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Gold / Silver / Bronze / Basic
The government's four tiers decide what a policy must cover. Here's what each one includes, and which one you actually need.
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More guides on this topic.
What each tier must cover by law
Gap fees and out-of-pocket costs explained
Medicare pays 75% of the MBS fee, your insurer at least 25%, and you pay the rest. What no gap and known gap mean, and what insured patients pay in 2026–27.
Basic hospital cover: what it does and does not cover
Basic hospital cover must include only 3 of 38 clinical categories, on a restricted basis. What it pays, what it leaves out, and what it costs in 2026–27.
Is Gold hospital cover worth it?
Gold is the only tier that must cover 9 categories, including joint replacements and cataracts. What it costs in 2026–27, and when it is not worth it.
Silver Plus and Bronze Plus hospital cover: what Plus actually adds
Silver Plus is not a fifth tier. The rule behind the Plus label, why one Silver Plus policy adds 1 category and another 8, and how to check yours in 2026–27.
Basic hospital cover and the Medicare Levy Surcharge: what actually counts
Which hospital policies remove the Medicare Levy Surcharge in 2026–27: the A$750 excess limit, what a Basic policy must cover, and where the break-even sits.
Gold, Silver, Bronze and Basic hospital cover compared
The 38 clinical categories, the minimum tier that must cover each one, what a Plus policy really adds, and what the four tiers cost in 2026–27.
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