Australian Healthcare system??
May 2nd 2009, 10:51 am
#46
BE Forum Addict
Joined: Jun 2004
Location: Hills District
Posts: 1,399
Re: Australian Healthcare system??
You do not get 85% of what you paid rebated.
You get 85%, or whatever the % is, of the scheduled fee for that consultation rebated.
If the scheduded fee is $37.95 (which is what I found to be the scheduled fee for a Cat A consultation), then you get back the % of that $37.95, whether you actually paid the doctor $40, $50 or $60.
The confusion, in my mind, is that the current payment/rebate made by medicare for a "Surgery consultation - Level B." is $33.55. That is either 85% or 100% of the current scheduled fee for that consulation level.
But it doesn't seem to agree with the scheduled fees that I have seen quoted.
You get 85%, or whatever the % is, of the scheduled fee for that consultation rebated.
If the scheduded fee is $37.95 (which is what I found to be the scheduled fee for a Cat A consultation), then you get back the % of that $37.95, whether you actually paid the doctor $40, $50 or $60.
The confusion, in my mind, is that the current payment/rebate made by medicare for a "Surgery consultation - Level B." is $33.55. That is either 85% or 100% of the current scheduled fee for that consulation level.
But it doesn't seem to agree with the scheduled fees that I have seen quoted.
May 2nd 2009, 12:07 pm
#47
Lost in BE Cyberspace
Joined: Dec 2008
Posts: 6,039
Re: Australian Healthcare system??
I think people new to Australia and Australian healthcare should dig a little into the pros and cons of the system: don't assume that the private insurance works the same way as the UK model, with basically just an excess to pay if you need treatment.
Yes, you will usually pay an excess, but you will also pay a great deal on top of that which neither Medicare nor the insurance will cover.
And be prepared, especially outside major cities, for disintegrating public hospitals and lack of doctors and nurses.
(Our local public hospital is near collapse - only this week there was a rally to try and make the NSW government aware of this. Fat chance - they only spend any money at all on marginal Labor seats. They have had to close the maternity unit because all the staff have left.)
Yes, you will usually pay an excess, but you will also pay a great deal on top of that which neither Medicare nor the insurance will cover.
And be prepared, especially outside major cities, for disintegrating public hospitals and lack of doctors and nurses.
(Our local public hospital is near collapse - only this week there was a rally to try and make the NSW government aware of this. Fat chance - they only spend any money at all on marginal Labor seats. They have had to close the maternity unit because all the staff have left.)
Another tip for people new to private insurance here - when possible only go to the hospitals on your private insurers recommended list - they have negotiated deals with these one's so accommodation costs will be gap free. Also, always ask if you can be treated as a "No Gap" patient. This eliminates the doctors gap that Wol is talking about. They usually have a list of doctors that will consider treating you as a "No Gap" patient. I have never been knocked back when I have asked. This is only relevant to private insurance.
When we had our child in a private hospital my wife had an emergency c-section. The anaesthetist, a friendly bloke, was chatting to us the next day and said that he charges based on how wealthy his clients look. Talked about looking at how they were dressed and whether they were dripping in jewels or not (there's the randomness in the private system Wol was talking about I think). He then turned to the matter of our bill and said he was only charging us $100. I didn't know whether to be happy or insulted
.BTW, have just got back from one of the major public hospital's in Brisbane 10 mins ago....no I did not go just to check it out to prove you wrong Wol
...my sister is in there again and she told me she had a doctor from the uk being treated in the bed next to her the day before - the doctor said they found the system here far better than the NHS - I debated whether to tell you that as it sounds like a 'ours is better than yours' comment but thought it might help reassure people still in the UK that they are not going to come to a 3rd world system - unless you emigrate to the bush maybe . Of course another doctor could say the exact opposite....but at least 1 doctor in the world thinks this. It is different and probably has more options that can lead to forking out if you don't know what you're doing so make sure you ask someone who really understands it to explain it to you.
