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Private health insurance provides coverage for health care that Medicare does not cover, such as physical therapy and glasses. According to your policy, hospitalization may allow you to be treated as a private patient.

Depending on your policy, private health insurance:

  • It allows you to be treated in the hospital as a private patient.
  •  It can help pay for medical costs that Medicare doesn't cover

You can still choose to be a public patient at the hospital if you have private health insurance.

Types of coverage

Private health insurance policies provide hospital coverage and additional coverage (general treatment).

If you want both, you can have a compact coverage or mix and match separate policies to suit your needs.

You can also get ambulance coverage if your state or territory government doesn't cover it for you.

Coverage for hospital treatment

Covering the hospital helps with the costs of treatment as a private hospital patient.

Extras and ambulance coverage

The extra coverage helps with the costs of out-of-hospital health services that medical care doesn't cover.

Coverage for an ambulance car can help cover the cost of emergency transportation and medical care.

What is not covered

By law, private health insurance does not cover medical services outside of the hospital, including:

  • Visits to the general practitioner
  • Consult with professionals in your rooms
  • Diagnostic Imaging and Out-of-Hospital Testing


If the hospital, doctor, or specialist you meet charges more than the MBS fee for a service, it may be more than Medicare pays and your insurance company will pay. In this case, you will have to pay your out-of-pocket expenses.

Some natural remedies are not covered by private health insurance. Ask your health insurance company for more details on some natural remedies.


Waiting periods

There may be a waiting period to pass before you can claim some medical costs. There is a one-time exemption for some mental health services and treatments.

Cost of cover (premiums)
Your premiums will depend on the policy you take. Your premiums will be higher if you want to:

  • Coverage for more health services, such as supplements
  • Higher level of hospital coverage
  • Zero surpluses or joint payments

Government deductions and deductions can also affect your premiums.

  • With lifetime health insurance, if you get hospital coverage when you're over 30, you may pay a higher premium for the next 10 years.
  • If you qualify for a private health insurance discount, you can use it to lower your premiums.


Premium increases

The insurance company must inform you in advance if your premium is going to increase. This gives you time to wander and shop around for health insurance policies.

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