Basic Hospital Cover

Basic hospital cover has the fewest mandatory inclusions of any tier. The government requires Basic policies to cover only a small core set of categories, with insurers free to add others at their discretion.

Always included on Basic:

• ✅ Rehabilitation (inpatient recovery programs)
• ✅ Hospital psychiatric services (inpatient mental health)
• ✅ Palliative care

May be included (varies by insurer and policy):

• ⚠️ Some accident-related hospital admissions
• ⚠️ Limited emergency-related procedures
• ⚠️ Select additional categories at insurer's discretion

Excluded on Basic (most clinical categories):

• ❌ Pregnancy and birth
• ❌ Assisted reproductive services (IVF)
• ❌ Joint replacements
• ❌ Joint reconstructions
• ❌ Cataracts
• ❌ Heart and vascular system
• ❌ Lung and chest
• ❌ Brain and nervous system
• ❌ Back, neck and spine
• ❌ Bone, joint and muscle
• ❌ Digestive system
• ❌ Hernia and appendix
• ❌ Gastrointestinal endoscopy
• ❌ Kidney and bladder
• ❌ Gynaecology
• ❌ Ear, nose and throat
• ❌ Eye (all)
• ❌ Skin procedures
• ❌ Breast surgery
• ❌ Dental surgery (hospital)
• ❌ Diabetes management
• ❌ Dialysis
• ❌ Chemotherapy, radiotherapy, immunotherapy
• ❌ Pain management
• ❌ Sleep studies
• ❌ Plastic and reconstructive surgery
• ❌ Weight loss surgery
• ❌ And most other categories

What's NOT covered on any tier:

• Cosmetic procedures (not medically necessary)
• Experimental/unproven treatments
• Out-of-pocket gaps (doctor/specialist fees beyond schedule)

Important: Basic coverage varies significantly between insurers. Some Basic policies include a handful of additional categories; others cover only the bare minimum three. Always check the specific PDS to understand exactly what your Basic policy covers.

✅ MLS avoidance (primary use case):

• Income over $97K (singles) or $194K (families)
• Cheapest way to avoid 1.0–1.5% surcharge
• Often saves more in MLS than the premium costs

✅ LHC loading avoidance (approaching age 31):

• Lock in 0% LHC loading at the lowest possible cost
• Upgrade to Bronze/Silver/Gold later without penalty
• Satisfies the "holding hospital cover" requirement

✅ People who prefer the public system:

• Comfortable using public hospitals for all treatment
• Don't want to pay for private hospital cover they won't use
• Want the tax benefit without the cost of real coverage

✅ Absolute budget minimum:

• Premiums from $15–$35/week
• Cheapest tier available
• Some coverage is better than no coverage for tax purposes

❌ Basic is NOT suitable if you:

• Want genuine hospital coverage for any condition
• Expect to be admitted to a private hospital
• Want to choose your own doctor or surgeon
• Have any chronic conditions
• Want accident or emergency hospital cover (consider Bronze)
• Are planning pregnancy, surgery, or any elective procedure

The most common question about Basic is whether it's worth spending an extra $10–$20/week to upgrade to Bronze. Here's the comparison:

Feature	Basic	Bronze
Clinical categories	~3 minimum	~17
Accident/emergency surgery	❌ Usually excluded	✅ Covered
Cancer treatment	❌ Excluded	✅ Covered
Mental health (inpatient)	✅ Covered	✅ Covered
Digestive/hernia/appendix	❌ Excluded	✅ Covered
Bone, joint and muscle	❌ Excluded	✅ Covered
Gynaecology	❌ Excluded	✅ Covered
Pregnancy	❌ Excluded	❌ Excluded
Joint replacements	❌ Excluded	❌ Excluded
Cardiac surgery	❌ Excluded	❌ Excluded
Typical cost	$15–35/week	$30–60/week

Key insight: Basic is an MLS/LHC compliance product. Bronze is actual hospital insurance. If you ever expect to use your hospital cover — even for an unexpected accident or emergency — Bronze is substantially better value for $10–$20/week more.

When Basic makes more sense than Bronze:

• Your sole purpose is avoiding the MLS and the cheapest Basic premium is less than the MLS you'd pay
• You would use the public system regardless and have no interest in private hospital treatment
• You're on an extremely tight budget and even the $10–$20/week difference matters

Feature	Gold	Silver	Bronze	Basic
Clinical categories	All 38	~26	~17	~3 minimum
Pregnancy	✅	⚠️ Plus only	❌	❌
Joint replacements	✅	⚠️ Some Plus	❌	❌
Heart surgery	✅	⚠️ Restricted	❌	❌
Cancer treatment	✅	✅	✅	❌
Mental health	✅	✅	✅	✅
Accidents/emergency	✅	✅	✅	❌ Usually
Average cost	$80–140/wk	$50–90/wk	$30–60/wk	$15–35/wk

Key insight: Each tier up from Basic adds significant real coverage. Basic → Bronze is the biggest jump in value relative to cost.

Excess	Impact	Best for
$250	Base premium	Those who may claim
$500	Save $2–4/week	Middle ground
$750	Save $3–5/week	Pure MLS avoidance (lowest premium)

MLS savings example:

Income	MLS without cover	Cheapest Basic (annual)	Net saving
$100,000	~ $1,000/year	~ $780–$1,820/year	Up to $220 saved
$120,000	~ $1,500/year	~ $780–$1,820/year	Up to $720 saved
$150,000	~ $1,875/year	~ $780–$1,820/year	Up to $1,095 saved
$200,000	~ $3,000/year	~ $780–$1,820/year	Up to $2,220 saved

The higher your income, the more Basic saves you compared to paying the MLS. At incomes above ~$120K, even mid-range Basic policies cost less than the surcharge.

Government rebate tiers:

Income (Singles / Families)	Rebate
Under $97K / $194K	24.608%
$97K–$113K / $194K–$226K	16.405%
$113K–$151K / $226K–$302K	8.202%
Over $151K / $302K	0%

LHC loading impact:

Age at joining	Loading	Extra cost on Basic
30 or under	0%	No loading
35	10%	+~$2–4/week
40	20%	+~$3–7/week
45	30%	+~$5–11/week

Default query: All Basic policies for current profile, sorted by premium ascending.

Filter panel:

• Excess: [$250] [$500] [$750]
• Insurer: [Dropdown]
• Max price: [Slider]

Table columns: Insurer | Policy Name | Tier | Premium/week | Excess | Categories Covered | [Compare]

Disclaimer below table: Prices are indicative only and were last updated on {{LAST_UPDATE_DATE}} using data from PrivateHealth.gov.au. Premiums shown include the government rebate at the base tier (24.608%) and are calculated for {{PROFILE_LABEL}}. Actual premiums may vary. Always confirm pricing and coverage directly with the insurer before purchasing.