Private vs. public hospitals

Discover the difference between the hospital systems and what your options are as a private patient.

Comparing private and public

Understanding the Australian hospital systems can help you make more informed choices when it comes to your health care. To help take out the guess work, we’ve broken down the key differences between private and public hospitals.

Know your options

In Australia, there are two main types of healthcare systems: the public system, and the private system.

The public system, which includes public hospitals, are managed and funded by Australian state and territory governments1. In comparison, the private hospital system is made up of private hospitals that are owned and managed by independent organisations2. Private hospitals help take the pressure off the public system.

Both systems offer different types of hospitals that can be accessed depending on your health needs.

Why go to a private hospital?

With hospital insurance, your health fund will help cover costs if you go to a private hospital for treatment. As a private patient in a private hospital, you have more control over your health care experience. You’ll be able to choose your hospital, your specialist, avoid public hospital waiting lists and gain access to a private room (subject to availability).

Types of private hospitals
Services provided
Overnight hospitals
Provide a range of services including elective surgery, intensive care, rehabilitation, palliative care and psychiatric services. Some private overnight hospitals also include 24/7 emergency departments.
Day hospitals
Offer diagnostic, surgical and medical treatments and services that are suitable for same day/23 hour care. Treatments and services offered include oral surgery, colonoscopies, chemotherapy, and ear, nose and throat procedures.
Psychiatric hospitals
Specialise in both short and long-term care for patients experiencing mental health difficulties.
Rehabilitation hospitals
Offer rehabilitation services for patients to restore function and recover from injuries or surgeries.

Why go to a public hospital?

If you are entitled to full Medicare benefits, you can choose to be treated in a public hospital as a public patient even if you have an appropriate level of hospital insurance. In this situation, Medicare would cover the full cost of your treatment. Unless your treatment is considered urgent, you will likely be placed on a waiting list. You can’t choose the hospital where you’ll be treated, or when you’ll be admitted. When you are admitted for treatment as a public patient in a public hospital, you will be treated by a doctor appointed by the hospital. It's also more likely that you'll share a room with other patients.

If you have an appropriate level of hospital insurance you can also choose to be treated in a public hospital as a private patient. In this situation, both Medicare and your health fund will contribute towards the cost of your treatment, however you may still have some out-of-pocket costs. The flip side is if you choose to be treated as a private patient is a public hospital, you may still be placed on a waiting list. When you are admitted for treatment, you may not have your choice of doctor and may have to share a room with other patients.

Types of public hospitals
Services provided
Acute hospitals
These often offer 24/7 emergency departments, intensive care units, elective surgery and other specialised care units, with the option to stay overnight or for a longer period of time (if deemed medically necessary).
Psychiatric hospitals
Specialise in both short and long-term care for patients experiencing mental health difficulties.
Rehabilitation hospitals
Offer rehabilitation services for patients to restore function and recover from injuries or surgeries.

Receiving treatment

What is a private patient?

A private patient is someone who chooses to use hospital insurance to help cover the cost of hospital treatment. You can choose to be treated as a private patient in both private and public hospitals, but with either option you may still need to pay out-of-pocket costs (your out-of-pocket costs will depend on the type of agreement your health fund has with the hospital). It’s worth noting if you do choose to go to a public hospital as a private patient, public hospital waiting lists still apply.

If you don’t have private hospital insurance, you can still choose to go to a private hospital for treatment. Medicare doesn’t cover private hospital costs (for example, theatre fees or accommodation), so if you do choose to go to a private hospital without adequate insurance, you should be aware and prepared for associated costs.

What is a public patient?

A public patient is someone who either doesn’t have hospital insurance for the required treatment or does and chooses not to use it when admitted into a public hospital for treatment. If you go to a public hospital as a public patient, Medicare will cover the cost of your treatment, so long as it’s listed on the Medicare Benefit Schedule (MBS).

Experience comparison

So what’s the key difference between going to a private hospital as a private patient, and going to a public hospital as a private or public patient? Below is a summary of the options you have:

Private patient in a private hospital
Private patient in a public hospital
Public patient in a public hospital
Can I choose my own hospital?
Yes, you can choose the hospital where you’d like to receive treatment, provided your specialist works there.
Possibly, although it depends on if the treatment you need can be performed at your chosen public hospital.
No, you’ll be allocated a public hospital determined by the treatment required. You have no choice in where you go to receive treatment.
Can I choose my own specialist?
Yes, you can choose the specialist that will treat you.
Possibly, depending on the treatment you are receiving and if the specialist can treat patients admitted at the public hospital you are receiving treatment. Otherwise a specialist appointed by the public hospital will perform your treatment.
No, a specialist appointed by the public hospital will perform your treatment.
Can I choose to stay in a private room?
Yes, you can stay in a private room if are admitted to a Member Plus hospital and a private room is available.
Yes. However, private rooms will always be prioritised for patients with clinical need for one.
No, you’ll be allocated a room by the public hospital – this could be a shared or private room depending on availability and clinical need.
Do I have to pay during my stay?
Possibly, as it depends on your level of cover. Your accommodation and specialist fees will either be fully or partly covered (but you may have an excess or other out-of-pocket costs).
Possibly, as it depends on your level of cover. Your accommodation and specialist fees will either be fully or partly covered but you may have an excess and you may be charged extra for a private room.
No, Medicare will cover all your accommodation and specialist fees.