Questions and Answers
Helpful information about Health Insurance, Energy and BetterBills
What does private health insurance cover?
This obviously depends on your private health insurance policy. You can insure against some costs of health services which are not always covered by Medicare, such as:
- hospital expenses (theatre fees or accommodation) in either a public or private hospital
- dental treatment
- prescription glasses and contact lenses
- physio, occupational, speech and eye therapy
- chiropractic treatment
- remedial massage and acupuncture
- other general services
Every year, your private health insurer will tell you what you are entitled to claim. Depending on your policy there may be some costs which you cannot claim for.
Benefit limits - policies may have set limits on the amount you can claim for each service – for example, up to $200 for general dental services per year, which means if you spend $300 at the dentist in one year, you will have to pay for the additional $100 out of your own pocket.
Combined limits - some policies have combined limits, using the dental example, a combined limit for dental care could include general dental, major dental (eg crowns and root-canal) and orthodontics (eg braces).
Hospital cover usually insures you against the additional costs of being a private patient in either a public or private hospital. Before you go into hospital you should always check with the doctor and health insurer to make sure there are not any out of pocket expenses or medical ‘gaps’ to pay. Some funds also offer 'gap cover' to cover the difference between the doctor's fee for services provided in hospital and the combined Medicare benefit and health insurance benefit. This is usually provided by healthcare providers that have an agreement with the health insurer.
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