Medicare, the Government health insurance system, provides Australians with universal healthcare cover. Available to all Australian citizens, Medicare provides access to free or low-cost services such as doctors, outpatient care, hospital care and some dental procedures. Permanent residents who are not Australian citizens may also can qualify for the scheme.
What private health insurance offers is greater choices about how your healthcare is administered, e.g. which hospital, doctor and type of accommodation. Private cover also often offers reimbursable extras such as glasses, massages and other items.
For severe ailments, however, even private patients are put back into the public health system. The private hospitals are generally just not well enough equipped to cope with critically ill patients and specialised emergency procedures. Examples of conditions that tend to be treated within the public system are head trauma, cancer, heart surgery, organ transplants, dialysis and other items. Private hospitals usually take care of conditions like childbirth, shoulder and knee reconstructions.
What does private health insurance cover?
Depending on the level of cover, private health insurance covers some or all of the expense of being treated as a private hospital patient in a public or private hospital.
Private hospital patients are charged for their accommodation, theatre fees, drug costs and doctorsâ€™ fees, as well as many other costs, but their insurance company will reimburse them for large portions of these costs.
In addition to hospital care, private health insurance can cover some or all of the costs for many medical services Medicare does not. These may include podiatry, chiropractic treatment, dental treatment and many other procedures. It can also cover more "wellbeing" options such as glasses and contacts, as well as some natural therapies and acupuncture.
For elective surgery (non-life threatening surgery) public system waiting lists can be very long, and private patients can book into the hospital of their choice, often a lot sooner than is possible for a public patient. An example might be elective knee or shoulder surgery.
Ultimately, the decision to go private is a very personal one and tends to depend on your household income, fitness obligations and whether you are carrying any injuries or experiencing any chronic health conditions. Most Australians would benefit from private medical insurance, and it is often a case of choosing the right plan rather than whether to choose it or not.