The Australian healthcare system is comprised of public (Medicare) and private healthcare.
Under the public system, residents enrolled in Medicare have access to a range of medical services at no (or at a lower) cost, including:
- treatment at a public hospital as a public patient;
- doctors, optometrists, and other allied health professionals; and
- cheaper prescriptions, wherever listed on the Pharmaceuticals Benefits Scheme (PBS).
As a private patient in a public or private hospital, Medicare will cover 75% of the Medicare Benefits Schedule (MBS) fee. Private health insurance will then contribute the remaining 25% of the MBS, providing your policy offers coverage towards the service.
Other benefits of health insurance may mean you can opt for your choice of doctor, have a private room where available, and you may also avoid long waiting periods.
On top of this, private health insurance is community-rated. This means insurers will not deny your health cover claim based on your age, gender, medical history, or how likely you may be to claim on benefits. The only eligibility requirement is that you must hold a Medicare card and have served the applicable waiting periods for your services before admission and claiming.
Your health insurance may also pay benefits towards other services where Medicare does not pay a benefit, including, but not limited to, dental, optical, and physiotherapy.
To learn more, please read our guide on private vs. public health insurance.