Reforms make hospital cover easier to understand


Private health insurance reforms will be introduced from 1 April 2019.

The reforms, developed by the Australian Department of Health, have been designed to offer transparency when choosing the cover to best meet your needs. The changes were made after government consultations found hospital insurance products were complicated and confused consumers.

Standardised clinical categories will be introduced to ensure all insurers are describing hospital treatments the same way, making it easier to compare ‘apples with apples’.

The categories, or tiers, also will make it easier for you to know what the different insurance products do and don’t cover.

The four tiers – Gold, Silver, Bronze and Basic – will:


  • Apply to all hospital cover
  • Need to meet a minimum standard of provided benefits
  • Offer the option to have higher excesses in exchange for lower premiums
  • Include travel and accommodation rebates for regional and rural consumers
  • Offer improved access to mental health treatment.

Insurers will have until 1 April 2020 to implement the new tier system.

Further information on the health insurance reforms can be found on the Department of Health website. 

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