chris and farideh

Hi guys,

Can someone please explain how medicare and health care in Oz works please? Specifically:

Do you pay to see the gp like in NZ?
Cost of prescriptions?
Is free medication given for life conditions such as epillepsy as in the UK?
Cost of operations/hospital visits?
Can you opt out of medicare into private insurance like in Germany?
Is medicare run by the state or administered by private insurance companies?
Will insurance companies pay for treatment of existing medical conditions?

Chris

Vash the Stampede

Sometimes. If your doctor offers bulk billing, you don't pay at all. If he doesn't, you will pay a fee of $25-35.

It varies, depending on the medication and the size of the government subsidy for that particular medication.

[quote]Is free medication given for life conditions such as epillepsy as in the UK?

I've no idea; I've never had to pay for them.

You can't "opt out" of Medicare, since you're always eligible for it - but you can choose to use private health insurance instead.

It is run by the state.

As a general rule, no. But you may be able to negotiate an exception under certain circumstances.

chris and farideh

[QUOTE=Vash the Stampede]Sometimes. If your doctor offers bulk billing, you don't pay at all. If he doesn't, you will pay a fee of $25-35.


Thanks for the info Vash, what is 'bulk billing'? Why dont all Dr's use it?

ABCDiamond

Bulk Billing

You will find some areas where most doctors will Bulk Bill, and other areas where few doctors will bulk bill.

In the cheaper areas of Western Sydney, almost all doctors bulk billed, but in the more expensive areas, very few doctors would consider it.

Due to recent legislation, we are now finding that more doctors are bulk billing for Children and Pensioners, due to financial incentives from the government for the Doctors to do this,

In essence when someone visits a Doctor, Medicare will pay 85% of the Medicare Schedule fee for services provided by the treating practitioner. Let's say that the "scheduled fee" is $30.00 (Based on 2004, these figures will now be different, I haven't checked for some time)

If a Doctor fully bulk bills, they will not charge you, but they will get paid 85% of that $30 scheduled fee direct from the Medicare.

Some Doctors wish to charge, say $40.00 or more, so one of two things happens:

1: The doctor will charge you say $40, and YOU claim 85% of the scheduled $30 fee back from the local Medicare Office ($25.50). Net cost to you = $14.50

2: The doctor collects $14.50 from you, and gets you to sign the Medicare benefit over to them, and they claim the $25.50 direct from Medicare. Net cost is the same.

This difference is called "A Gap"
More very recent legislation is putting a limit on the maximum "Gap" that you have to pay each year. ie: Once you have paid a certain figure, Medicare will step in again, and repay more of the doctors bill to you.

Public Hospitals don't charge anything for Medicare patients, and sometimes even give you free medicine !!

http://www.britzinoz.com/info/medical.htm

Also

If you need to see doctors or have tests regularly you could end up with high medical costs—the Medicare Safety Net is designed to help you when you need it most. It means that once you reach a safety net threshold, visits to your doctor or having tests may end up costing you less.