Last edited by fish.01; May 2nd 2009 at 12:17 pm.
May 2nd 2009, 8:33 pm
#48
BE Forum Addict
Joined: May 2004
Location: Umina, NSW
Posts: 2,453
Re: Australian Healthcare system??
Just as a note, if you are in the bush and need specialised treatment, there is a claim form you can use for help in payments, They will pay for KMs at I think 15c a km and approx $40 a night towards accomodation if it is necessary for you to stay near the place for treatment. Filled one out for a gent the other day who come to us to have his treatment from lightening ridge. It has to be the nearest available hospital though.
Another poiint is that if you get treated in a public hospital and they ask if you have private health you can say no if you dont, be wary of agreeing to use you private fund unless they agree not to send you gap payments. I have always said yes because they never charge me gap, but the hospital gets some money from my health ins, helps them and I then feel that the payments are worth it. I am in hospial at least once a year for 5 days at a time (please let me stay out this year). Mind you my treatment takes all of 1/2 hour daily so they let me go home in the day
.
Jo
Another poiint is that if you get treated in a public hospital and they ask if you have private health you can say no if you dont, be wary of agreeing to use you private fund unless they agree not to send you gap payments. I have always said yes because they never charge me gap, but the hospital gets some money from my health ins, helps them and I then feel that the payments are worth it. I am in hospial at least once a year for 5 days at a time (please let me stay out this year). Mind you my treatment takes all of 1/2 hour daily so they let me go home in the day
.Jo
May 2nd 2009, 11:19 pm
#49
too busy to work members
Joined: Jan 2003
Location: Tahmoor NSW - Southern Highlands
Posts: 1,385
Re: Australian Healthcare system??
Having had the same operation (rotato cuff repair) in both UK and Australia I must say the Oz experience was by far the better
IN both cases I had private cover but of course it cost me a large gap here whereas it did not in the UK.
The pre-op practice was more complicated here as you have to book the hospital yourself not through the doctor/specialist who has told you when he will do it.
But the aftercare and contact between staff and patient is much better in Oz I was still in trouble after about 18 months in UK but back to normal after 3 and half months here. Perhaps some is due to the years between and the new ways but I still think except for the cost Oz was better.
IN both cases I had private cover but of course it cost me a large gap here whereas it did not in the UK.
The pre-op practice was more complicated here as you have to book the hospital yourself not through the doctor/specialist who has told you when he will do it.
But the aftercare and contact between staff and patient is much better in Oz I was still in trouble after about 18 months in UK but back to normal after 3 and half months here. Perhaps some is due to the years between and the new ways but I still think except for the cost Oz was better.
May 3rd 2009, 12:06 am
#50
Lost in BE Cyberspace
Joined: Mar 2003
Posts: 9,397
Re: Australian Healthcare system??
Having had the same operation (rotato cuff repair) in both UK and Australia I must say the Oz experience was by far the better
IN both cases I had private cover but of course it cost me a large gap here whereas it did not in the UK.
The pre-op practice was more complicated here as you have to book the hospital yourself not through the doctor/specialist who has told you when he will do it.
But the aftercare and contact between staff and patient is much better in Oz I was still in trouble after about 18 months in UK but back to normal after 3 and half months here. Perhaps some is due to the years between and the new ways but I still think except for the cost Oz was better.
IN both cases I had private cover but of course it cost me a large gap here whereas it did not in the UK.
The pre-op practice was more complicated here as you have to book the hospital yourself not through the doctor/specialist who has told you when he will do it.
But the aftercare and contact between staff and patient is much better in Oz I was still in trouble after about 18 months in UK but back to normal after 3 and half months here. Perhaps some is due to the years between and the new ways but I still think except for the cost Oz was better.
Outof interest, where did you get the RC done here?
May 13th 2009, 12:22 pm
#51
BE Forum Addict
Joined: Jul 2007
Posts: 2,285
Re: Australian Healthcare system??
