If you're eligible for Medicare your private health insurance and Medicare will cover the Medicare fee (MBS fee) for your doctor or specialist. You may need to pay the insurance excess if you use your private health cover.
Sometimes your insurance pays hospital charges like accommodation, prosthetics and theatre fees. You'll need to check your policy to see what they'll cover. If they don't cover items, you'll need to pay for them yourself.
Your doctor might also charge you a higher fee for being a private patient. Medicare won't pay this fee. Check if your health insurer will pay this for you. If they won't, you'll need to pay it yourself.
If you use Medicare, all your clinical hospital costs as an inpatient get paid by Medicare as long as your treatment is clinically needed. Medicare doesn't cover accommodation.
If you can't use Medicare, you may need to pay for your care. Health insurance doesn't always cover 100% of the hospital costs for Medicare ineligible patients.
When you're thinking about using your private health insurance in a public hospital, these questions might help you decide what's best for your care:
When you choose to move to a private hospital for treatment as a private patient you'll need your own private health insurance or other funding to meet the costs of treatment. You need to check if you'll have extra costs if you transfer to a private facility.
Our staff cannot give advice about treatment costs in a private hospital or facility. You must ask your health insurance provider as they'll only give details about your cover to you.
Your Private Health Insurance provider will tell you: