Private health insurance provides a way to bridge Medicare gaps.

This type of health care kicks in when the government won't pay for a treatment or examination.

Essentially, there are two types of private health care including hospital and general treatment.

Some private health care policies cover both types while other policies only cover one or the other.


Hospital coverage

Hospital coverage includes hospital stays, treatments, surgeries, and most other things associated with an in-patient hospital visit.

Plastic surgery and other superficial surgeries are rarely covered by private health care.

Three different types of hospital coverage exist, and each type varies drastically.

  1. Top Private Coverage: This type of plan does not include any restrictions.

  2. Medium Private Coverage: Medium coverage plans do not exclude any items on the Medicare Benefits Schedule, though some restrictions do exist.

  3. Basic Coverage: While less expensive, basic coverage almost always comes with at least one restriction and one exclusion.

Deciding which type of coverage to sign up for can be tricky. Top coverage is the best kind of coverage available, though you'll wind up paying for a lack of restrictions or exclusions.

Medium coverage is tolerable if you can live with some basic restrictions.

Basic coverage should only be considered if the one exclusion and restriction are not of importance.

As with any other kind of insurance, it's best to comb through each policy offered by private insurers before buying any kind of coverage.

General treatment coverage

Not all conditions, illnesses, and pains require in-hospital treatment. Ancillary treatments are covered through general treatment plans.

Optical, dental, and any other kind of extra treatment is typically covered by a general treatment plan.

As with hospital coverage, there are three different types of general treatment coverage.

  1. Comprehensive Coverage: This is the cream of the general treatment coverage crop. Almost all ancillary treatments are covered through comprehensive plans.

  2. Medium Coverage: This type of coverage includes nearly every type of ancillary treatment, though it does not usually include hearing aids, orthodontics, and various other types of treatment (check each policy carefully).

  3. Basic Coverage: Basic coverage provides, well, basic ancillary care. One chiropractic, optical, dental, and physiotherapy session is covered.

As with hospital coverage, comprehensive coverage is the best possible option.

Medium coverage can be useful if you only plan on receiving ancillary treatments occasionally.

Basic coverage is better than no coverage at all, but it is not the best possible option.

Hospital, ancillary, or both?

While most health funds combine hospital and ancillary treatments, you are not stuck with a package deal.

Various funds also offer mix and match options.

If you want to have more hospital coverage and less general treatment coverage, you can opt for top private hospital coverage and a basic general treatment plan.

Finding a fund that is flexible is the best way to gain all of the coverage that you need.

Taking the time to browse various plans is the best course of action.

While private health insurance is almost always necessary, there are many different plans to select from.

You may find that a complete health care package provides you with what you need.

Alternately, you may discover that mixing and matching various policies is the only way to gain the best of both worlds.


This guide is opinion only and should not be taken as medical or financial advice. Check with a financial professional before making any decisions.