Key takeaways
- Gold, Silver, Bronze, and Basic tiers set minimum clinical categories — not maximum.
- Plus products add categories beyond the tier minimum.
- Choose tier based on services you need, not the metal colour alone.
Hospital tier reforms standardised what Gold, Silver, Bronze, and Basic must include. But Plus products and extras bundles still vary widely between funds — here is how to read them.
On this page
The four hospital tiers
Each tier must cover a defined minimum set of clinical categories. Gold includes the most (pregnancy, joint replacements, cataracts). Basic covers the least plus accident-related admission in many cases.
| Tier | Minimum categories | Examples of covered services |
|---|---|---|
| Gold | All 38 clinical categories | Pregnancy, joint replacements, cataracts, psychiatry |
| Silver | 26 categories | Heart surgery, lung cancer, dental surgery in hospital |
| Bronze | 18 categories | Broken bones, hernias, joint reconstructions (limited) |
| Basic | 3 categories + accident cover | Accidents, ambulance, palliative care (varies) |
Insurers may offer "Plus" products with extra categories beyond the tier minimum. Always read the clinical category list in the PDS.
What 'Plus' means
A Silver Plus policy includes more clinical categories than the Silver minimum — sometimes approaching Gold coverage at a lower premium. Always read the clinical category list, not just the tier label.
Extras is separate from hospital tiers
Extras cover reimburses dental, optical, and allied health regardless of your hospital tier. Extras generosity depends on annual limits and provider networks, not whether you hold Gold or Bronze hospital.
How to choose your tier
List the hospital services you are likely to need in the next few years — pregnancy, joint issues, cardiac care — and find the lowest tier that includes them. Paying for Gold when you only need Bronze categories wastes premium.
General information only — not personal financial advice. Consider your own circumstances and read the Product Disclosure Statement (PDS) before purchasing any policy. Moneyhero may earn referral fees from some providers when you switch through us; this does not change how results are ordered. How we compare
Frequently asked questions
Straight answers about comparing in this category — what affects prices, how switching works, and how to read product documents before you decide.
Is Gold always the best health insurance?
No. Gold covers the most clinical categories but costs the most. If you do not need pregnancy, joint replacement, or other Gold-only services, a lower tier may offer better value.
What is the difference between Silver and Silver Plus?
Silver Plus includes additional clinical categories beyond the standard Silver minimum. The exact list varies by fund — compare the clinical category schedule.
Does Basic cover accidents?
Many Basic policies include accident-related hospital admission, but definitions vary. Read the PDS for what counts as an accident admission.
Do tiers affect extras cover?
No. Hospital tiers and extras are separate products. You can hold any extras level with any hospital tier.