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Only 3 in 10 Australians can answer this basic health insurance question

Image: Getty
Image: Getty

Do you know what your health insurance provides when it comes to hospital cover?

It’s one of the most important purchases you’ll ever make, but 66 per cent of Australians would say “no” to that question, according to new research from

And 55 per cent of us – equivalent to 6.2 million Australians – aren’t even across the details.

But with the government set to introduce reforms simplifying private health insurance, it’s a good time to clue in to what you’re actually paying for, insurance specialist at finder Sophie Walsh said.

“The reality is health insurance often falls into the ‘set and forget’ basket. Many of us signed up years ago, so it’s understandable we don’t remember all the ins and outs of hospital cover,” she said.


Concerningly, one in five Australians don’t know what their hospital cover actually includes and 18 per cent don’t know about the limits of their cover for certain procedures, leaving them in the dark when it comes to their entitlements.

“Now is the time to pay attention to your hospital policy. Take a closer look at not just the cost but also the restrictions and any exclusions.”

The simplified system would see hospital cover products classed into ‘gold’, ‘silver’ and ‘bronze’ tiers depending on the degree of coverage.

Break down the tiers for me

Naturally, gold is the highest tier, and according to finder is likely the best policy for those starting a family and who want to have a private room. Seniors needing cataract surgery and joint replacements should also consider this tier.

Silver will cover about 68 per cent of procedures covered by gold policies, so if you’re planning on starting a family and just want solid coverage, this is probably a wise choice.

And for those who just want to cover the basics, bronze cover is probably what you’re after. These policies cover about 48 per cent of what’s offered with a gold policy. This is a baseline policy.

And if you’re really just looking for the bare essentials at an affordable price, the basic hospital cover could be a good choice for you. It provides a limited range of cover, but could be a good choice if you’re young and looking to avoid the Medicare Levy Surcharge.

“Not knowing what you’re covered for could leave you with a rejected claim, and a big bill to pay. Invest a few moments of your time reading the Product Disclosure Statement (PDS),” Walsh warned.

“If you aren’t sure about anything, give your health fund a call to get the facts straight from the horse’s mouth.”

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