Looking at the UK Dental system at: http://www.nhs.uk/NHSEngland/Healthc...ntalcosts.aspx
It would appear the main difference is for children being able to get free treatment, and pregnant/new mothers - (that reminds me that my wife [Australian] got that in the UK, even though I [British] couldn't ! )
It would appear the main difference is for children being able to get free treatment, and pregnant/new mothers - (that reminds me that my wife [Australian] got that in the UK, even though I [British] couldn't ! )
'You are also entitled to free NHS dental treatment if you or your partner (including civil partners), receive either:
Income Support
Income-based Jobseeker’s Allowance
Income-related Employment and Support Allowance
Pension Credit Guarantee Credit; or
you are named on, or entitled to (use your award notice as evidence), an NHS tax credit exemption certificate, or
you are named on a valid HC2 certificate.'
May 13th 2009, 1:14 pm
#52
Forum Regular
Joined: Mar 2009
Posts: 51
Re: Australian Healthcare system??
These categories are also exempt in UK from the very low Band 1,2 and 3 charges:
'You are also entitled to free NHS dental treatment if you or your partner (including civil partners), receive either:
Income Support
Income-based Jobseeker’s Allowance
Income-related Employment and Support Allowance
Pension Credit Guarantee Credit; or
you are named on, or entitled to (use your award notice as evidence), an NHS tax credit exemption certificate, or
you are named on a valid HC2 certificate.'
'You are also entitled to free NHS dental treatment if you or your partner (including civil partners), receive either:
Income Support
Income-based Jobseeker’s Allowance
Income-related Employment and Support Allowance
Pension Credit Guarantee Credit; or
you are named on, or entitled to (use your award notice as evidence), an NHS tax credit exemption certificate, or
you are named on a valid HC2 certificate.'
I read somewhere that Australia has one of teh best program for Family raising, starting from the pregnancy where they will arrange the medecal treatment plus education programs for the parents and specially for the mother in how to deal with her pregnancy.
Anyone has idea is this information is true? because I couldnt find it in any official resource..
May 13th 2009, 1:28 pm
#53
High in the Dandenongs
Joined: Apr 2003
Location: Listening to Puffing Billy
Posts: 9,183
Re: Australian Healthcare system??
Like wise my Mums cancer care has been done immediately with no waits or fees
Specialists are interesting with the medicare schedule fee, like $300 appointments that refund $65, freak now when I hear the words specialst
,
May 13th 2009, 1:35 pm
#54
High in the Dandenongs
Joined: Apr 2003
Location: Listening to Puffing Billy
Posts: 9,183
Re: Australian Healthcare system??
MOST Australians pmsl! Maybe you should have added "that you know" because it certainly isn't the case here!
Medical test coverage varies but expect to pay for pathology and be relieved when you dont.
I got my purse out to be told that
'oh no, of course we bulk bill, if we didn't we'd have no customers"
Yeah, I'm a right scabby migrant me!
May 13th 2009, 1:43 pm
#55
High in the Dandenongs
Joined: Apr 2003
Location: Listening to Puffing Billy
Posts: 9,183
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!
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!
The private system on the other hand is a minefield!
If you have private health and use it as an out patient in a non participating hospital (they have a list on their websites) you will have to pay any gaps and will be stung. Yes, sure you want to use it, but it needs to be used properly otherwise you will pay dearly, as you have found out.
PH is fantastic for non urgent scenarios like hernias, knee ops etc etc but for anything else forget it and use medicare. The system is great and works very well in a lot of places, but yes, ceryainly something to consider when going rural etc etc.
May 13th 2009, 9:15 pm
#56
Lost in BE Cyberspace
Joined: Apr 2004
Posts: 10,375
Re: Australian Healthcare system??
Not true in Melbourne. We waited a week to get my son MRI'ed (non urgent, just as a check and now go routinely every year, if there are dramas in between I ring and am seen within a week and have never been billed.
