What Is The Difference Between Medicare And Private Health Insurance Funds Like Medibank?

With Medibank in the news for all the wrong reasons, that does lead many Aussies to wonder if private health insurance is actually worth it. They start wondering what is the difference between Medicare and private health insurance like Medibank, and whether they will be better under the public health system (Medicare). We’ve already done a number of articles on the difference between Medicare and private health insurance for some handy reference points.

In this post, we will discuss what is Medicare and what actually is private health insurance (with funds like Medibank, the largest private health fund in Australia). We will also learn the best way to do a private health insurance comparison and compare health insurance in Australia even if you’re just under the Medicare or public health system.

What Is Medicare And The Public Health System?

Medicare is the foundation of Australia’s healthcare system. Under Medicare you can be treated as a public patient in a public hospital by a doctor appointed by the hospital and generally for no charge. As a public patient, you can’t choose your own doctor and you may not have a choice about when you are admitted to hospital. We’ve already done some great articles on

What is Private Health Insurance?

Private health insurance generally consists of Hospital cover and general treatment cover, also known as Extras cover. There are different types of cover that offer different benefits.
With Hospital cover, if you’re an Australian resident with private health insurance, you can choose to be treated as a private patient at either a private or public hospital (provided the services is included under your cover and you have served your waiting periods) or a public patient at a public hospital.

If you are a private patient at a private hospital, you may also have more choice as to when you’re admitted to hospital. If you are a private patient in a public hospital, the hospital waiting lists still apply for elective surgery.

Extras cover helps with the cost of services generally not covered by Medicare and focus on keeping you on top of your health. Extras include things like dental, glasses, physiotherapy and a range of other services.

You may be able to select a basic Hospital cover and a comprehensive Extras policy to create your own combined package. You can get packaged cover where Medibank has created a package of Hospital and Extras together, or you can mix-and-match a Hospital and Extras cover – the choice is yours.

What is Medibank Private?

Medibank Private is Australia’s leading private health fund, committed to providing our members with affordable and high quality care. We offer a range of tailored hospital and extras covers to suit all kinds of individuals and families. You can also mix and match our hospital and extras covers, or choose a package cover, which is a combination of both. As a Medibank member you can access our Members’ Choice network, one of the largest health provider networks in Australia.

Why Has Medibank As A Private Health Insurance Fund Been In The News?

In October Medibank was the victim of hackers who stole customer data. After their ransom demands were not met by Medibank, the hackers have been releasing private customer information onto the dark web. This has led to many customers thinking they should change health funds and querying the differences between Medicare and private health insurance. Many have even done a private health insurance comparison through Billy Explores.

What Is The Role Of Private Health Insurance Funds Like Medibank?

Private health insurers such as Medibank can assist people with the costs of accessing private hospital treatment. The private healthcare system complements the public healthcare system.

Is Private Health Insurance Worth It?

Private health insurance gives you flexibility when it comes to your healthcare. With Hospital Cover you can choose your own doctor, and decide whether you will go to a private or a public hospital.
You may also have more choice as to when you’re admitted to hospital. As a private patient in a private hospital you’ll be treated as soon as you and your doctor are ready, and you may get a private room depending on hospital resourcing, availability and clinical need.

There may still be out-of-pocket costs or gap fees depending on things like the hospital you’re admitted to and what services are included or restricted under your cover. With private health insurance it’s always best to contact your private health insurer before arranging treatment to find out what they pay towards the treatment, and whether there will be out-of-pocket expenses related to your treatment.

Private health insurance also helps you stay on top of your health with Extras cover, which helps with the costs of treatment by health service providers like dentists. The extent of your cover depends on the type of policy you select and may include: dental, glasses, physio and more. A yearly trip to the dentist is an example of one of the most commonly used treatments.

There are limits that may apply, for example: a limit per service, per year, or lifetime limits. Some services may not be included at all. Get familiar with your policy so you know what your cover includes.

Why Private Health Insurance Funds Like Medibank Can Help You With Your Tax

The Australian government provides the Australian Government Rebate on private health insurance to encourage people to take out private health insurance.
If you don’t have Hospital cover with an Australian registered health fund by 1 July following your 31st birthday and then decide to take out hospital cover down the track, you could pay the Lifetime Health Cover loading on top of your hospital premium. The loading increases for every year you are over 30.

If you are not covered by an appropriate private hospital insurance policy and you earn above a certain income threshold, you may have to pay the Medicare Levy Surcharge when you lodge your tax return.

Is The Difference Between Medicare And Private Health Insurance Enough To Change?

As we have mentioned above, there are a lot of differences between Medicare and Private Health Insurance (with funds similar to Medibank Private). Of course, with the current cyber attack situation, Aussies might be wondering if it’s worthwhile to continue with any private health insurance at all.

That answer is entirely up to you. However it still doesn’t hurt to compare health insurance Australia. If you feel like you can get a better deal on your health insurance policy, then why not do a private health insurance comparison. The easiest way to do a health insurance comparison is through Billy Explores. You can save time and effort, and explore potential savings simply by doing a health insurance comparison.

Important Links For Health Insurance Comparison

Insurance Comparison
Compare Health Insurance
Compare Life Insurance
Difference Between Medicare and Private Health Insurance
Compare Private Health Insurance
Compare Health Insurance In Australia