Your decision-making about insurance will be made easier with the new tiers because you can more easily identify the level of cover you need for a given condition or range of treatments.
If you study this table you can see at a glance how the levels of cover are divided into four categories. The scope of cover for increasingly expensive treatments rising in stages from Basic through to Gold.
The lowest cost tier, Basic, offers few or limited number of services or treatment categories that must provide cover and even then need only provide for restricted or limited benefits.
Bronze is required to offer cover for a significantly wider range categories of treatment, such as for operations for hernia and appendix and for several types of cancers including breast cancer.
More expensive categories appear in the Silver tier and include treatments for heart and vascular problems and medically necessary plastic and reconstructive surgery.
Gold provides, as a minimum, coverage for all categories of treatment, meeting all hospital costs, less any excess the consumer has agreed with the health fund to pay.
The tiered approach, in grouping of treatments by their cost, can help you to focus your calculations on which treatments or range of treatments you would like to or expect to need to cover in the future.
Bronze cover, for instance, does not have to include cover for treatment for the heart and vascular system, an important consideration when we consider that cardiac disease is the most common cause of death. In its acute forms, cardiac disease is routinely treated in public hospitals at no direct cost to the patient.
Then, consider Silver, which does not have to include cover for cataracts, another very common procedure for which there tends to be long waiting lists in the public hospital system.
In both cases health funds may offer in their lower premium tiers some form of cover for these clinical categories.