Coverage limits: Some health insurance policies only pay for health care up to a certain dollar amount. The insured person may be expected to pay any charges in excess of the health plan's maximum payment for a specific service. In addition, some insurance company schemes have annual or lifetime coverage maxima. In these cases, the health plan will stop payment when they reach the benefit maximum, and the policy-holder must pay all remaining costs.
The compulsory insurance can be supplemented by private "complementary" insurance policies that allow for coverage of some of the treatment categories not covered by the basic insurance or to improve the standard of room and service in case of hospitalisation. This can include complementary medicine, routine dental treatment and private ward hospitalisation, which are not covered by the compulsory insurance.
Having that kind of control over your heart health is particularly welcome news right now, with cardiovascular disease remaining the number-one killer of both men and women. A recent CDC report revealed that “largely preventable” heart problems killed around 415,000 Americans in 2016. Under its Million Hearts campaign—which aims to prevent 1 million heart attacks and strokes by 2022—the CDC identified approximately 2.2 million hospitalizations and 415,000 deaths from heart attacks, strokes, heart failure and related conditions in 2016 that likely could have been avoided.
Most aspects of private health insurance in Australia are regulated by the Private Health Insurance Act 2007. Complaints and reporting of the private health industry is carried out by an independent government agency, the Private Health Insurance Ombudsman. The ombudsman publishes an annual report that outlines the number and nature of complaints per health fund compared to their market share [10]

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