Private health insurance covers some of the costs of care in a private hospital. You can also use private health insurance to get treatment as a private patient in a public hospital. Private health insurance can help pay for other treatments that Medicare doesn't cover.
Medicare provides free and subsidised health services for most Australians. You can find out what services Medicare covers on the Medicare Benefits Schedule (MBS) (Opens in new tab).
To get private health insurance, you need to:
There are different types of cover provided through private health insurance:
Most private health insurers offer:
Hospital cover helps with the costs of care and accommodation as a private patient in hospital.
You can choose to be cared for as a private patient in either a public hospital or a private hospital. You can also choose your own doctor.
Extras cover (or ancillary cover) covers health services provided outside of a hospital. This can cover:
Depending on where you live (Opens in new tab) you may need private health insurance to cover transport by ambulance (Opens in new tab). Medicare does not cover the cost of ambulance services or other emergency transport.
Some insurers cover all ambulance travel, while others only cover ground travel. Check with your insurer about which type of ambulance cover best suits your needs.
If you choose to take out private health insurance, try to make sure that you understand:
Private health insurance policies are described as:
The higher the category, the more conditions are covered. Higher categories of hospital insurance cost more.
Costs for many treatments are covered by Medicare and your private health insurance.
However, doctors often charge more than the MBS fee for your care as a private patient in hospital. This is called the gap fee. You may have to pay the gap out of your own pocket.
As a private patient in a public or private hospital you might have to pay for:
Private health insurance also does not cover:
If you are treated as a public patient at a public hospital, you do not have to pay anything.
You do not have to have private health insurance in Australia. All Australian residents can get healthcare through Medicare.
Waiting times for elective (planned) surgery under Medicare can sometimes be long. Having private hospital insurance can help you get surgery more quickly in the private system.
The Australian Government helps you take out and keep private health insurance through the:
You must pay the Medicare levy surcharge if you earn a certain amount and don't have private health insurance. The levy is currently 1.5% of your taxable income.
The private health insurance rebate lowers the cost of your private health insurance. The amount that you get depends on your income.
Lifetime Health Cover helps you avoid paying higher premiums for private hospital cover. You need to take out hospital cover before you are 31 years old. Otherwise, you may need to pay more for the next 10 years.
If you have a problem with your private health insurance, start by talking with your private health insurer.
If you aren't happy with how your private health insurer deals with your concerns, you can call the Commonwealth Ombudsman (Opens in new tab).
Most visitors to Australia are not covered by Medicare. Some countries have a reciprocal health care agreement (Opens in new tab) with Australia. This mean that you might be able to get emergency healthcare in Australia.
The countries with reciprocal health care agreements are:
It's wise to take out travel insurance to cover you for medical emergencies while you are in Australia.
Some Australian visas need you to take out private health insurance (Opens in new tab). If you are studying in Australia and have a temporary student visa, you will need overseas student health cover (Opens in new tab).
You can learn more in the article How do I pay for healthcare?
To find out more about private health insurance you can visit the Australian Department of Health, Disability and Ageing website (Opens in new tab).
The Australian Government website PrivateHealth.gov.au (Opens in new tab) allows you to compare private health insurance policies. This can help you decide what type of private health insurance is best for you and your family.
The fact sheet — Making private health insurance simpler for everyone (Opens in new tab) —is in languages other than English.
You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.
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Last reviewed: August 2024
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