HOW TO UPGRADE OR DOWNGRADE HEALTH INSURANCE

Upgrading means moving to a higher tier that covers more clinical categories — Bronze to Silver, Silver to Gold, or any jump between tiers.

What happens when you upgrade:

Change	Categories carried over (no new wait)	New categories (new waiting periods)	Premium impact
Basic → Bronze	~3 (rehab, psychiatric, palliative)	~14 additional categories	+{{BASIC_TO_BRONZE_PREMIUM_DIFF}}/week
Basic → Silver	~3	~23 additional categories	+{{BASIC_TO_SILVER_PREMIUM_DIFF}}/week
Basic → Gold	~3	~35 additional categories	+{{BASIC_TO_GOLD_PREMIUM_DIFF}}/week
Bronze → Silver	~17	~9 additional categories	+{{BRONZE_TO_SILVER_PREMIUM_DIFF}}/week
Bronze → Gold	~17	~21 additional categories	+{{BRONZE_TO_GOLD_PREMIUM_DIFF}}/week
Silver → Gold	~26	~12 additional categories	+{{SILVER_TO_GOLD_PREMIUM_DIFF}}/week

Waiting periods on new categories:

New category type	Waiting period
General hospital services (e.g., skin, lung, blood)	2 months
Major services (pregnancy, joint replacements, cardiac)	12 months
Pre-existing conditions in new categories	12 months

Categories you were already covered for on your lower tier carry over with no new waiting period. You can claim on those immediately after the upgrade.

When to upgrade:

Trigger	Recommended upgrade	Timing
Planning pregnancy	Bronze/Silver → Gold or Silver Plus	At least 12 months before expected due date
Approaching age 50	Bronze → Silver or Gold	Before joint, cardiac, or cataract issues develop
Diagnosed with condition in excluded category	Current tier → tier that covers it	Immediately — 12-month pre-existing wait starts from upgrade date
Want comprehensive peace of mind	Any → Gold	Any time — all 38 categories, no exclusions
GP identifies new health risks	Current → tier covering relevant categories	As soon as risk is identified, before symptoms develop

The pre-existing trap: If your doctor has already told you that you need knee surgery (excluded on Bronze), upgrading to Gold starts a 12-month pre-existing condition waiting period for joint replacements. You cannot upgrade and claim immediately for a condition you already know about. The lesson: upgrade before you need the treatment, not after.

Downgrading means moving to a lower tier to reduce your premium, accepting fewer covered clinical categories.

What happens when you downgrade:

Change	Categories you lose	Premium savings	Risk
Gold → Silver	~12 categories (IVF, weight loss, hearing devices, etc.)	Save {{GOLD_TO_SILVER_SAVINGS}}/week	Lose IVF, some specialised categories
Gold → Bronze	~21 categories (+ cardiac, cataracts, back/spine, etc.)	Save {{GOLD_TO_BRONZE_SAVINGS}}/week	Lose most elective and age-related categories
Gold → Basic	~35 categories	Save {{GOLD_TO_BASIC_SAVINGS}}/week	Lose almost all practical hospital coverage
Silver → Bronze	~9 categories (cardiac, cataracts, back/spine, etc.)	Save {{SILVER_TO_BRONZE_SAVINGS}}/week	Lose key mid-life categories
Silver → Basic	~23 categories	Save {{SILVER_TO_BASIC_SAVINGS}}/week	Lose most coverage

The re-upgrade penalty: If you downgrade and later need a dropped category, upgrading again triggers new waiting periods for those categories — including the 12-month wait for major services. Your previous time on the higher tier doesn't carry through a downgrade gap.

Example: You downgrade from Gold to Bronze to save money. Two years later, you need cardiac surgery (excluded on Bronze). You upgrade back to Gold — but face a 12-month waiting period for cardiac, even though you were previously covered for years on Gold. Those two years on Bronze reset your entitlement.

