Private health cover options in Australia compared
Medicare only, hospital tiers, extras and combined cover compared on how they work, who they suit and what to watch.
This table compares types of cover, not insurers. Premiums vary by insurer, state, excess and the people on the policy, so no prices are shown. Use the table to decide which tier and combination to look at, then compare real policies with their Private Health Information Statements on privatehealth.gov.au and the hospital policy comparison tool. Clinical category lists are the government minimums for each tier; a 'Plus' policy adds categories on top.
Select a column header to sort.
| Option | How it works | Good for | Watch out for |
|---|---|---|---|
| Medicare only | Free treatment as a public patient in public hospitals; subsidised GP and specialist visits | People below the surcharge thresholds who are comfortable with public waiting lists | Surcharge if your income is above the threshold; Lifetime Health Cover loading if you join hospital cover after 31; no cover for ambulance, most dental or optical |
| Basic hospital | Must cover rehabilitation, hospital psychiatric services and palliative care, which may be restricted | Avoiding the surcharge and loading at the lowest premium | Often covers very little else; restricted categories pay only shared-ward rates in a public hospital |
| Bronze hospital | Basic categories plus 18 more, including joint reconstructions, chemotherapy and gynaecology | Younger people wanting cover for common surgery | No pregnancy and birth, heart and vascular, back and spine or joint replacements unless it is Bronze Plus |
| Silver hospital | Bronze plus 8 categories such as heart and vascular, lung and chest, back, neck and spine, and dental surgery | Middle-aged people and those with heart or back concerns | Pregnancy and birth, joint replacements, cataracts and dialysis still need Silver Plus or Gold |
| Gold hospital | All 38 clinical categories, none restricted | Planning pregnancy, IVF, joint replacements, cataracts or sleep studies | Highest premium; still has excess, waiting periods and possible gap fees |
| 'Plus' policy | Meets a tier minimum and adds chosen categories | Getting one or two extra categories without paying for Gold | Read which categories are added; names alone do not tell you |
| Extras only | Benefits for dental, optical, physio and similar, with annual limits | Regular dental or physio users below the surcharge threshold | Does not avoid the surcharge or the loading; limits and waiting periods per service |
| Combined hospital and extras | Both on one policy, sometimes sold as a package | Convenience and one rebate claim | Package may include extras you do not use; compare against buying separately |
| Ambulance-only cover or state subscription | Covers emergency ambulance fees in states where residents are charged | People in NSW, Victoria, SA, WA, NT or the ACT without ambulance in their policy | Rules differ by state; Queensland and Tasmania residents are covered by the state |
Tier minimums are those published on privatehealth.gov.au. A policy covering a clinical category must cover everything in it. Check the Private Health Information Statement for restrictions, exclusions, excess and waiting periods before you buy. Surcharge and rebate figures: privatehealth.gov.au and ato.gov.au. Ambulance arrangements: your state or territory ambulance service. Complaints: the Private Health Insurance Ombudsman at ombudsman.gov.au.