Private health insurance packages simplified

New rules will make private health insurance easier to understand from 1 April, 2019 with easier to understand clinical categories and a Gold, Silver, Bronze and Basic classification system.


The approach will provide clearer information to consumers and allow them to compare different health insurance policies and choose the cover that best suits their needs.


Consumers will not be forced to change their policy cover if they are happy with it.


The change to health insurance builds on reforms already announced by the Australian Government:

  • Young Australians aged 18 to 29 will benefit from premium discounts of up to 10 per cent – which they will be able to keep until they turn 40 – which could translate to saving $200 each year on a $2000 policy.
  • Allowing people to upgrade their coverage and avoid a waiting period. Health insurers have reported that hundreds of customers have already taken up this option.
  • Australians living in rural and remote areas will get more support, with insurers now able to offer travel and accommodation benefits as part of hospital treatment cover. This will help those who can’t access treatment locally.


New insurance policies will be categorised under the system from 1 April 2019, and by April 2020 all products must fully comply with the new arrangements.


The new product tiers have minimum and standard clinical categories, which mean consumers can easily identify the services covered, or excluded, by their policies.


The Basic and Bronze cover levels are affordable options covering key health services. Basic policies are suitable for regional and rural patients.


Silver and Gold polices provide more comprehensive cover – providing services that are needed at different stages of life.


For Silver, Bronze and Basic, insurers can also offer additional cover to those listed as the minimum requirements, in which case the products may be named [Silver, Bronze, Basic] Plus (+).


Importantly, women will benefit from improved coverage including guaranteed cover for gynaecological services, ovarian and breast cancer treatment and breast reconstruction in Bronze tiers and above.


Insurers must also improve the information they provide to consumers. A new Private Health Information Statement will include mandatory information about what each policy covers.


All products will be included on the enhanced website


Full details on the Gold, Silver, Bronze, Basic and Clinical Categories and PHI reforms are available on the Department of Health Website at


12 October 2018.