Types of private health insurance cover
This covers you for some or all of the extra costs of being a private patient in a public or private hospital. Medicare generally covers you for 75% of the Medicare Benefits Schedule (MBS) fee while private health insurance funds cover the remaining 25%. However, doctors may charge more than the standard MBS fee, meaning there is a "gap" between what Medicare and your fund will cover. Some funds offer "gap cover" but generally any amount beyond the MBS fee will have to be paid by you. In addition to the hospital charges, you may also have to pay for the cost of hospital theatre fees, intensive care, drugs and pharmaceuticals to name a few.
This covers you for treatment by what are known as "ancillary health service providers" such as dentists and dental specialists, chiropractors, physiotherapists, and optometrists. Policies vary widely between the different health funds. Treatment that is be covered by one private health insurer may not be covered by another. As well, the rebates, which is the amount you receive back from your private health insurer when you make a claim for a service, will be different between the different insurers. There are also limits on the amount you can claim back each year.
Medicare does not cover you for ambulance services so you either need to have it included as part of your hospital or general treatment policy, or you can take out a separate ambulance-only policy. The type of cover offered by health funds varies depending on the state in which you live.