Gems

Also in some rural areas you may find no bulk bill doctors on only for children.
My town has no adult bulk billing doctors.
The one surgery that does kids bulk billed is always booked up.
We now think its easier just to pay and claim some money back.

Gems

moonsurfer

Doctors in Australia are free to charge whatever they like for any procedure. There is no 'cap' on this as the Government considers them independent professionals just like other people offering a service in exchange for payment.

The Government sits down twice a year with a group of experts and decides how much the Government will pay ('Medicare Schedule Fee) for any given medical procedure or service - about 1000 are listed in a book, the 'Medicare Benefits Schedule' which you can find online. Only services or procedures listed in this book will attract this government payment.

When you have one of these procedures or services, you get back 75% of the 'Medicare Schedule Fee'.

However, many (most!!) doctors think the Medicare Schedule Fee is too low and charge above this. Hence people being out of pocket much of the time.

Let's say your GP charges you $100 for a consultation and (say) the Medicare schedule fee for the standard consultation is $50. You'll get back 75% of $50, which is $37.50. The difference between $37.50 and $100
($62.50) you'll have to pay for yourself.

ABCDiamond

Actually, according to Medicare, the figure is 100% of the 'Medicare Schedule Fee'
78.6% of all Non-Referred (GP) Attendances were Bulk Billed in the quarter March 2010

quoll

Why bother going to the trouble of sourcing one? Just find a GP you can get on with and enjoy the continuity of care and pay the co-payment. Most bulk billers are in medical centres where you dont get that continuity or they bulk bill for concession card holders. It isnt like it is hugely expensive and it wasnt designed for people who can afford to pay the co-contribution. If you cant afford the co-contribution then you may be eligible for a health care card as a low income earner and get bulk billed anyway.

I know migrants coming from the NHS expect it all to be free but that isnt the way it works here, it is a foreign country with a different health care provision.

moonsurfer

Sorry - I must have spent too long at work it's all a bit confusing.

Yes you are right, the 75% Medicare Schedule fee only applies to in-hospital services - and in which case if you have private health insurance the insurer makes up the 25% difference.

Bulk billing means the doc has decided to charge you the Government recommended rate and claim it straight back from the Govt on the spot, so you sign the docket and pay nothing.

sniffydog

What a complete F***wit. We all joined for help somewhere along the line. Can't someone just kick tw**s like this off the system?

sniffydog

Sorry was so angry with the reply I hit reply without reading all the far more considered responses from the fantastic moderators than my rant.

Apologies in response to my own post!

mark213

Unlikely you will find a bulk bill doctor out of hours anywhere. Hence the $100 charge. Normally 60-65 is paid for billing doctors - so the $40 is the premium for this "emergency".

Medicare wont rebate you any more than the "Scheduled Fee" regardless of the time you visit, unless you are on a concession card/or FBT-A (there are others - ask Medicare), then 80% of your out of pockets are covered.

In this case if you are hard-up a hospital visit is your only option to get "free" treatment.

Private Health Cover wont help for any GP or any out patient visits, nor will it cover any gaps in payments from GP's. Private health only pays for visits to private hospitals and even then there is likly to be excesses and out of pockets. If you take "Extras" cover you get some rebates for visits to say Physio's that Medicare do not give any rebate for.

mark213

Ive never experienced/known of the 2nd one below. The doctors dont' claim the $33.55 from Medicare unless they bulk bill.

If full billing, you will most likely always be charged the (say)$50 (to go on your credit card or whatever), you can at most surgeries now claim the $33.55 directly back from medicare in to your bank. Net cost is the same, but you still have to finance the full doctor charge in all cases of full billing.

The reason for this is that not everyone gets the same rebate - so how to the doctors know what to charge you vs the next person in the line - some get more or less depending on your medicare situation (ie concession or FTB-A)

In some cases you only pay the "difference", and a cheque is forwarded to you with the doctors name on it. You are to then take/post the cheque to the doctor. But this is rare.

geordie mandy

It has helped getting a varied view on the bulk billing and medicare. Ive managed to get the yellow pages and im looking into getting a dr now. The main reason for wanting a bulk billing dr was simply to try and save us a little money, as we have been spending most of our savings on deposits for a car and setting ourselves up in Darwin.

The only reason i think im finding it so confusing, is that i thought medicare was just like the NHS, as my husbands employer at interview last year gave that impression, so i was quite shocked at having to pay to see a dr.
Mark thanks or explaining about the private health cover and dr's surgeries on what is covered.

Mandy

fish.01

My doctor has supported just paying the difference and then we send them the cheque for years. Not sure how rare it is.

"The doctors dont' claim the $33.55 from Medicare unless they bulk bill."

I think you might be a little out of date.

My doctor supports claiming direct from Medicare even though not bulk billing.

After swiping your medicare card it charges you the exact outstanding amount depending on your circumstances....eg if you have gone over the medicare safety net it reduces the gap payment by 80% on the spot.

So last time instead of paying $10 gap at the counter I paid $2. The surgery claims the medicare benefit directly and no cheques etc are involved at all.

Also, I'm not positive but I think you always have the option of not paying up front and waiting until medicare give you the cheque and then paying the balance to the GP at the same time you give the GP the medicare cheque.

itigo

I use a private GP practice and pay the fees. However, they often bulk bill for children and if I see my GP 2 days on the trot because he's asked me to, then he will bulk bill me then too. Also when I have gone for a little query, he's bulk billed as he hasn't needed to do much. It's called an incentive payment!! Don't really think they should incentivise trips to the Dr though!!

moneypenny20

In my (limited) experience of 'out of hours' doctors, they all bulk bill. However it does have it's downside because there aren't many fully bulk billing doctors around here so lots of people use the 'out of hours' as their GP and block up the system. If I have to use the facility, I tend to book in and get the wait time and go home and wait.

mpgrewal

How to politely ask/ know how much consultation fee the doctor is going to charge at the end.

I don't want to get into a situation where im paying 70% of the fee from my pocket despite being a Medicare member. I'll avoid such doctors and better find another cheaper alternative

moneypenny20

Each practice should have a list of charges they can give you.