Like wise my Mums cancer care has been done immediately with no waits or fees
Again not so here. I have only ever paid one cosultation fee, the first and it s\cost me $52.
Like wise my Mums cancer care has been done immediately with no waits or fees
Again not so here. I have only ever paid one cosultation fee, the first and it s\cost me $52.
That sounds amazing value, Consultants/Specialist charging less than a GP
terrific value, thats less than the medicare rebate which is only $67 for a first visit with specialist. You have written on here about many medical problems
, I wonder if youve reached the limit where your subsidised by medicare? Hence the cheaper bills. My FIL in melb is currently waiting for surgery on his leg, and when R's mother died their medical bills ended up at $22,000, mind you she was in for several weeks and they paid for a lot of stuff to be done immediately as otherwise there would have been a wait. Rudd himself was on about Cancer treatment wait times, so its really great your mum has got seen immediately.
It certainly shows how 'hit and miss' the whole medicare system is. I price our medical treatment around
there are a variety of charges and wait times. Also if people have private, study up on how to minimise "gap' fees get a list of your funds participting medical practitioners, we had something done recently for a $200 fee and the woman next to us said she was being charged almost $1000, she had no idea about gap fees or even the 20% tax rebate available.
May 13th 2009, 11:06 pm
#57
Lost in BE Cyberspace
Joined: Dec 2008
Posts: 6,039
Re: Australian Healthcare system??
That sounds amazing value, Consultants/Specialist charging less than a GP terrific value, thats less than the medicare rebate which is only $67 for a first visit with specialist.
You have written on here about many medical problems, I wonder if youve reached the limit where your subsidised by medicare? Hence the cheaper bills. My FIL in melb is currently waiting for surgery on his leg, and when R's mother died their medical bills ended up at $22,000, mind you she was in for several weeks and they paid for a lot of stuff to be done immediately as otherwise there would have been a wait.
Rudd himself was on about Cancer treatment wait times, so its really great your mum has got seen immediately.
It certainly shows how 'hit and miss' the whole medicare system is. I price our medical treatment around there are a variety of charges and wait times. Also if people have private, study up on how to minimise "gap' fees get a list of your funds participting medical practitioners, we had something done recently for a $200 fee and the woman next to us said she was being charged almost $1000, she had no idea about gap fees or even the 20% tax rebate available.
terrific value, thats less than the medicare rebate which is only $67 for a first visit with specialist. You have written on here about many medical problems
, I wonder if youve reached the limit where your subsidised by medicare? Hence the cheaper bills. My FIL in melb is currently waiting for surgery on his leg, and when R's mother died their medical bills ended up at $22,000, mind you she was in for several weeks and they paid for a lot of stuff to be done immediately as otherwise there would have been a wait. Rudd himself was on about Cancer treatment wait times, so its really great your mum has got seen immediately.
It certainly shows how 'hit and miss' the whole medicare system is. I price our medical treatment around
there are a variety of charges and wait times. Also if people have private, study up on how to minimise "gap' fees get a list of your funds participting medical practitioners, we had something done recently for a $200 fee and the woman next to us said she was being charged almost $1000, she had no idea about gap fees or even the 20% tax rebate available.The $67 rebate you are talking about is with a private specialist not a public specialist. Medicare kicks in some money for private specialists as well - but you do not have to use them. Just ask to be referred to a public specialist and it is free.
I think a lot of people who talk about medicare charging for specialists are really talking about the private system, not the public.
May 14th 2009, 12:21 am
#58
High in the Dandenongs
Joined: Apr 2003
Location: Listening to Puffing Billy
Posts: 9,183
Re: Australian Healthcare system??
That sounds amazing value, Consultants/Specialist charging less than a GP terrific value, thats less than the medicare rebate which is only $67 for a first visit with specialist.
