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Last Updated on 24 February 2019

Investigation: Does Medicare Cover all Health Care Needs?

Are you contemplating on purchasing a private health insurance policy? Do you feel insecure having solely the Medicare benefits to rely on? It is a known fact that despite having one of the most developed and effective health care systems in the world, the number of health insurance subscribers in Australia is increasing over the years. It is without doubt that many families purchase private health insurance with the aim of being financially secure in the event of a health emergency.

It is indeed tempting to ignore private health insurance altogether and be fully content with the benefits that Medicare has to offer. While Medicare offers access to free treatment as a Medicare patient in a public hospital, free or subsidised treatment by practitioners and a range of in-hospital and out-of-hospital services such as X-ray tests, examinations and pathology tests, most immunisations and 100% of prescription medicine costs, it doesn’t cover other crucial areas in the event of a health emergency such as ambulance assistance or ambulance transport to hospital and private patient hospital costs such as theatre fees or accommodation.

Based on closer inspection, the benefits that Medicare does not cover are grouped into the following categories:

Extra Cover

Medicare’s benefits are limited in that it doesn’t offer extra covers such as that provided by private insurance companies. The extras include cover for minor and major dental treatments, physiotherapy, speech and eye therapy, optometrist services, the use of hearing aids and home nursing. Beside, alternative treatment like acupuncture, naturopathy and remedial massage are covered as well.

Access to Care

While most of Australia’s public hospitals are of state-of-the-art quality, the real value in private health insurance lies in the security it offers to private health subscribers in the form of access to care. This includes waiting time for major surgeries, treatments and operations in the hospitals which can be long and tiresome in public hospitals as a result of Australia’s public health system design. Such a wait can be eliminated with private care. In this respect, private health customers enjoy the advantage of shorter wait times, less bureaucratic inconveniences to deal with and hence, less pre-operational stress.

Quality Treatment

There is a significant advantage over the care quality for those with private health insurance despite the high level of care made available in Australia’s public hospitals. This advantage lies with the fact that private insurance customers get to choose which hospital they want to be treated in and which doctor or specialist they want to be treated by. Moreover, there is also a greater flexibility in scheduling surgery and all hospital fees, including accommodation, doctor’s fees and theatre costs are covered by private health insurance. In this regard, there is a distinct preference for the private hospitals that offer better health care delivery in terms of quality and speed for non-emergency operations as well as a wider choice of doctors based on individual preference.

Despite there not having a perfect health system in the world, Australia’s blend of private and public healthcare seem to work for most. While Medicare undeniably forms the basis for general healthcare for Australians, there is no reason why a person shouldn’t seek more extensive coverage from private healthcare providers that better meet his or her health needs. Given the wide range of insurance policies available for all age groups and status, many options can be tailored to suit the needs of the individual and his or her family.

Disclaimer: The above information is correct and current at the time of publication

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