Since most Australian residents are automatically covered by Medicare, the Government’s public health system, they typically won’t explore other health care options. In fact, they may not even know private health insurance is available for them.

However, if you want to reduce surgery waiting times or be compensated for dental and ambulance fees, keep reading.

What is Covered Under Public Health?

Before discussing what can be gained when you buy a more comprehensive health insurance coverage, let’s take a look at what you have rights to as an Australian tax-paying citizen:

  • Public health treatment at the hospital 
  • Doctors visits, whether they’re planned or unplanned
  • Tests and exams issued by the doctor during your appointment
  • Routine eye tests initiated by an optometrist
  • Doctor consultation fees (sometimes specialists fees)
  • Certain therapeutic or surgical procedures performed inside a doctors clinic
  • Life-threatening surgical procedures that must be performed in a hospital
  • A few public health dentistry procedures, like wisdom teeth removal
  • Whatever is publicly covered for Cleft lips, Palate Schemes, and EPC programs
  • Health management procedures, like for certain chronic diseases
  • Basic coverage for pharmaceutical drugs and medications

Thankfully, Australia’s Medicare system is already substantial enough to cover most emergencies and hospital procedures through taxes, and most Aussies won’t require more than what’s offered.

Still, there are many health treatments that aren’t covered by public health.

What is Covered Under Private Health?

Under private health insurance, you’ll receive the same quality medical treatment as those under Medicare. However, Australians who choose to be covered under private health insurance gain access to private hospitals, their choice of hospital doctors, and the ability to request their own room.

As it stands, private health insurance exists to take the strain off of public health care.

Under private health, you’ll receive certain services depending on your plan:

  • Ambulance services
  • Emergency department and facility fees
  • Cosmetic or non-necessary clinical surgeries
  • International comprehensive health coverage 
  • Routine dental treatments and examinations
  • Eye, speech, and occupational therapy
  • Physiotherapy and Chiropractic services
  • Psychological (mental health) services 
  • Acupuncture
  • Appliances that aid the 5 senses, like hearing aids
  • Glasses and contact lenses
  • Nursing home care
  • Better drug coverage

The services that become available to you are determined mainly by the type of private health policy and its subsequent add-ons you buy into. For each health care add-on, you’ll pay extra.

For example, top hospital coverage will cover chosen doctor’s fees, hospital expenses, and private hospital bills. However, medium hospital coverage will only cover pregnancy, cataract procedures, joint replacements, and dialysis for kidney failure.

General (extra) coverage lets you add on as many extras as you want, provided you can pay for the premiums. 

On top of the above benefits, private health insurance gives you access to rebates, like the Private Health Insurance Rebate.

However, if you don’t pay for private health coverage before 30, you will be subjected to higher rates under the Lifetime Health Coverage Act

If you earn over a set amount and still choose not to pay into a private health insurance plan, you’ll be issued a Medicare Levy Surcharge.

The Government introduced this surcharge on the off chance it will encourage those that can pay for private health care to do so finally.

Public Health vs. Private Health: What’s Better?

The average Aussie won’t have much need for private health insurance unless they have a specific condition that may become expensive without the added coverage. However, there’s no denying the amount of privilege private health insurance brings if you can afford it.

If you’re well off but not well enough to receive the Medicare Levy Surcharge, you’ll still get a lot of value.

Anyone well-off enough to receive the Medicare Levy Surcharge should immediately apply for private health insurance to remove that yearly bill. What’s more, wealthier, younger Aussies should opt-in ASAP, so they avoid paying more under the Lifetime Coverage Act.


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