Cover

In Australia, taking out a private health insurance policy helps you pay for the cost of medical treatment.

Private health insurance helps you cover the cost of:

• being treated in hospital as a private patient (not a public patient)
• healthcare that Medicare does not cover such as physiotherapy, glasses and occupational therapy
• receiving treatment from paramedics and being transported by an ambulance.

In Australia, there are 3 types of private health cover:

• Hospital Cover
• Extras Cover (also known as general treatment or ancillary cover)
• Ambulance Cover.

When you buy private health insurance, you have to decide what type of cover you need.

You can buy different types of cover separately or combine Hospital Cover and Extras Cover in one policy.

Sometimes Hospital Cover and Extras Cover policies include Ambulance Cover.

Hospital Cover

Hospital Cover helps you pay for some or all of the cost of treatment as:

• a private patient in a private hospital
• a private patient in a public hospital
• a private patient in a day hospital.

Extras Cover

Extras Cover helps you pay for medical and allied health services that:

• you receive outside hospital
• Medicare does not cover.

Some examples include:

• Chiropractic
• General Dental
• Optical (glasses and contact lenses)
• Orthodontics
• Physiotherapy
• Podiatry
• Psychology
• Speech Therapy.

Ambulance Cover

Ambulance Cover helps you pay for the cost of an ambulance if you live in a state or territory that does not provide a free ambulance service.

Under Australian law, private health insurance does not cover a range of treatments, including:

• Cosmetic Surgery
• Home Care Packages
• some Natural Therapies
• Residential Aged Care
• Visits to your GP
• Visits to your specialist in their consulting rooms.

To get private health cover you must:

• buy a policy from a registered insurer
• pay regular premiums to stay covered.

There are 30 registered insurers that sell private health insurance policies in these categories:

• Hospital Cover
• Extras Cover
• Combined Hospital and Extras Cover
• Ambulance Cover
• Overseas Visitors Health Cover
• Overseas Student Health Cover.

To find out if your Hospital and Extras Cover policies are combined, look at your Private Health Information Statement (PHIS), which is a PDF emailed to you when you first take out cover, and then every 12 months. Your Policy ID is shown at the bottom left-hand corner of the PHIS.

If your Hospital and Extras policies are combined, you will have one Policy ID for both types of cover, but if you have 2 different Policy IDs they are not combined and they are treated as ‘separate’ policies by your insurer.