Medicare vs Private Health Insurance: Which One is Better?

It is important to have your health care needs covered in order to ensure that your hard-earned savings are not spent after your medical expenditure when you grow old or fall sick. One should either have Medicare or private insurance to take care of their healthcare needs. Whether to choose Medicare or private insurance is a tough decision to make. Every person has different healthcare needs and financial situations. You have to keep everything in mind before making a final decision. Insurance brokers Adelaide can provide you with valuable guidance in this matter so that you can make informed decisions. Here we are trying to bring some clarity about Medicare and Private Health Insurance to help you make the best suitable choice.

Is there any difference between Medicare and Private Health Insurance?


Medicare is the backbone of Australia’s healthcare system. If you are covered under Medicare, you can get treatment as a public patient in a public hospital by a doctor appointed by the hospital. By and large, you will not need to spend even a single penny for the treatment. However, you will not get the privilege to choose your own doctor since you are a public patient. When you are required to be admitted to the hospital will also be decided by the appointed doctor. There will be hardly any scope for your opinion.

Private Health Insurance

Private health insurance includes hospital cover and general treatment cover which is also known as extras cover. Each cover has its own set of benefits. If an Australian resident has a private health insurance, he can get treatment in the hospital of his choice- either private or public. The only precondition is that the services should be included in the cover and you should have served your waiting period. Under Private Health Insurance, you can also choose to get treatment like a public patient at a public hospital. Private patients at a private hospital get more choices in comparison to a public hospital. There you will have to follow the rules of waiting lists for elective surgery.

Should you have Medicare or private health insurance?

Aged care insurance Adelaide and private health insurance is sold by private insurance companies not by the government. While Medicare is provided by the federal government. One should keep in mind that Medicare does not cover the cost of extra services. Its prime focus is to keep you on top of your health. Dental, glasses, physiotherapy and many other services like this are covered in extra. Medicare is not liable to pay for them.

You do not have to pay a premium for Medicare. Private health insurance will cost you a monthly premium. Since Medicare is free, people opt for it even if they are covered by employer-based insurance. Considering your health needs, you should decide whether Medicare will be sufficient or you need private insurance to cover your extra needs. You can make a smart choice by understanding the limitations and benefits of both Medicare and private insurance.

Can you have both employer insurance and Medicare?

People with Medicare mostly choose to have health coverage from somewhere else as well. There are two types of Medicare- Part A and Part B. For Part A you need not pay any premium while for Part B you have to pay monthly premiums. If you are receiving benefits of group health insurance from an employer or your spouse’s employer, it is advisable not to sign up for Medicare Part B. For that, the employer needs to have more than 20 employees. After the end of employment, you get a special enrolment period of eight months. Within this duration you can enroll for Part B of Medicare insurance without paying any late penalties.

Considering your situation, you have to decide whether the employer insurance can become your primary insurance or not. Primary insurance generally pays medical claims first.  Secondary insurance then pays for the services which are not covered under primary insurance. If you are working for a small organization, you need to check whether your healthcare needs will be taken care of by the employer insurance. If not, you should sign up for Medicare. Remember, if you fail to enrol for Medicare, you will be left without any insurance policy which means that you will have to pay from your savings for your healthcare needs.

Consider your situation, weigh your options well and then decide which insurance is the best for you. If the combination of both works for you, then you should go for that as well.  

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