What is Silver health cover and how much does it cost?
Silver hospital cover is the second-highest level of health insurance and covers an extensive range of treatments that Bronze and Basic don’t.
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Silver hospital cover is relatively comprehensive and can offer you peace of mind and convenience, should you find yourself in need of hospital care.
But with myriad policies available, it can be difficult to work out which policy might be best for you and your circumstances.
Australia has a standardised four-tier system for hospital cover, which works to make that task easier.
Along with Silver cover, you can purchase Gold, Bronze and Basic cover and these offer varying levels of cover based on a range of standardised clinical categories.
They can be ‘restricted’ (R), where insurers only pay only a limited amount towards your hospital costs, or ‘unrestricted’, which means they are completely covered by your health fund.
What is Silver health insurance?
Silver hospital cover sits below the Gold tier and above Bronze and Basic and is required to cover a total of 29 of the clinical categories – eight additional medical categories to Bronze and nine less than Gold, with restricted cover for the same categories as Bronze and Basic cover.
However, health insurers may optionally add other categories into their Silver policies, which makes them vary, so keep your eye out for a good deal to suit you.
What does Silver health insurance cover?
Silver hospital cover provides restricted cover for rehabilitation, hospital psychiatric services and palliative care, and unrestricted cover for the categories of brain and nervous system; eye (not cataracts); ear, nose and throat; tonsils, adenoids and grommets; bone, joint and muscle; joint reconstructions; kidney and bladder; male reproductive system; digestive system; hernia and appendix; gastrointestinal endoscopy; gynaecology; miscarriage and termination of pregnancy; chemotherapy, radiotherapy and immunotherapy for cancer; pain management; skin; medically necessary breast surgery; diabetes management (excluding insulin pumps); heart and vascular system; lung and chest; blood; back, neck and spine; medically necessary plastic and reconstructive surgery; dental surgery; podiatric surgery; and implantation of hearing devices.
What doesn’t Silver health insurance cover?
Silver tier hospital insurance may not cover cataracts; joint replacements; dialysis for chronic kidney failure; pregnancy and birth; assisted reproductive services; weight loss surgery; insulin pumps; pain management with device; or sleep studies.
But that’s not to say Silver cover policies won’t ever include these categories – it’s optional for health insurers to include any of the above categories to entice new customers to their products, and this is how Silver policies can differ.
Health insurers also offer policies with other additional treatments in the Silver tier, which are known as Silver plus [+].
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What about out-of-hospital treatments?
Gold, Silver, Bronze and Basic tiers only apply to hospital policies, however, some insurers offer extras policies, which can be packaged to complement Silver hospital cover (Silver hospital and extras).
These may also include some out-of-hospital services not covered by a hospital policy, such as ambulance, home nursing, glasses and contact lenses.
Who is most suited to Silver health insurance?
Silver health insurance is an ideal level of hospital cover for people who foresee a need for future dental or podiatric surgery or insulin pumps, for example, or for those seeking increased peace-of-mind and convenience of care.
While it might not be your go-to option if you’re planning on adding to your family, some health insurers may include pregnancy and birth in their Silver cover so it’s important that you do your research and review all the options available to you.
How much does Silver insurance cost?
According to the Private Health Insurance Ombudsman’s comparison of health insurance policies, Silver hospital cover for a single adult in NSW can range from around $188 to $258 per month before any rebates are applied.
The cost of Silver cover varies significantly between policies, states and territories and health insurers so you’ll need to do your homework to determine which is the best cover and value for money for you.
Silver cover is generally more expensive than Bronze cover but less expensive than Gold.
To determine the cost difference, it helps to compare policies and decide on which will best suit your health requirements and budget.
Can I take out Silver hospital insurance if I have a pre-existing condition?
Yes, you can. Australian hospital policies must cover pre-existing conditions – but you’ll still have to wait out the waiting period set on the policy.
Most have in place a 12-month waiting period before you can claim on a pre-existing condition.
What do I need to know about excess?
Excess is an agreed payment you must make to your health insurer when making a claim.
This is an amount you must pay in contribution to the out-of-pocket costs of a hospital stay and can sometimes be applied to hospital insurance and help lower the cost of your premium.
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