Every Australian is entitled to free medical care under Medicare, however there are many cost which Medicare does not cover. Not sure if private cover is for you?
What exactly does Medicare cover?
Hospital
- 100% of the costs of being treated in a public hospital with a doctor appointed by the hospital.
Medical
- 100% of the costs of being treated in a public hospital with a doctor appointed by the hospital.
- 75% of the Medical Benefits Fee (MBF) for the cost of being treated in a private hospital.
- 85% of the Medical Benefits Fee (MBF) for any treatments outside of a hospital.
- 100% of the Medical Benefits Fee (MBF) for any treatments outside of a hospital by a bulk-billing doctor.
Pharmaceutical
- The amount covered under the Governments Pharmaceutical Benefits Scheme (PBS).
Ambulance Cover
- Medicare does not cover and ambulance costs.
With Medicare seemingly providing so much cover you might ask yourself why take out private insurance? Two key reasons;
Choice
Under the public system you have no say in the hospital or the doctor.
Waiting periods
In the public system you may have lengthy delays for any surgery deemed 'elective'.
If you are in need of medical attention do you want to be in control or do you want to be part of an increasingly over-worked and under-funded public system?
Two other factors which should be considered are;
Government incentives and surcharges
Medicare Levy Surcharge - For singles earning over $50,000 and families earning over $100,00 the government charges an extra 1% in income tax if you don't have qualifying health insurance. This may mean that the cost of buying health insurance is less than the cost of not buying it.
Lifetime Health Cover - If you join after your 31st birthday you pay a 2% surcharge per year up to a maximum surcharge of 70%. So, for example, if you join at 45 you pay 30% more than someone who joined at 30.
Federal Government Rebate – For every dollar that you contribute to your private health insurance premium the Government will give you back 30 cents if you are under 65, 35 cents if you are aged 65-69 and 40 cents if you are over 70.
Extras
If you frequently use the services of dentists, optometrists, physiotherapists, chiropractors and other practitioners it may be worth taking out extras or ancillary cover as part of your private health insurance mix.
If you do decide to take out private health insurance make sure you do plenty of research as the size and scope of policies and premiums varies significantly.
Source; Private Health Insurance Administrative Council
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