Originally Posted by Wol

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!

Originally Posted by moneypen20

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 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.

Originally Posted by Sammy T

I'm confused too!

If the Medicare rebate is 100 % how come I had a doctor's appointment on Monday, was charged $86.00 and got back $32 from Medicare which means I paid $54.......

Presumably that means the treatment code only indicated to Medicare that their standard charge was for $32 and the rest is profit for the doctors, charged as record keeping, admin etc.

Sam

Originally Posted by MartinLuther

The SN in MPSN stands for Safety Net. So it helps you when you're health bills are excessive.

The other thing is that is spend more than $1500 on medical in a year (and you can include the children's bills on with one of the parents) then you can claim 20% of the excess back, on the tax return.

You pay through your normal tax contribution. You don't pay anything extra.

Originally Posted by quoll

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.

Originally Posted by quoll

Prescriptions also cost you about $30 max for a drug on the Pharmaceutical benefits scheme. Treatment in public hospitals is free.

Originally Posted by quoll

Medical test coverage varies but expect to pay for pathology and be relieved when you dont.

Originally Posted by quoll

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.

Originally Posted by Wol

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!

Originally Posted by Wol

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!

Originally Posted by fish.01

Out of interest is a dentist visit a lot cheaper in the UK? How many go to a NHS dentist...I've noticed a lot of British complaining about the standard of dental service they provide? Do the NHS dentists charge anything?

under 18
18 and in full-time education
pregnant, or have had a baby in the 12 months before treatment starts,
an NHS inpatient and the treatment is carried out by the hospital dentist, or
an NHS Hospital Dental Service outpatient. There may be a charge for dentures and bridges

Originally Posted by fish.01

A lot of the things you are talking about have nothing to do with Medicare? Dentistry, private insurance, prescriptions. With respect, I think it is a more difficult system to understand because it offers more choices billing etc but I don't agree that medicare is a shambles....maybe you don't understand it fully yet.