In Australia, health care is made up of a mixture of services funded by the Australian Government and private health insurance. Australian residents are automatically covered for many hospital and medical costs under the Government’s Medicare scheme, but many Australians choose to take out additional cover through the private health care system.
Medicare covers areas of medical, hospital and pharmaceutical costs, but doesn’t cover medical services like private hospital costs, dental, physiotherapy and similar services, emergency ambulance assistance or other transport to hospital.
The benefits you get when you have OSHC or OVHC are similar to the cover Australians get through Medicare.
You’ll have to pay a gap fee if the amount the medical provider charges is more than the benefit you’re entitled to under your cover. You’ll need to pay the gap fee yourself – you won’t be able to claim that amount.
We recommend you call your doctor before your appointment to get an idea of what it will cost you.