Private Health Insurance: Understanding Your Options

Private health insurance is a type of insurance that pays for medical expenses not covered by Medicare, the government-funded health insurance program. Private health insurance can help you pay for services that Medicare does not cover, such as dental care, vision care, prescription drugs, and more. In this article, we’ll take a closer look at private health insurance and help you understand your options.

What is Private Health Insurance?

Private health insurance is a type of insurance that provides coverage for medical expenses that are not covered by Medicare. It is purchased by individuals or families, rather than provided by the government. Private health insurance policies can vary widely in terms of what they cover and how much they cost.

There are two main types of private health insurance: hospital cover and extras cover. Hospital cover provides coverage for medical expenses incurred while you are admitted to the hospital, while extras cover provides coverage for other medical expenses such as dental, optical, and physiotherapy.

Hospital Cover

Hospital cover provides coverage for medical expenses incurred while you are admitted to the hospital. This can include things such as accommodation, theatre fees, and inpatient medical services.

Hospital cover can also provide coverage for emergency ambulance services and in some cases, rehabilitation services. However, it is important to note that hospital cover does not cover medical expenses that are incurred outside of the hospital.

In Australia, private health insurance policies are regulated by the Australian Prudential Regulation Authority (APRA) and the Private Health Insurance Ombudsman. This means that all private health insurance policies must meet certain standards and regulations.

Extras Cover

Extras cover provides coverage for other medical expenses that are not covered by Medicare or hospital cover. This can include things such as dental, optical, physiotherapy, and acupuncture.

Extras cover can also provide coverage for other services such as chiropractic, naturopathy, and hearing aids. However, it is important to note that extras cover does not cover medical expenses that are incurred while you are admitted to the hospital.

Why Consider Private Health Insurance?

Private health insurance can provide you with additional coverage for medical expenses that are not covered by Medicare. This can include things such as dental care, vision care, prescription drugs, and more.

Private health insurance can also provide you with greater flexibility and control over your healthcare. With private health insurance, you can choose your own doctor and specialist, and you can often access medical services more quickly than you could with Medicare.

Additionally, private health insurance can provide you with peace of mind knowing that you will be covered for medical expenses that are not covered by Medicare. This can help you avoid unexpected medical bills and financial stress.

How to Choose a Private Health Insurance Policy

When choosing a private health insurance policy, it is important to consider your individual healthcare needs and budget. Some factors to consider include:

  • What medical services do you need?
  • How often do you visit the doctor, dentist, and other healthcare providers?
  • What is your budget for health insurance premiums?
  • What level of coverage do you need?

It is also important to compare policies from different health insurance providers to ensure that you are getting the best value for your money. You can do this by researching different policies and comparing their benefits, costs, and exclusions.

Frequently Asked Questions (FAQ)

What is the difference between hospital cover and extras cover?

Hospital cover provides coverage for medical expenses incurred while you are admitted to the hospital. Extras cover provides coverage for other medical expenses such as dental, optical, and physiotherapy.

Will I still need to pay for medical expenses if I have private health insurance?

It depends on your policy. Some private health insurance policies will cover all or most of your medical expenses, while others will only cover a portion of your expenses. It is important to carefully review your policy to understand what is and is not covered.

Can I choose my own doctor and specialist with private health insurance?

Yes, with private health insurance, you can usually choose your own doctor and specialist. This can give you more control over your healthcare and ensure that you receive the best possible care.

How much does private health insurance cost?

The cost of private health insurance can vary widely depending on the level of coverage you choose and your individual healthcare needs. It is important to compare policies from different providers to ensure that you are getting the best value for your money.

Can I still use Medicare if I have private health insurance?

Yes, you can still use Medicare if you have private health insurance. However, Medicare will only cover medical expenses that are covered by the Medicare Benefits Schedule (MBS). If you have private health insurance, you may be able to access additional medical services that are not covered by Medicare.

Hospital Cover
Extras Cover
Accommodation
Dental
Theatre fees
Physiotherapy
Inpatient medical services
Optical

In conclusion, private health insurance can provide you with additional coverage and flexibility for your healthcare needs. It is important to carefully consider your individual healthcare needs and budget when choosing a policy and to compare policies from different providers to ensure that you are getting the best value for your money.