costs.

Unrestricted cover pays benefits towards your theatre and accommodation fees as a private inpatient in a private hospital or a private day hospital facility. It also means you’re covered up to the Medicare Schedule of Fees for clinical categories included as unrestricted on your policy.

Both restricted and unrestricted cover allow you to choose the available doctor or specialist, provided your doctor has an arrangement with the hospital you want to be treated at and the hospital you have chosen has available beds.

A Basic tier policy would suit those who are taking out hospital cover purely to avoid the Medicare Levy Surcharge (MLS) or Lifetime Health Cover loading (LHC). For example, it may suit higher income earners who want to avoid paying MLS or LHC but are happy to rely on Medicare for their hospital care or pay for private care out of pocket.

If you want health insurance to help cover the costs of private treatment for in hospital procedures, a Basic policy will probably be too limited for your needs, especially if you have specific treatments you want to be covered for.

Basic health insurance is typically only worth it to avoid Medicare Levy Surcharge and Lifetime Health Cover loading. In terms of actual hospital cover, it is lacking compared to the other tiers.

As it has limited benefits, Basic hospital cover may not be worth it if you require cover for additional hospital treatments. If this is the case, a Basic Plus, Bronze or even a higher tier may provide more peace of mind.

For a single person in Qld, Basic hospital policies cost between $102 to $159 per month, according to the Private Health Insurance Ombudsman.¹ These prices do not include any rebates, loadings or surcharges. Your policy prices may be higher or lower than the above figures, depending on your personal circumstances.

The base premium of a Basic health insurance plan will depend on your state, which health fund you’re with and what’s included in your policy. Basic health insurance policies will generally cost less than higher tiers (e.g. Bronze, Silver or Gold health insurance), as they include fewer hospital treatments.

A simple way to find out how much a Basic health insurance plan might cost is to compare policies online. If you’re considering downgrading to a basic health insurance to save money, there are other things you can try first before giving up clinical categories you may later need.

For example, if you’re currently on a Bronze policy, it’s worth using a comparison tool to see whether you can get the same level of cover for a better price just by switching to another health fund. Our 2025 Household Budget Barometer shows that those who switch policies are paying 29% less than those who have stuck with the same health fund for a decade or more.

No, because the government reforms regarding the classification of health insurance only apply to hospital products. Levels of extra cover and what they include vary between health funds. However, there continues to be a full range of extras cover options available, including entry-level products. Common treatments covered by ‘basic’ or entry-level extras include general dental (dental check-ups, minor procedures), optical (prescription glasses or contacts) and physiotherapy.

Lower-level extras policies usually come with lower annual limits and rebates, which could lead to higher out-of-pocket expenses If you use a lot of extras, you might find it worthwhile to pay an additional amount in premiums in order to take advantage of higher limits and rebates and potentially have lower out of pocket expenses.

Some combined hospital and extras policies may be named Basic hospital cover and extras. Keep in mind, extras-only cover won’t help you avoid the Medicare Levy Surcharge (MLS) or Lifetime Hospital Cover (LHC) loading. You must have an eligible hospital policy to avoid these extras costs. However, a combined hospital and extras policy will allow you to avoid MLS and LHC loading while also getting extras cover.

“Be careful because cheaper “extras” health cover won’t offset the levy. A bloke this week was telling me he was avoiding the MLS with a cheap [extras policy with dental]. Should have seen his face when I said it didn’t qualify and for the last 5 years he had unknowingly been paying the surcharge…”- David Koch