When you’re treated as a private patient, Medicare and your private health insurance will pay a benefit towards your treatment costs if you hold the right level of cover. However, you’ll usually, you’ll still have to pay:
Your gap payment is the difference between what Medicare and your health fund pays, and what the hospital charges, while your excess is a flat amount you pay on admission.
Your total gap amount will also depend on your fund’s gap cover scheme. A no-gap scheme means your entire gap will be covered, while a known-gap scheme means your gap will be reduced to a predetermined amount that you’ll be made aware of before treatment.