Australian citizens, and certain overseas visitors, all qualify for universal healthcare coverage. This is possible through Medicare, and coverage includes the right to healthcare for free or at a lowered cost from primary care providers, general practitioners, specialists, hospital visits, or for prescription medicine. The Medical Benefits Schedule is a detailed list of all the services provided by Medicare and associated fees. Hospital cover is part of Medicare, and it gives you the right to be treated as a public patient in a public hospital with no charge. It will not cover private patient costs, medical services not deemed necessary, ambulance services, or emergency room services. Medicare also won’t generally cover exams for life insurance, dental services, optometry services, or hearing aids.
Those who want additional coverage to fill Medicare gaps and save out of pocket costs can opt to purchase a private health insurance plan from a provider. Here’s what you need to know about private medical plans and how you can compare health insurance with iSelect to ensure you’re on a plan that’s right for you.
These plans offer additional benefits for a monthly premium, and roughly half of Australians choose to opt-in. Private health insurance lets many Australians qualify for tax rebates, and enrolling before age 31 saves the insured from higher premiums. If you have an emergency that qualifies you for public hospital care, you can still choose to be admitted as a private patient with your health insurance. These are some of the greatest advantages.
One of the best parts of having private insurance is that you get to select your doctor. If surgery has been booked during your hospital stay, you can choose your preferred specialist to treat you and provide recovery care. It’s important to remember that if you’re admitted to a public hospital due to an emergency, you will receive your initial health care services from an on-call doctor. As a private patient, you can later be transferred to another doctor experienced with your condition.
Of course, choosing to be a private patient means your insurance company is covering the costs, and possible cons could be higher premiums, and you’ll face out of pocket costs for anything not covered. Being a private patient can come with extra benefits, but it should never affect the quality of care you receive. It’s simply your right to make the choice.
Staying as a public patient generally means you’ll be staying in a hospital room with four or more patients with varying conditions. Using a private insurance plan always means you can get a private room in a private hospital, and you’ll be prioritized for one even in a public hospital. Your odds of getting a private room in a public hospital increase if you have a serious condition or are expecting a baby.
If you enter a public hospital via the emergency room but opt to use your private medical plan, you can avoid the fees normally associated with this, including the copay. The hospital also benefits from you using your private plan as the accommodation costs they collect from your health insurance company are used to help fund the hospital.
Private health plans provide benefits beyond hospital stays as well. You’ll have shorter wait times for elective surgeries and other health care services, and depending on your type of insurance plan you may qualify for rebates on non-Medicare services. Private insurance also lets you cover any gaps in public coverage, so you can get things like dental coverage for an orofacial pain diagnosis.
Arguably the biggest disadvantage to private insurance is simply how complex insurance products can be. There are so many types of plans and levels of coverage within them that it can be overwhelming to find the right health plan. You also may be limited to a network of providers you’ll have to use for your insurance company to cover your costs. Compare health insurance with iSelect to find the best plan for your needs.