Private Patient Extras

As a private patient you get more choice about the doctor you want to provide your care, and the hospital you want to attend. But you have to pay for this extra choice.

As a private patient you will be charged for the hospital accommodation and medical services you receive, whether in a private or public hospital, but Medicare will refund 75% of the MBS fee.

Private health insurance covers you against some or all of the costs associated with being a private patient in either a public or private hospital. Depending on the health fund and the policy options you choose, you can be insured against a range of medical services not covered by Medicare, both within and outside hospital.

The Medical Gap

The medical gap is the difference between the combined health insurance and Medicare benefit, and the fees charged by a doctor and hospital. You should check, whenever possible, what the gap will be for any medical services provided, as this will be the amount that you will
be required to pay from your own hard-earned savings. Some health funds do have gap cover arrangements that will cover these costs, but you need to check for yourself.