Need to know
- Silver Plus policies with restrictions can cost hundreds more per year than Gold policies with full cover
- Premiums increased on 1 April, but you can dump these overpriced policies and switch to better value cover at any time
- Health funds including Medibank, Bupa, HCF, HBF, NIB and Frank (GMHBA) charge more for policies without pregnancy cover
It's always a good time to check if your health insurance policy is good value for money and that you have the right level of cover for your needs.
The Gold, Silver and Bronze system of health insurance introduced by the government in 2019 ranks policies by cover, but there is no guarantee that a lower tier means a cheaper premium.
In some states, the most expensive policy is a Silver Plus policy, not a Gold policy
We've found 196 Silver and Silver Plus policies that cost more than Gold policies from their competitors – and provide less cover.
You might be surprised how much you can save when you compare health insurance. Our own CHOICE editor Pru Engel was told by her insurer her family would get moved to a new Silver Plus policy with less cover and a higher premium.
Instead, she found a better Silver Plus policy that covers her needs and saves her $1800 per year (without rebate).
Silver Plus policies allow you to tailor your health insurance, giving you the level of cover provided by a Silver policy, plus cover for one or more procedures usually only covered by Gold insurance.
Silver and Silver Plus policies give you less cover than Gold, so you'd expect them to cost less. But we've found Silver Plus policies that cost up to:
- $450 more in WA
- $500 more in SA
- $550 more in the ACT and NSW
- $650 more in Qld
- $700 more in Vic
- $800 more in Tas
- and up to a shocking $1250 more in the NT.
Silver Plus policies give you the level of cover provided by a Silver policy, plus one or more procedures usually only covered at Gold level.
Why is Silver Plus often more expensive than Gold?
Unlike other types of insurance, like car insurance, you won't pay more for health insurance if you've had to make a claim in the past. However, health insurers price their policies based on the likelihood that their members will claim and how expensive those claims will be.
While pregnancy and birth cost the insurer around $10,000, a hip replacement costs three times as much.
Younger people who are planning a family may be less likely to go to hospital for other treatments, whereas older people may need a range of hospital treatments. Therefore, policies that cover procedures such as hip and knee replacements but don't cover pregnancy can cost more than Gold policies that cover everything.
This makes older people the perfect targets for overpriced Silver Plus policies.