Basic health insurance policies

Average customer rating: 4.3/5
Written by Joshua Malin
Reviewed by Steven Spicer
Updated March 07, 2024

Why do health insurance tiers exist?

To make health insurance easier to understand, the Australian Government introduced private health insurance reforms in 2019, which required health funds to categorise their hospital products into four different tiers: Basic, BronzeSilver and Gold.

The tiers are classified by how many clinical categories they cover (each clinical category includes certain hospital treatments), with higher tiers including more clinical categories than the lower ones. In order to meet the classification, the product must include all of the clinical categories required for that tier (e.g. if a policy does not include ‘brain and nervous system’ or ‘joint reconstructions’ as a minimum category inclusion it can’t be classified as bronze).

Insurers can also offer ‘plus’ or ‘+’ tiered policies, which include some of the categories of a higher-level tier but not enough to enter that tier (e.g. a Basic plus policy might include ‘brain and nervous system’ and ‘joint reconstructions’ but none of the other categories that are a minimum requirement for a bronze policy).

What is Basic health insurance

Basic health insurance is the lowest level of hospital cover a fund can offer. These policies will have limited features and the most exclusions. Basic hospital cover is only required to include restricted cover^, for hospital psychiatric services, rehabilitation and palliative care as a private patient in a public hospital.

This means that you are only covered to a very limited extent. If you want a policy that includes a broader range of services without breaking the bank on premiums, consider comparing Basic Plus and Bronze tiered policies using our free comparison tool.

Expert tips on basic health insurance

Our health insurance expert, Steven Spicer, has some tips on basic health insurance and how to choose a hospital insurance tier that works for you.

Steven Spicer
Executive General Manager – Health, Life & Energy

Consider you and your family’s medical history

It can be tempting to just get ‘the basics’ to keep your premiums low. However, cheaper doesn’t necessarily mean better. To avoid finding yourself underinsured, consider any previous hospital admissions along with your family’s medical history when looking at different levels of cover.

Pay attention to your waiting periods

Keep in mind there could be waiting periods that apply when taking out health insurance for the first time or upgrading your policy. Therefore, it’s important that you strongly consider the level of cover that will be suitable for your needs. This will allow you to start serving your waiting periods immediately, so that the cover is available if you need it.

Avoid ‘junk’ cover

While it’s tempting to reduce costs by going for the cheapest option, many of these policies are nicknamed ‘junk’ as they may provide next to no coverage. Bronze coverage doesn’t cost much more and it will cover you for hundreds more procedures.

Inclusions and exclusions

What does Basic health insurance cover?

What is a Basic Plus policy and what does it cover?

What is not included on a Basic health insurance policy?

Choosing your tier

Who might suit Basic tier cover?

Is Basic health insurance worth it?

What does Basic health insurance cost?

Can I get a Basic level of extras-only health insurance?

Meet our health insurance expert, Steven Spicer

Steven Spicer
Executive General Manager – Health, Life & Energy

As the Executive General Manager of Health, Life and Energy, Steven Spicer is a strong believer in the benefits of private cover and knows just how valuable the peace of mind that comes with cover can be. He is passionate about demystifying the health insurance industry and advocates for the benefits of comparison when it comes to saving money on your premiums.

^ Restricted cover – this means you’re covered as a private patient in a public hospital. It also means that if you go to a private hospital as a private patient, 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 – this means you’re covered for 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 (MBS) for clinical categories included as unrestricted on your policy. This level of cover allows you to choose the available doctor who treats you, provided your doctor has an arrangement with the hospital you want to be treated at and the hospital you have chosen has available beds.