Gold health insurance policies

Average customer rating: 4.3/5
Written by Joshua Malin
Reviewed by Steven Spicer
Updated 26 March, 2024

Why are there health insurance tiers?

In 2019, the Australian Government introduced Private Health Insurance Reforms to simplify health insurance. Because of these government reforms, all hospital policies are categorised into four distinctive tiersBasicBronzeSilver and Gold.

Each tier is categorised based on hospital treatments and services it includes, which are listed under respective clinical categories.

So, let’s take a look at what constitutes the Gold health insurance tier and why you might consider taking out Gold health cover.

What is Gold health insurance?

The Gold tier offers the highest level of cover available on the health insurance market. It’s essentially the ‘comprehensive’ or ‘top’ level of hospital insurance.

This means that you’ll be covered for all in-hospital procedures listed on the Medicare Benefits Schedule (MBS) as a private patient in either a private or public hospital. When you go in for treatment, your health fund may pay 25% of the MBS fee for your treatment, as well as hospital charges such as accommodation, theatre fees, medicines and dressings. The other 75% of the MBS fee is paid by Medicare. If your treating doctors choose to charge above the MBS fee, you could be responsible for paying the gap, so you may have some out-of-pocket expenses.

Depending on your state of residence, your Gold hospital insurance will often also include cover for ambulance services. For example, QLD residents are covered for ambulance services through their state government, so they don’t need to worry about whether ambulance cover is included in their insurance. However, residents in other states (like NSW) might want to consider a policy that offers ambulance cover, as it’s not covered by their state government.

Expert tips on Gold health insurance

Our health insurance expert, Steven Spicer, knows how important it is to get hospital insurance that works for you and your family, which is why he’s put together these tips on how to choose your hospital policy tier:

Steven Spicer
Executive General Manager – Health, Life & Energy

Cover gives you more choice

Private health insurance gives you the ability to improve the quality of your healthcare options. Having cover allows for more choice and control of when and where you’re treated, and by whom.

Increase your excess for cheaper premiums

While having lower premiums is tempting, cheaper doesn’t necessarily mean better. Instead of sacrificing inclusions on your cover, consider increasing your excess to lower costs.

Know your options

There are many options out there when it comes to private health insurance. This is why speaking to a health insurance specialist can be so important. With the right cover you can have peace of mind knowing you have access to high-quality health care of your choice.

Inclusions and exclusions

What does Gold health insurance cover?

Are there waiting period on Gold tier policies?

Choosing your tier

Who might suit Gold tier cover?

How much is Gold health insurance?

How does Gold health insurance compare to Silver and Bronze?

Is Gold the top health insurance available?

Can I get a Gold Plus policy?

Can I get a Gold extras health insurance policy?

Is Gold tier health insurance worth it?

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: Your insurer will pay a limited benefit for any private hospital costs in that category. You might have to pay significant out-of-pocket costs.

*Unrestricted cover: Your insurer is likely to have an agreement with a hospital. You might not have to pay any out-of-pocket costs other than the agreed excess or co-payments.