Compare bronze health insurance

As a minimum, Bronze health insurance policies must cover 21 clinical categories out of the total 38. Of these, three categories – rehabilitation, hospital psychiatric services and palliative care – may be offered on a restricted basis.

If a certain clinical category is offered on a restricted basis, it means the insurers pay only a limited amount of the private hospital costs. According to the Australian Commonwealth Ombudsman, this means people are more likely to face significant out-of-pocket expenses for treatments with restricted benefits.

For the remaining 18 categories, your insurer must cover all treatments available within that category.

The clinical categories covered under a Bronze policy are:

• Rehabilitation (restricted cover permitted)
• Hospital psychiatric services (restricted cover permitted)
• Palliative care (restricted cover permitted)
• Brain and nervous system
• Eye (not cataracts)
• Ear, nose and throat
• Tonsils, adenoids and grommets
• Bone, joint and muscle
• Joint reconstructions
• Kidney and bladder
• Male reproductive system
• Digestive system
• Hernia and appendix
• Gastrointestinal endoscopy
• Gynaecology
• Miscarriage and termination of pregnancy
• Chemotherapy, radiotherapy & immunotherapy for cancer
• Pain management
• Skin
• Breast surgery (medically necessary)
• Diabetes management (excluding insulin pumps)

Bronze health insurance policies are not required to cover the following 17 hospital clinical categories:

• Heart and vascular system
• Lung and chest
• Blood
• Back, neck and spine
• Plastic and reconstructive surgery (medically necessary)
• Dental surgery
• Podiatric surgery (provided by a registered podiatric surgeon)
• Implantation of hearing devices
• Cataracts
• Joints replacements
• Dialysis for chronic kidney failure
• Pregnancy and birth
• Assisted reproductive services
• Weight loss surgery
• Insulin pumps
• Pain management with device
• Sleep studies

However, insurers may offer these treatments and services as an optional addition to their policies in the form of ‘Bronze Plus’ health insurance.

‘General’ treatment and services, such as dental or podiatric care, may not be covered unless you’ve taken out an ‘extras’ policy along with your Bronze hospital cover. The table at the top of the page only compares Bronze hospital health insurance policies, but you can change the filters to include extras.

A Bronze Plus policy is one that includes additional coverage for clinical categories outside of the minimum standard required for Bronze tier health insurance. For example, you could have a Bronze Plus policy that includes cover for dental surgery, which is a minimum standard available under a Silver or Gold policy.

It is up to your insurer whether or not it offers ‘Plus’ policies and what clinical categories are included in them. It could be a wise idea to check with your health insurance provider what is and isn’t covered, and check the Product Disclosure Statement (PDS).

The cost of Bronze health insurance can vary depending on several factors, such as the provider you choose, the policy you select, the excess you’re willing to pay and where you live. The price of your health insurance premiums will also depend on whether you’re covering for just yourself or the whole family.

In addition, if you’re taking out hospital cover for the first time and you’re over 30, you may pay higher premium costs under Lifetime Health Cover (LHC). The additional costs you pay on top of your hospital premium cost , known as ‘LHC loading’, is a 2% loading amount for every year you are aged over 30, based on your age on the 1 July prior to joining.

But, if you’re eligible, you may be able to use the Government’s Private Health Insurance Rebate to lower the cost of your Bronze cover premiums. The Private Health Insurance Rebate is an amount the Federal Government contributes towards your private health insurance costs. But the rebate is income tested, meaning your eligibility will depend on your annual income.

With all these factors in mind, the cost of your Bronze health insurance will heavily depend on your own individual circumstances as well as the policy and provider you end up choosing. That is why comparing premiums can be one way to determine how much you’ll likely pay for your monthly premiums.

The table at the top of this page shows a range of Bronze hospital policies, including premium estimates, from our Online Partners. You can change the filters to suit your requirements.

Whether Bronze hospital cover is suitable for you will depend on your own individual circumstances and the clinical categories you wish to be covered for. Keep in mind that Bronze health insurance has a lower level of coverage compared to Silver and Gold, so it may be more suitable for those who do not have a serious history of illness. For example, since Bronze tier provides treatment for joint reconstructions as well as bone, joint and muscle hospital treatments, Bronze cover may be suitable for someone with an active lifestyle or a physically demanding job where these treatments may be needed.

On the other hand, a Bronze policy may not be appropriate if you suspect your back, neck or spine may need attention or treatment. If you wish to be covered for any of the clinical categories not listed as a minimum standard requirement for a Bronze health insurance policy, such as heart and vascular or back, neck and spine, you may want to consider either Bronze Plus, Silver or Gold cover.

If you are considering a Bronze Plus policy, be sure to check with your insurer for a full list of what is and isn’t covered, as well as reading the full Product Disclosure Statement (PDS)