Australian Healthcare system??
 

Hi Everybody
I wondered if somebody could just clarify very simply to me how the Australian Health care system works when you are a new migrant? I have been looking at various posts and the wiki articles on here, and Ive got myself all confused:huh:

Is this right.. when you land in Australia you first need to enrol into the medicare system and then once you are accepted you can use them towards any medical treatment needed? So basically, if you are ill, you go to a doctor, pay them, and then you can claim the majority of this back through medicare-is this right???

Sorry if this has been answered somewhere,but i have looked at various sites, and cant seem to get my head around it??

Thanks in advance...

Re: Australian Healthcare system??
 

Yup that is basically right. Although the migrant Poms seem to have this big think about finding "free" medical coverage from doctors who "bulk bill" - must be a throw back to their NHS expectations. Most Australians generally pay about half the cost of a doctor's visit - they usually pay the whole lot up front then get about $30 refunded through medicare. Prescriptions also cost you about $30 max for a drug on the Pharmaceutical benefits scheme. Treatment in public hospitals is free. Medical test coverage varies but expect to pay for pathology and be relieved when you dont. Dentists are not covered by medicare so expect to pay (check out if the dentist is driving a Porsche before you enrol with him/her). Private health insurance can cover some of the costs of dentists and other ancillary services.

Re: Australian Healthcare system??
 

Thanks for this Quoll-that's really helpful! :thumbsup:

Re: Australian Healthcare system??
 

You are covered from the moment you land, so even if you havent been into medicare you can still claim for medical costs when you do. We had this happen to us, my son bless him (which I did) stood on a stingray in our first week. We paid for GP and when we went to Medicare to register we could still claim it as they knew all about us from Immigration. Also I think it is slightly higher than $30 for some scripts, one of mine costs $33 a month and one of hubbies is also over $30 (both on PBS) but probably not much more. If its not on PBS it can be lots more. So in summary scripts are generally more expensive here.

Jo

Re: Australian Healthcare system??
 

Somewhat bizarrely, sripts can be cheaper if you don't get them on Medicare but get them as a private prescription. For example, I take a number of prescription meds for migraine and they are all cheaper as private scripts.

For one of them, I can only get four tablets on a medicare prescription (and on Medicare I can only have a limited number of tabs per year). For that quantity each tablet costs $8.25. If I get it as a private sript, I can get 12 tablets per script and the cost is then $5.50 per tablet.

There are many online pharmacies and they give you the Medicare and private price for prescription medicines. Chemist Warehouse is the cheapest in my experience: www.chemistwarehouse.com.au I am lucky and have one near me (don't have to pay postage).

Even for Medicare prescription, different pharmacies charge different prices. There are no fixed charges here, only a fixed maximum. Definitely shop around!

Re: Australian Healthcare system??
 

My injection is about $1200 + per month and I get 4 for $33 bucks, think I will keep to Medicare in this case, but a very good point, and if you got health fund they will normally pay towards non psb dugs too. $50 per script in my case.

Jo

Re: Australian Healthcare system??
 

What I don't understand and hope someone can explain in words of one syllable please is that we've had loads of medical expenses this year and have subsequently gone over our MPSN threshold and so now get 80% of our money back. How does this work then? I would have thought if we reached a threshold we would get less back, not more :confused: Do we get clobbered at tax time? What does it all mean? Not complaining - daughter saw the doc yesterday, billed us $55, nipped round the corner to Medicare and got $50.75 back ;) Sure I'll have to pay somewhere along the line though.

Re: Australian Healthcare system??
 

Hiya

We just enrolled in Medicare the other day, go to your local medicare office fill out the form and just provide your UK passport as ID and they will send your card etc to your new home address.

Your medicare card entitles you to a rebate on your doc bills. i.e you make an appointment with your doctor, pay for it, then take your doctors bill into the medicare office and get your rebate. Think you only get like 30 - 40% of the orginal cost back. Look for a doctor who bulk bills that way you just pay the amount your supposed to and the doctor will bill Medicare for the remaining amount.

