The answer? It depends on your health, income, and lifestyle — but in many cases, private health cover can save you money, time, and stress.
✅ What Does Medicare Cover?
Medicare is great for:
- GP visits
- Hospital treatment as a public patient
- Limited specialist care
- Bulk-billed services (if available)
- Some prescription medications under the PBS
🩺 But it doesn’t cover dental, optical, physio, or private hospital treatment unless you have extras or private hospital cover.
💡 Reasons to Consider Private Health Insurance in 2025
1. Skip Public Hospital Waiting Lists
With private hospital cover, you can:
- Choose your own doctor
- Get faster treatment
- Access private hospitals
⏱️ No more waiting months for knee surgery or other electives.
2. Avoid the Medicare Levy Surcharge (MLS)
If you earn over:
- $93,000 (single) or
- $186,000 (couple/family)
and don’t have hospital cover — you’ll pay a 1–1.5% tax surcharge.
💸 Hospital cover can cost less than the MLS — meaning it may actually save you money.
3. Access Extras Like Dental, Physio & Glasses
These aren’t covered by Medicare.
Extras cover helps with:
- Dentist visits and cleaning
- Glasses and contact lenses
- Physiotherapy and chiropractic
- Mental health services
- Natural therapies (e.g., acupuncture)
🦷 Perfect if you or your family need regular check-ups or treatment.
4. Claim Government Rebate
The Australian Government offers a rebate (up to 24.6%) on private health insurance premiums, depending on your age and income. It can be:
- Applied as a discount to your premium
- Claimed back at tax time
💡 More affordable than many people realise.
🧾 What to Look For in a Health Policy
- ✅ Hospital vs Extras cover (you can get one or both)
- ✅ Coverage for services you actually use
- ✅ Annual limits & waiting periods
- ✅ Gap payments — know what’s not fully covered
- ✅ Is it Gold, Silver, Bronze, or Basic tier?
Compare using tools like privatehealth.gov.au, iSelect, or Compare the Market.
🚫 When You Might Not Need Private Cover
- You’re young, healthy, and under the MLS income threshold
- You’re happy using the public system
- You have limited use for extras like dental or optical
But even then, basic hospital cover can be a smart move for tax and emergency protection.
