What Does Private Health Insurance Offer That Public Insurance Doesn’t?


There are some significant differences between public and private health coverage in Australia. Things such as where you are treated, medical providers, and how long it takes to treat non-emergency conditions will differ between public and private coverage. Public health care covers many basic services and costs. However, patients are limited in their options. Private health coverage gives Australians the ability to choose their own hospitals and doctors and will help pay for medical services not covered by the Medicare plan.

Since 1984, Australia has offered citizens and permanent residents Medicare public health coverage. The government-sponsored Medicare plan offers generous coverage to care for a large proportion of basic medical costs. Australia’s public health care is primarily funded through a tax or “Medicare levy” placed on citizens as part of their basic tax payments. There are many advantages to the Australian health care system, and it is often touted as one of the best public systems in the world. However, it doesn’t cover all treatments, and patients can often have lengthy hospital wait times. As a result, many Australians have turned to private coverage.

While Medicare is available to all residents, about half of all Australians invest in private insurance. With private health insurance, you’re able to select your doctor and seek treatment at a private hospital. Health insurance can also be purchased to supplement Medicare coverage and help with costs such as specialized treatments. Let’s take a look at some of the differences between private and public health insurance.

Physician and Hospital Visits


As discussed, Medicare covers treatment for many basic services. Medicare will pay for treatment at all public hospitals, GP visits, and 85 percent of the cost for a specialist visit. With insurance through a private insurer, patients can purchase hospital cover to choose their own doctor and hospital. It will pay for any private doctor’s fees and hospital expenses. Fees such as hospital accommodation and surgery fees are covered whether you are being treated in a private hospital or as a private patient in a public hospital.

Private plan hospital cover also pays for the majority of medical services listed on the Medicare benefits schedule. The public insurance plan can mean long wait times for some doctors and hospitals. A private plan allows patients to avoid long waits at public hospitals and be treated at private institutions by private physicians.

Additional Coverage


Citizens relying on public health insurance coverage have access to other services, including eye tests, limited dental treatments, and some prescription drugs. Private insurers provide general coverage for things like dental treatment, hearing aids, and glasses. While Medicare provides limited coverage for other services, general private plans typically provide coverage up to certain insurers’ limits.

A private plan covers general and major dental, endodontic, orthodontic, non-PBS pharmaceutical, optical, psychology, physiotherapy, and podiatry care. The next tier or medium plan covers dental and endodontic treatment. Additionally, a medium plan will cover any five of the other offerings of a comprehensive plan, including hearing aids. The basic level will cover all other policies.

Ambulance Transportation


In general, Medicare doesn’t cover ambulance services. In a few states and territories, ambulance transportation is covered locally with a subsidy. For the most part, however, a private plan is needed to pay for emergency transportation. Private health plans will pay for the cost of an ambulance. However, some policies will not pay if medics are called to a scene but do not transport you. Some plans cover this fee while others do not.

If Medicare insurance isn’t enough coverage for you or your family, you’ll need to find private health benefits. To find the right option for your needs, you should evaluate the monthly premium and coverage offered. Your private health coverage can serve as supplemental insurance for your Medicare coverage.


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