Specialist doctors

Health insurance, Medicare and out-of-pocket costs

Average customer rating: 4.3/5
Written by Joshua Malin
Reviewed by Steven Spicer
Updated 2 April, 2024

What is a specialist doctor?

In the healthcare industry, the term ‘specialist’ refers to a specific type of medical doctor who has completed specialist training and is registered as a specialist through the Australian Health Practitioners Regulation Agency (AHPRA).1

When you see a specialist with a referral from your GP, the specialist will usually send their recommendations or diagnosis to your GP, who will remain your primary physician. This allows your GP to coordinate your healthcare with other specialists or medical professionals and avoid prescribing you incompatible medications or treatments.

There is a large range of approved specialties that doctors can be trained and registered for, so it can be hard to know exactly what each specialist does. Here is a list of common specialisations and what they do:2

Specialist What they do
Radiologist Uses medical imaging such as x-rays to diagnose and treat illness or injury.
Ophthalmologist Diagnoses and treats eye damage and disease with surgery, glasses and contact lenses.
Cardiologist Diagnoses and treats diseases or conditions of the heart and cardiovascular system, such as heart disease and heart failure.
Gastroenterologist Diagnoses and treats diseases or conditions of the digestive system and diagnoses with endoscopies and other methods.
Oncologist Diagnoses and treats cancer. Oncologists often focus on a specific area of cancer treatment (e.g. surgical, radiation or medical).
Neurologist Diagnoses and treats nervous system disorders. The nervous system can include the brain, spine, nerves and muscles.
Orthopaedic surgeon Diagnoses, treats and rehabilitates musculoskeletal injuries such as scoliosis, sports injuries and congenital disorders.
Psychiatrist Diagnoses and treats mental health disorders through psychotherapy and medication.
Obstetrician/Gynaecologist Often known as an OB-GYN, these doctors specialise in both obstetrics and gynaecology. They diagnose and treat medical conditions relating to pregnancy/infertility and the female reproductive system.
Urologist  Diagnoses and treats conditions relating to the urinary tract and male reproductive system.

Private health insurance and specialists

Does private health insurance cover specialist appointments?

How does private health insurance cover specialists as an inpatient?

How can I reduce my out-of-pocket specialist costs?

Be treated by an agreement specialist

Go to a bulk billing specialist

Consider other costs

Questions to ask your insurer and specialist before treatment

When signing on the dotted line for treatment, it’s important you’re providing informed financial consent – that is, you understand and are fully aware of the costs your treatment will incur.

Below are some questions you can ask to help guide you through the process.

Ask your insurer

Ask your specialist

Meet our health insurance expert, Steven Spicer

Steven Spicer
Executive General Manager – Health, Life & Energy

As the Executive General Manager of Health, Life and Energy, Steven Spicer is a strong believer in the benefits of private cover and knows just how valuable the peace of mind that comes with cover can be. He is passionate about demystifying the health insurance industry and advocates for the benefits of comparison when it comes to saving money on your premiums.

1 Australian Department of Health: Medical doctors and specialists in Australia. Accessed January 2024.

2 Better Health Victoria: Seeing a specialist. Accessed January 2024.