Private health insurance gives you access to similar hospital treatments to what's covered by Medicare – but you get other benefits like your choice of doctor, private rooms, and wait times are significantly shorter. The amount you pay for health insurance depends on the tier of hospital cover you have.
If you're treated as a private patient in a hospital (either private or public), Medicare will cover 75% of the Medicare Benefits Schedule (MBS) fee for services that are listed on the MBS.
Your health insurance typically covers the other 25%, plus accommodation costs and theatre fees, depending on your level of cover and provided you have served relevant waiting periods. You will often be out of pocket for costs like the excess, and the gap between the MBS fee and the total cost of your procedure.
Not sure if private health insurance is worth it? Here are some key differences between the public and private healthcare systems in Australia:
| Public system | Private health insurance | |
|---|---|---|
| Doctor | A public hospital will allocate a doctor for you. You don't get to choose. | You can choose which doctor you see. |
| Private room | You'll likely end up in a shared room in a public hospital. | Insurance gives you access to a private room if there's one available. |
| Waiting lists | Waiting lists for elective treatments can range from a few weeks to a few years. | Private insurance usually involves a shorter wait. For some procedures, you may even be able to pick your date. |
| Treatment types | Medicare doesn't cover most dental, hearing aids or other out-of-hospital treatments. | Extras can give you cashback on out-of-hospital services such as optical, dental, psychology and hearing aids. |
| Ambulance costs | In most cases, Medicare won't pay for your ambulance except in Queensland and Tasmania. | Most health funds include cover for an emergency ambulance, even on Basic policies. |
"Private hospital insurance covers all the same treatments as Medicare. The difference lies in the standard of care. It's kind of like choosing between a dependable budget car or something flashier. Both will get you from A to B but one is a faster and nicer place to be."
"I've always been a big proponent of private health cover – and geez I was glad I had it when I was diagnosed with breast cancer in 2021. With any unexpected serious illness, the type of treatment – and crucially the speed of it – could make all the difference."
"Health insurance is heavily regulated in Australia, which makes it easier to compare health insurance policies like-for-like. That said, funds still have different products and prices, so it's still important to make sure you're getting the right cover for you and your family."
"Changing health insurance had been on my to-do list for ages, but I found it very confusing. Eventually I compared and took advantage of sign-up offers –by switching health insurers, I've saved around $800 so far."
The Medicare Safety Net provides extra financial support to people who incur high out-of-pocket medical costs. Learn more.
AIA health insurance offers a competitive range of health insurance packages, each offering membership to the unique AIA Vitality health and wellness program.
Single parent health insurance is a cost-effective way for you to protect yourself and every one of your dependants.
Read our guide to health insurance and health funds specific to residents of the Northern Territory.
Read our guide to health insurance for people living in South Australia.
Guide to finding health insurance for those living in Tasmania.
If you’re looking for private health insurance in Victoria, compare the most popular health funds in your state and how much it costs to take out cover.
Start your search today to find a Queensland health fund that offers value for money and the cover you need.
Guide to travel insurance for residents of New South Wales.
Check out our list of the most popular health funds in WA and see how private health cover costs in WA compare with the rest of the country.
HI My parents Are currently on BRIDIG VISA A as w applied for Subclass 864 Parets contributory visa for both My Mom age 71 and Dad 69. could You please suggest us a best insurance or a broker for the particular visa please.
Hi Singh, Finder is a financial comparison site so we aren’t able to provide information around visas or brokers. We also aren’t allowed to give financial advice around insurance products. If you are interested in researching health insurance for your parents, you can visit our Overseas Visitors Health Cover page. Hope this helps!
Ceyda
Hi
I am a NZ citizen working in the Aust for the last 5 years. Do you know any private medical insurance companies that covers Aust and NZ?
Many thanks
Hi Hester, thanks for your question.
Unfortunately, you won’t find a single private health insurer that will cover you on both sides of the pond with a single policy. This is mainly because Australia has a very highly regulated health insurance sector that leaves no space for multi-country cover.
Of course you are eligible for Medicare as a Kiwi living in Australia, so you certainly have full access to the public hospital system, as well as the ability to take out private hospital coverage. But if you want private cover in both countries, you’ll probably need a separate policy from 2 different health funds.
My health insurance is with Medibank and it costs $600 a month. My husband & I are both retired & cannotbafgord it. Need help.
Hi Nenita,
There are a few things you can do to bring costs down, I’ll leave some suggestions below.
1. Spend some time looking into what other policies are out there that offer the same coverage. When it comes to hospital cover, all providers have to cover the same things so it’s worth hunting around and seeing who can offer the level you need at a cheaper price. You can do this via our quiz and then sorting by price once the table loads.
2. If the pricing comes back and it’s still unsustainable for your budget, you could look at dropping to a lower level of cover. Of course, you’ll have to decide if this is the right move for you as it will mean losing access to some treatments. Be sure to read what you’ll be covered for and what you won’t be covered for before you decide to do this.
3. Have a look at the discounts available across a few insurers here: https://www.finder.com.au/health-insurance/health-insurance-deals. End of financial year (30 June) is a great time to look at switching providers because it’s when the insurers are offering their best deals and there’s some serious cash to be saved. Keep in mind, that link does not include the full market of health insurers and you’ll often have to hold cover for a minimum period of time before you become eligible for the deal.
I hope this helps and you’re able to find a better deal that works for you!
I am currently insured with Australian Unity. I have Classic Hospital with $750 Excess Silver Plus, with 64% loading. My annual membership is due next week and it will be $4094.99. So my question is are there health insurance providers that are cheaper. I will need to be covered for joint replacements.
Thanks
Hi Nellie, The cost you’ll pay will depend on your age and income, as well as the loading involved. There are certainly silver plans with a lower base cost in our database – if you take the quiz at the top of this guide, you can compare your options. You might also find our guide to health insurance for joint replacement useful. Hope that helps.
Hello,
I have been switching health funds every year for the past few year’s now.
I’d like to think that I’ve saved some but life is getting expensive.
My question is, is this a short term gain? Or is there a possibility of getting a member discount if I stick with one fund for longer?
Hi Angus, Health funds raise their fees annually, and you’re unlikely to score a direct discount just because you’re a long-term member. That said, many health funds do have loyalty schemes that offer increased cover for some extras or specialist treatments – we have a full guide on what’s on offer there. That could provide a reason for sticking with one fund, but otherwise shopping around can still make sense, provided you’re not resetting waiting periods on services that matter to you.