You have written on here about many medical problems, I wonder if youve reached the limit where your subsidised by medicare? Hence the cheaper bills. My FIL in melb is currently waiting for surgery on his leg, and when R's mother died their medical bills ended up at $22,000, mind you she was in for several weeks and they paid for a lot of stuff to be done immediately as otherwise there would have been a wait.
Rudd himself was on about Cancer treatment wait times, so its really great your mum has got seen immediately.
It certainly shows how 'hit and miss' the whole medicare system is. I price our medical treatment around there are a variety of charges and wait times. Also if people have private, study up on how to minimise "gap' fees get a list of your funds participting medical practitioners, we had something done recently for a $200 fee and the woman next to us said she was being charged almost $1000, she had no idea about gap fees or even the 20% tax rebate available.
terrific value, thats less than the medicare rebate which is only $67 for a first visit with specialist. You have written on here about many medical problems
, I wonder if youve reached the limit where your subsidised by medicare? Hence the cheaper bills. My FIL in melb is currently waiting for surgery on his leg, and when R's mother died their medical bills ended up at $22,000, mind you she was in for several weeks and they paid for a lot of stuff to be done immediately as otherwise there would have been a wait. Rudd himself was on about Cancer treatment wait times, so its really great your mum has got seen immediately.
It certainly shows how 'hit and miss' the whole medicare system is. I price our medical treatment around
there are a variety of charges and wait times. Also if people have private, study up on how to minimise "gap' fees get a list of your funds participting medical practitioners, we had something done recently for a $200 fee and the woman next to us said she was being charged almost $1000, she had no idea about gap fees or even the 20% tax rebate available.As FISh says medicare specialists are free. And before anyone bangs on about them not being proper doctors, thats bollocks! Matts specialist is one of the top neuro consultants in Melbourne and whenever we see him its free.
Well not exactly free as we pay the levvy and the rebate but thats our choice as we feel we are looked after well in the public system Now as for wait times? Thats why you get yourself TOP hospital cover, bugger the extras as they are worth nothing. Then if the needs be, you have cover for that too.
And yes, we have had a lot of bad luck re our health, but as I say time and time again, the care that we have had is second to none and it doesn't cost a fortune and neither is it a shambles, here where we live, in Melbourne....
You just need to be aware that where you live can make a difference, so do your research
May 14th 2009, 12:23 am
#59
High in the Dandenongs
Joined: Apr 2003
Location: Listening to Puffing Billy
Posts: 9,183
Re: Australian Healthcare system??
Also the $52 was my "out of pocket" and yes it was a private specialist.
May 14th 2009, 3:57 am
#60
Lost in BE Cyberspace
Joined: Apr 2004
Posts: 10,375
Re: Australian Healthcare system??
Public medicare specialists don't charge. My sister just got cancer and she had 3 public specialists meeting within 3 days to decide a plan of action and operate the next day. All free.
The $67 rebate you are talking about is with a private specialist not a public specialist. Medicare kicks in some money for private specialists as well - but you do not have to use them. Just ask to be referred to a public specialist and it is free.
I think a lot of people who talk about medicare charging for specialists are really talking about the private system, not the public.
You are totally overlooking the fact most public specialists have massive waiting lists, and most doctors wont even consider adding you to the list unless you are critical.
Of course you can insist on a public specialist, I have a mate right now waiting for an appointment at the public hosp with a gyno, they are talking 2 years, she could have seen a private doc in around 3/4 weeks. Yep shes saving money
and hoping the condition does not become terminal in that time FFS
As for cancer, heart attack, run over by a bus, does anyone really think the wait will be years
of course not, as I said before thats emergency type care. However its nothing at all for some cancer patients to not get seen for a month or so, which can make a difference to the outcome. Hence why so many suddenly, private fund or not, cough up or borrow for private care.If your in an area where your seen for everything free and within days, your very lucky and I say that having worked in a Medical Centre at one stage.
Last edited by jad n rich; May 14th 2009 at 4:00 am.