Medicare is the public health scheme, providing free health care, both medical and hospital to all eligible Australian residents. Medicare is funded by the Government and a levy paid by individuals on their taxable income. Medicare covers public hospital accommodation and medical expenses when admitted to a public hospital as a public patient and treated by a hospital appointed doctor or specialist.

Private health insurance provides cover for hospital accommodation in either private or public hospitals. For individuals who have taken responsibility for these costs, the patient has greater control over when, where and by whom, treatment is provided. Patients can consult any specialist of their choice and be admitted to a private hospital at a time that suits them.

Private health insurance generally covers accommodation, theatre and labour ward fees, intensive care and pharmaceuticals while admitted.

Medicare covers 75% of the Medical Benefits Schedule Fee, which is a fee set by Government, for in-hospital medical services, such as the surgeon and anaesthetist’s fees, pathology services, x-rays, etc.

The private health fund covers the ‘Medical Gap’ or 25% balance between the 75% Medicare benefit and the Medicare benefit Schedule Fee for in-hospital medical services.

Please proceed to the Cover Options page for more information on Transport Health’s range of covers.

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