The benefits of having a two-tiered medical insurance system is that no matter what medical attention you might require, there is an affordable option available.  Every citizen is covered by Medicare.  In addition, you may wish to obtain coverage through a private health insurance.

What does Medicare Cover?

Each year when paying taxes, part of the proceeds go towards funding universal health insurance.   According to PrivateHealth.gov.au, Medicare covers hospital expenses, medical expenses, and pharmaceutical expenses. Through Medicare,  a public hospital will treat you at no charge with a hospital-appointed doctor.  You can also visit a general practitioner and receive reimbursement.  Finally, you only will have to pay a portion of the costs for most prescription medications you might be required to take.

If Medicare Covers Me, What Does Private Insurance Cover?

Even though Medicare covers everyone, many still choose to purchase private health insurance.  This is because while Medicare covers most of the expenses for healthcare, Medicare does not cover everything you may require to remain healthy through your lifetime.  In addition, if your income is over a certain threshold, unless you carry private medical insurance, you will be subjected to the Medicare tax levy.

Items not covered by Medicare include:

• Ambulance costs
• Private patient hospital costs
• Medical costs incurred while traveling
• Medical costs related to surgeries or services that are not deemed necessary
• Examinations for the purposes of obtaining life insurance
• Vision care needs
• Dental Care needs
• Hearing aids
• Long-term care through home nursing
• Physiotherapy, speech therapy, psychology, etc.

You can purchase private insurance to cover many of the above expenses.

What Types of Private Insurance Exist?

Basically, there are two types of private medical coverage:  hospital and general treatment.  Hospital coverage is just like it sounds, it covers you at various levels in case of a visit to the hospital.  General treatment coverage provides coverage for services including dental, vision, occupational therapy and more.

Hospital Cover – There are four categories of private hospital coverage:

• Top private hospital cover – this has no exclusions restrictions on what will be paid by the company
• Medium private hospital cover – no exclusions, but there are restrictions on some items for coverage
• Budget private hospital cover – this excludes at least one coverage item
• Public hospital cover – it covers benefits only if you are treated in a public hospital.

General Cover – There are three categories of general coverage

• Comprehensive cover – this coverage includes at the very least dental, orthodontics, vision, physiotherapy, occupational therapy, hearing aids, pharmaceuticals, chiropractic and podiatry
• Medium Cover – this level of coverage leaves out orthodontics and health management and more, but it does include dental, optical, and physiotherapy and more
• Budget cover – it includes at least one area such as dental, optical, physiotherapy and chiropractic services (for more information, you may wish to view the glossary page at PrivateHealth.gov.au).

Finding the Policy that Works for You

Finally, once you know what additional medical coverage you would like (if any), then you can research the different companies that offer that level of coverage.  In order to decide whether you would like a private health insurance policy, you may find the publication, “Insure? Not sure?”, is an invaluable resource.  The PrivateHealth.gov.au website features a tool that can help you find approved companies for your medical insurance needs.  The website sorts the companies by monthly premium price, and features links to each provider’s website.

Photo by celestehodges

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