Appropriate level of private patient hospital cover

Private patient hospital cover

Private patient hospital cover is provided by registered health insurers for hospital treatment provided in an Australian hospital or day hospital. You must arrange and pay for your cover directly with the insurer.

For singles, an appropriate level of cover must have an excess of $750 or less. Couples or families must have an excess of $1,500 or less.

If your private health insurance policy doesn't provide an appropriate level of private patient hospital cover, and your income for MLS purposes is above a certain threshold, you may have to pay the Medicare levy surcharge (MLS).

General cover, commonly known as 'extras', is not private patient hospital cover. It covers items such as optical, dental, physiotherapy or chiropractic treatment.

Travel insurance is not private patient hospital cover for the purposes of the MLS. Similarly, private patient hospital cover does not include cover provided by an overseas fund.

Travelling overseas

If you cancel your private patient hospital cover while travelling overseas, you may be liable to pay the Medicare levy surcharge (MLS). You should contact your health fund to work out the amount of premium you expect to save by cancelling or suspending your private patient hospital cover. You can then compare that to the MLS you may have to pay.

For the purposes of MLS, travel insurance is not private patient hospital cover. Similarly, private patient hospital cover does not include cover provided by an overseas fund.