What does private health insurance cover that Medicare doesn’t?

Private health insurance can help to cover some medical and health costs that Medicare does not cover.

How much and what private health insurance covers depends on the policy you purchase. 

Examples of some of the medical services Medicare provides for free or at a reduced cost include:

• hospital treatment at a public hospital by a doctor appointed by the hospital
• visits to general practitioners (GPs) 
• visits to specialists in their rooms
• some tests and scans such as x-rays
• some prescription medicines
• eye tests by optometrists.

Medicare does not cover:

• private patient hospital costs
• ambulance services
• most dental services
• most allied health services such as physiotherapy, occupational therapy, speech therapy, eye therapy, chiropractic, podiatry and psychology services
• treatment or transport by ambulance.

There are 3 types of private health insurance:

• Hospital Cover, which covers, for example, accommodation and theatre fees
• Extras Cover, which covers, for example:
  • general dental
  • physiotherapy
  • chiropractic
  • podiatry.
• Ambulance Cover.

Many Australians purchase private health insurance because you can:

• choose your own surgeon or specialist
• be treated in a private hospital
• be treated in a public hospital as a private patient.
• avoid long waiting lists.

It can also help you pay for dental services and allied health services that Medicare does not cover.