No-one wants to get sick or injured, but if you do at some point, it’s important to know what treatment options will be available.

While everyone with Medicare has access to free treatment, some people also elect to have private health insurance, which may offer more choice around the hospital and in some cases, waiting times for non-life-threatening situations.

If you’re considering private health insurance, it’s worth looking at the coverage, cost and waiting times.

To begin with, let’s take a quick look at the difference between public and private health insurance.

Public vs. private health insurance

In Australia, serious and non-serious health conditions are covered for free in the public health system. That means, if you don’t have private health insurance, you can still get treated if you are sick or injured under Medicare.

However, some people choose to have private health insurance for the following reasons:

• You may be able to choose your doctor and be treated in a private hospital, depending on where you live;
• For non-life-threatening matters, such as elective surgery, you may be able to receive treatment more quickly.
• Private hospitals may be smaller and have better facilities (i.e. private room).

Private health insurance

If you’re considering buying a private health insurance policy, here are a few things to consider:

1. What is the level of coverage?

Private health insurance packages come in different shapes and sizes, with some covering the basics – such as hospital insurance – and others covering “extras”, such as dental, physio and optical. Generally, the higher the level of coverage and more extras, the more you will pay.

2. What are the waiting periods?

Some conditions have waiting or exclusion periods, which means you can’t get cover for a set period of days, weeks or months after you buy the policy for that particular condition. For example, if you have a pre-existing knee problem, you are unlikely to be able to buy a policy that allows you to have private surgery the next day. It’s worth looking at the fine print to ensure the waiting periods match your expectations.

3. What is the excess or gap payment for different situations?

In addition to the amount you pay for the insurance policy, sometimes you have to pay extra or “out of pocket” if you are admitted to hospital or use the policy for treatment. These payments are sometimes known as gap payments or an excess. It’s important to know what these amounts are ahead of time, so you’re not left surprised if you have to make a claim.

If you’d like to look at how much private health insurance would cost you, the Government has a comparison service you can visit here.

Like every article on this website, this is not personal financial advice.