Silver hospital cover

Silver hospital cover: broad cover for the years it starts to matter

For established families and over-40s — 29 categories including heart, lung, spine and dental surgery, without paying for pregnancy or fertility.

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Who is the cover for?

So we can price it correctly.

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What Silver hospital cover includes

Silver is the most-chosen tier in Australia, and for a reason. It covers everything in Bronze and adds the eight categories that account for most middle-age admissions: heart and vascular, lung and chest, blood, back/neck/spine, medically necessary plastic surgery, dental surgery, podiatric surgery and implanted hearing devices.

Included versus restricted, in one line

Included means the fund pays its share wherever you're treated, including a private hospital. Restricted means you're only covered as a private patient in a public hospital — which is far cheaper for the fund, and far less useful for you.

Recovery, mental health and end-of-life care

  • Rehabilitation — restricted cover — Physical recovery after illness, injury or surgery.
  • Hospital psychiatric services — restricted cover — Admitted treatment for mental health conditions.
  • Palliative care — restricted cover — Care that manages symptoms rather than curing them.

Bones, joints and muscles

  • Bone, joint and muscle — Fractures, tendon repairs and most orthopaedic surgery.
  • Joint reconstructions — Rebuilding a damaged joint — ACL repairs, shoulder reconstructions.
  • Back, neck and spine — Spinal surgery including disc procedures and fusions.
  • Podiatric surgery (registered podiatric surgeon) — Limited benefits apply — the fund pays part of the hospital cost.

Heart, lungs and blood

  • Heart and vascular system — Stents, bypass surgery, pacemakers.
  • Lung and chest — Lung, pleura and chest wall procedures.
  • Blood — Treatment of blood and bone marrow disorders.

Digestive system and abdomen

  • Digestive system — Stomach, bowel, liver and gallbladder surgery.
  • Hernia and appendix
  • Gastrointestinal endoscopy — Colonoscopy and gastroscopy.

Eyes, ears, nose and throat

  • Eye (not cataracts)
  • Ear, nose and throat
  • Tonsils, adenoids and grommets
  • Implantation of hearing devices — Cochlear implants and bone-anchored devices.

Brain, nerves and pain

  • Brain and nervous system
  • Pain management — Treatment for chronic pain without an implanted device.

Kidney, bladder and men's health

  • Kidney and bladder
  • Male reproductive system — Prostate surgery and related procedures.

Women's health, pregnancy and fertility

  • Gynaecology — Investigation and treatment of the female reproductive system.
  • Miscarriage and termination of pregnancy
  • Breast surgery (medically necessary) — Including reconstruction after cancer.

Cancer, skin, dental and reconstructive

  • Chemotherapy, radiotherapy and immunotherapy for cancer — Cancer treatment delivered as an admitted patient.
  • Skin — Removal of lesions, cysts and skin cancers.
  • Dental surgery — Surgical dental work in hospital — not everyday dentistry.
  • Plastic and reconstructive surgery (medically necessary)

Diabetes and metabolic

  • Diabetes management (excluding insulin pumps)

What Silver doesn't cover

Silver holds back the nine most expensive categories, and they're the ones that split households in two directions: pregnancy and fertility for younger families, joints and cataracts for over-60s.

Bones, joints and muscles

  • Joint replacements — covered from Gold up.

Digestive system and abdomen

  • Weight loss surgery — covered from Gold up.

Eyes, ears, nose and throat

  • Cataracts — covered from Gold up.

Brain, nerves and pain

  • Pain management with device — covered from Gold up.
  • Sleep studies — covered from Gold up.

Kidney, bladder and men's health

  • Dialysis for chronic kidney failure — covered from Gold up.

Women's health, pregnancy and fertility

  • Pregnancy and birth — covered from Gold up.
  • Assisted reproductive services — covered from Gold up.

Diabetes and metabolic

  • Insulin pumps — covered from Gold up.

Silver Plus is often the smarter buy

Funds sell 'Silver Plus' policies that add Gold categories on top of the Silver minimums — and some include joint replacements and cataracts while sitting well below Gold on price. For over-60s who don't need pregnancy cover, this is frequently the sweet spot in the entire market.

Who chooses Silver

Established families

With teenagers rather than newborns, pregnancy cover is dead weight — but heart, spine and dental surgery are increasingly relevant. Silver covers the parents properly and keeps the kids on the policy as dependants.

Over-60s who don't need pregnancy cover

If joints and cataracts are the concern, ask specifically about Silver Plus policies that include them. It's the comparison most people over 60 never get shown.

What it typically costs

Silver premiums vary widely because the Plus variants sit in the same tier. Two Silver policies at the same price can cover very different things.

  • Silver hospital cover for a single.
  • Silver hospital cover for a couple. Ask about Silver Plus variants that add joints and cataracts.
  • Silver hospital cover for a family.

Where to go next

Compare every tier side by side, or read the tier either side of Silver before you decide.

Silver hospital cover: common questions

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