However if you go to the hospital for emergency treatment etc you will not have to pay like the NHS systme. Also if you need for exampe a knee replacement you will not pay but have to sit on a huge waiting list for the surgery.

Apparently most aussie pay for their elective surgery and pay to avoid waiting lists.

Re: Australian Healthcare system??
 

No you wont get stung, it is so that people that spend a lot on medical expenses get more back when they hit a limit, especially if you have a few kids, if you need anything doing before the end of the year get a move on you will get heaps back and save youself loads. Also go to your chemist at the end of the year and ask for a print out of how much you spent in scripts, you can claim this against tax once it hits a certain limit (not sure if that is included in the threshold figure) Thats why I stick to one so I only get one report, and for your kids too.

Jo

Re: Australian Healthcare system??
 

Nearly right, but not quite..

Medicare will always pay 85% of the scheduled fee. The scheduled fee is the 'official' cost of the service you've received - not necessarily what the doctor charges.

Some doctors charge the scheduled fee (so you pay 15%)
Some doctors charge more than the scheduled fee (so you pay the difference between the 85% and what they charge)
and ...
Some doctors only charge 85% of the scheduled fee. This is what is called 'bulk-billing' when Medicare pays the whole lot - and the customer pays nothing.

Re: Australian Healthcare system??
 

Most Aussies we have spoken to have private health insurance as well. this could be due to the 30% levy also.

Re: Australian Healthcare system??
 

In the March quarter of 2008, 73.7% of all Medicare services were bulk billed.

I must admit I thought it was still 85% !! I suppose I never notice as I never actually pay anything.

Re: Australian Healthcare system??
 

Hospitals:
Accident and Emergency is all free

Doctors:
Bulk Billing Doctors are free (some only bulk billl children, disability and elderly).

Other Doctors, those who want to charge higher than the bulk billers... example based on some 2008 Medicare Rebate figures:

Scheduled rebates and Consultations category.
A= $37.95 - Simple diagnosis (not too much time spent in consultation)
B = $55.75 - Selective medical history required (not too much time spent in consultation)
C = $73.75- Comprehensive medical history required (or B and took over 20 mins)
D = $103.15 - Highly complex diagnosis (appointment was at least 40 mins)

If a doctor charges $50 for a standard "A" consultation, the patient’s out-of-pocket costs (the difference between the fee charged upfront and the Medicare benefit) will be about $12.

If the Doctor charged $70 for the same consulation, you would pay about $32.

Those are the theoretical figures...

Anyone been to the Doctor recently ?

Re: Australian Healthcare system??
 

In a word, Medicare is a shambles.

You can be bulk billed and pay nothing. The sam doctor might charge you $60 and Medicare refunds about $30. It seems totally random.

Many people will say it works very well, but perhaps have never been near a hospital here. Or have been in a hospital in another state. It's random!

Since Mrs Wol and I arrived, four and a bit years ago and both in good health, we have paid out $46,252 for healthcare, minus Medicare rebates of $8630 and private insurance refunds of $1463. These figures include prescriptions and dentists visits. Hospital charges that were incurred are not included - they were extra and paid by insurance.

The thing to note is that private insurance only refunds the "gap" - the difference between the Medicare assessed fee and the 85% of that. But the actual charge is likely to be well over the Medicare assessment. So if an anaesthetist charges $800, and the Medicare assessed fee is $100, you will only get back $85 from Medicare and, if privately insured, $15 from the insurance! Leaving you with a bill for $700.

I could go on, because the randomness is comical!

Re: Australian Healthcare system??
 

I had thought that medicare paid 75% of the costs leaving private insurance to pay the rest. However on the basis of your figures it would hardly seem beneficial to take out private health insurance. Also if the rebate is abolished in the forthcoming budget even less so.