Need to know
- The Gold, Silver, Bronze system ranks policies by cover, not by price
- Silver policies with restrictions can cost hundreds more per year than Gold policies with full cover
- Health funds including Medibank, Bupa, HCF, HBF and NIB charge more for policies without pregnancy cover
The new Gold, Silver, Bronze system of health insurance 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 215 Silver and Silver Plus policies that cost more than Gold policies from their competitors – and provide less cover.
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 $800 more per year than the cheapest Gold policy in Queensland, SA and WA, up to $700 more in ACT/NSW, up to $900 more in Victoria and Tasmania and up to a shocking $1700 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.