Health care

Medicare Vs. Private Health Insurance In Australia: A Simple Comparison

3 Mins read


The differences between Medicare, a public healthcare system in Australia, and private healthcare systems are many, but the most important one is that Medicare pays for patients to be treated in the public health system, whereas private health insurance pays for patients to be treated in the private health system. Also, Medicare is a universal healthcare system available to Australian citizens, permanent residents, and other eligible individuals.

On the other hand, private health insurance is available to literally everyone, but it’s good to know that a lot of people buy it to complement their Medicare insurance policies and fill in the gaps, if any. Here is a simple comparison that will help you figure out everything you need to know about both healthcare systems, so keep on reading and check it out!

What is the cost of being in the system?

As for the cost of being in the system, there are significant differences as Medicare is partially funded by the Medicare Levy, which is around 2% of your taxable income. Even though it’s designed to help you cover the costs of healthcare, it doesn’t actually cover all medical services, so make sure to take that into consideration. The cost of private health insurance, on the other hand, is borne by you completely, which means that you should pay premiums to your health insurance provider.

It’s very important to know that the cost of those premiums is likely to increase every year, and that’s because the cost of healthcare rises in accordance with your age, location, health status, and many other factors. Of course, you can always opt for private health insurance compare and find an option that suits your needs in the best possible way, so bear that in mind as well and you won’t make a mistake.

What is the cost of certain treatments?

When it comes to Medicare, the patients will receive either free or subsidized treatment by doctors and specialists, as well as accommodation in public hospitals as public patients. Also, patients are required to pay the gap between the fees charged by the doctors, hospitals, or pharmacists and the benefit paid by Medicare or PBS (Pharmaceutical Benefits Scheme). As for private health insurance, the patients are expected to pay for the gap between the doctor/hospital fees and the benefit paid by their health insurance company.

Since there are various policies provided by different insurers, these can pay a benefit that ranges from just a portion of the cost to 100% of the cost. This means that the cost of certain treatments largely depends on the patient’s choice of the insurer and the health insurance policy.

Is there a waiting list for those treatments?

Speaking of the waiting lists, the differences between Medicare and private health insurance are drastically different – in favor of private insurers, of course. Needless to say, waiting lists in the public healthcare systems are well-known for being extremely long, with delays that occur quite often. Did you know that waiting lists for non-emergency situations often range from 1 to 12 months? That’s right, and it gets even worse with free dental treatments – especially in rural areas, where the wait is often longer than 24 months.

On the other hand, patients who decide to get private health insurance usually have a much shorter wait. Besides that, they can even choose a date for some surgeries, such as elective C-section, so keep that in mind and choose an insurance policy that will work best for your needs.

Do I get to choose the doctor?

The possibility to choose the doctor who will treat you is another important aspect of opting for a certain type of health insurance policy, and the first thing you need to know that this isn’t an option when it comes to Medicare. When you’re in the public healthcare system, any doctor who is on call at the time you’re admitted to hospital will see you, which means that you can’t pick the doctor who will treat you. The same goes for scheduling appointments of any kind.

However, patients who choose private health insurance have an opportunity to pick a preferred doctor to treat them. Of course, this is a matter of availability – in other words, if your doctor is already seeing another patient or is in the OR when you’re admitted to the hospital, it’s highly likely that another doctor who is on-call at the moment will see you instead. If you’re fine with that, private health insurance is unquestionably the right choice for you.

As you can see, there are so many differences between Medicare, which is an Australian public healthcare system, and private healthcare systems that are gaining momentum in the Land Down Under these days. Of course, your final choice should depend on many factors, such as your budget, health status, and personal preferences in the first place, so make sure to choose one of these two systems according to these. Once you figure out your priorities and health goals, you’ll be able to make the right choice and do what’s best for your overall well-being, without a shadow of a doubt!

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