What is Private Health Insurance?

About Private Health Insurance

In Australia, Private Health Insurance is health insurance offered by registered private insurers.

You can buy a Private Health Insurance policy (Hospital Cover) to help cover the cost of being treated in hospital as a private patient rather than a public patient covered by Medicare.

You can also take out a Private Health Insurance policy (Extras Cover) that helps pay for healthcare that Medicare does not cover, such as:

• General Dental
• Chiropractic
• Optical
• Physiotherapy.

How does Private Health Insurance interact with Medicare?

Australia’s healthcare system is complex. 

It is a hybrid system – a mixture of a public and private system.

Medicare is Australia’s universal public health insurance scheme. Under Medicare, every Australian is entitled to:

• free access to public hospitals
• subsidised medical services provided by private medical practitioners 
• subsidised prescribed medicines. 

However, if you take out Private Health Insurance, it helps you:

• secure the doctor of your choice rather than one allocated by the hospital
• avoid lengthy waiting lists
• pay for treatment as a private patient in a hospital
• cover the cost of medical services that Medicare does not cover.

Private health insurance does not cover services covered by Medicare, including:

• visits to your General Practitioner (GP)
• consultations with specialists in their rooms
• out-of-hospital diagnostic imaging and tests.

What are the different types of Private Health Insurance?

In Australia, there are 3 types of Private Health Insurance:

• Hospital Cover
• Extras Cover (also known as general treatment or ancillary cover).
• Ambulance Only Cover.

You can also buy a policy that combines Hospital Cover and Extras Cover.

Hospital Cover

Hospital Cover helps you pay for some or all of the cost of treatment as:

• a private patient in a private hospital
• a private patient in a public hospital
• a private patient in a day hospital.

Extras Cover

Extras Cover helps you pay for medical and allied health services that Medicare does not cover and you receive outside a hospital setting, including:

• Chiropractic
• General Dental
• Optical
• Orthodontics
• Physiotherapy
• Podiatry
• Psychology
• Speech Therapy.

Ambulance Only Cover

Medicare does not cover ambulance services.

Ambulance Only Cover helps you pay for the cost of an ambulance if you live in a state or territory that does not provide a free or subsidised ambulance service.

How do I get Private Health Insurance?

To get private health insurance you must:

• buy a policy from a registered insurer
• pay regular premiums to stay covered.