When downgrading makes sense:

• After completing pregnancy and no more children planned (Gold → Silver or Bronze)
• Children leaving the family policy (family → couple or single — also saves on cover type, not just tier)
• Young and healthy with no foreseeable need for excluded categories
• Financial hardship — downgrading is better than cancelling entirely (you maintain LHC continuity and some coverage)
• Over 65 and reviewing whether Gold categories you've never used justify the premium

When downgrading is risky:

• Over 50 — joint replacements, cardiac, cataracts become increasingly likely
• Family history of conditions in excluded categories
• Active health conditions that may require specialist hospital treatment
• The premium savings are small relative to the coverage lost

Extras changes are simpler than hospital tier changes, but waiting periods still apply for new services.

Adding extras to hospital-only cover:

Extras level	What you gain	Waiting periods	Premium increase
Basic extras	General dental, optical, limited physio	2 months (general), 12 months (major dental)	+{{ADD_BASIC_EXTRAS_COST}}/week
Mid extras	+ major dental, broader allied health	2 months (general), 12 months (major dental)	+{{ADD_MID_EXTRAS_COST}}/week
Top extras	+ orthodontics, higher limits, psychology	2 months (general), 12 months (major dental, ortho)	+{{ADD_TOP_EXTRAS_COST}}/week

Upgrading extras level (Basic → Mid → Top): Waiting periods for services already covered on your current extras carry over — no re-waiting. New services added at the higher level (e.g., orthodontics added when moving from Mid to Top) have their own waiting periods.

Removing extras from combined cover: You can drop extras at any time to reduce your premium. Your hospital cover continues unchanged. The savings are immediate — typically {{REMOVE_EXTRAS_SAVINGS_RANGE}}/week depending on the extras level removed. If you add extras again later, all extras waiting periods restart from scratch.

Changing your excess is the simplest coverage change — and the one with no waiting period implications.

Change	Effect	When to do it
Lower excess ($750 → $250)	Premium increases by {{EXCESS_750_TO_250_DIFF}}/week	Before planned surgery — reduces your per-admission cost
Raise excess ($250 → $750)	Premium decreases by {{EXCESS_250_TO_750_DIFF}}/week	When you're healthy and want maximum premium savings

No new waiting periods apply when changing excess. The change typically takes effect from your next billing period. You can change excess as often as you like.

Strategic excess changes: Some people raise their excess to $750 during healthy years (saving {{EXCESS_250_TO_750_ANNUAL}}/year) and lower it to $250 before a planned hospital admission. Check your insurer's terms — some require a minimum period at the new excess before it applies to claims.

Cover type changes (single ↔ couple ↔ family ↔ single parent) affect your premium without changing your coverage level.

Change	When	Premium impact	Notes
Single → Couple	Marriage, de facto relationship	Increase (but cheaper than two singles — save {{TWO_SINGLES_VS_COUPLE_SAVINGS}}/week)	Partner joins with their own waiting period status
Couple → Family	Having a child	Increase (children covered at no extra premium on most policies)	Newborn covered from birth for {{NEWBORN_COVER_PERIOD}}
Family → Couple	Children leave policy (age 21/25/31)	Decrease — save {{FAMILY_TO_COUPLE_SAVINGS}}/week	Children need their own policies after leaving
Couple → Single	Separation, divorce	Decrease — save {{COUPLE_TO_SINGLE_SAVINGS}}/week	Ex-partner needs their own policy
Single → Single Parent	Having a child as single parent	Increase (children at no extra vs single parent rate)	Same as family — children covered

With your existing insurer:

1. Contact your insurer by phone, online portal, or app
2. Request the specific change (tier, extras, excess, cover type)
3. Insurer confirms the change and new premium
4. Change typically takes effect from next billing period
5. No paperwork for most changes — processed immediately

By switching insurer:

1. Compare policies using our comparison tool
2. Apply with the new insurer (they handle the transfer)
3. Portability rules apply — served waiting periods transfer for equivalent categories
4. New categories have new waiting periods
5. Old policy cancelled automatically via the transfer process

Which is better? Stay with your current insurer if they offer competitive pricing at your new coverage level. Switch if another insurer offers better pricing, hospital agreements, or service for the same coverage.