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How does private health insurance work?

Private health insurance is generally divided into hospital cover and extras cover. All private health insurance only covers for inpatient specialist care, meaning, if you are an outpatient and are not admitted to hospital, your private health insurance will not cover any of your costs related to specialist medical practitioner services.

There is an enormous range of private health insurance products on the market. The general rule is that the cheaper the premium, the less the product will cover. Such products will often exclude cover for specific medical treatments.

Patients need to be aware of what they are covered for and what is excluded from their health care policy. Unfortunately, the list of exclusions is getting larger all the time, often without transparency from health funds to their policy holders, so you must keep up-to-date with changes, remain informed and ask the correct questions of your fund.

To assist patients in understanding private health insurance and the effects of recent changes, AMA Queensland has collated several resources. For more information visit

If you are not sure if your private health insurance does cover your procedure with Gastroenterology Clinics Queensland please contact our friendly reception staff at 1800 199 920 and we will assist you.