You can choose to be treated as a private patient in either a public OR a private hospital.

You can choose your own doctor, and decide whether you will go to a public or a private hospital that your doctor attends. You may also have more choice as to when you are admitted to hospital. 

If you are a private patient in a public hospital, public hospital waiting lists still apply.

If you choose to be treated as a private patient in a hospital (public or private), Medicare will cover you for 75% of the Medicare Benefits Schedule (MBS) fee for associated medical costs.

You can be treated as a public patient in a public hospital by a doctor appointed by the hospital.

You cannot choose your own doctor and you may not have a choice about when you are admitted to hospital.

You can choose to be treated as a public patient even if you are privately insured.

The remaining hospital and medical costs will be charged to you - some or all of these costs may be covered on your private health insurance, depending on your policy.

The remaining costs include 25% of the MBS fee for doctors' services and any amount the doctors charge above the MBS fee, plus some or all the costs of:

• hospital accommodation;
• theatre fees;
• intensive care; 
• drugs, dressings and other consumables;
• prostheses (surgically implanted);
• diagnostic tests;
• pharmaceuticals; and
• any additional doctor's fees.

As a public patient you will be treated at no charge.

Medicare does not cover:

• private patient hospital costs (for example, theatre fees or accommodation);
• medical and hospital costs incurred overseas; 
• medical and hospital services which are not clinically necessary, or surgery solely for cosmetic reasons; and
• examinations for life insurance, superannuation or memberships for which someone else is responsible (for example, a compensation insurer, employer, or government authority).

For further information please see:

• What is covered by Medicare?
• What is covered by private health insurance?

Medicare does not provide benefits for the following:

• most dental examinations and treatment;
• most physiotherapy, occupational therapy, speech therapy, eye therapy, chiropractic services, podiatry or psychology services;
• acupuncture (unless part of a doctor's consultation);
• glasses and contact lenses;
• hearing aids and other appliances; and 
• home nursing.

You can arrange private health insurance to cover many of these services.

Medicare provides benefits for:

• consultation fees for doctors, including specialists;
• tests and examinations by doctors needed to treat illnesses, such as x-rays and pathology tests;
• eye tests performed by optometrists;
• most surgical and other therapeutic procedures performed by doctors;
• some surgical procedures performed by approved dentists;
• specific items under the Cleft Lip and Palate Scheme;
• specific items under the Enhanced Primary Care (EPC) program; and
• specific items for allied health services as part of the Chronic Disease Management Plan.

For further information please see:

• What is covered by Medicare?
• What is covered by private health insurance?

Under the Pharmaceutical Benefits Scheme (PBS), you pay only part of the cost of most prescription medicines purchased at pharmacies - this applies whether or not you hold private health insurance. The rest of the cost is covered by the PBS. You must present your Medicare card to obtain this benefit.

The amount you pay varies with the medicine, up to a standard maximum. People with concession cards have a lower maximum payment.

For further information please see:

• Ambulance