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Medicare/hospital

Old Jan 12th 2009, 11:41 am
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Default Medicare/hospital

HI there, we are hoping to moving to Adelaide in June 09. I am a Type 1diabetic of 25 years and our 9 year son has had open-heart surgery the last of which was carried out in April 07 and at present is being reviewed on an annual basis. We have a PR visa and wondered what we would need to do when we get to Adelaide. At present I am looked after for my diabetes at our local hospital; would it be the same in Adelaide or do they have clinics at the GP surgery. I have spoken to my son's consultant and they are happy to do a referral to a hospital in Adelaide. Do we just go into the one we think is appropriate with all his details?

I do not pay for prescriptions for my insulin in the UK. How will this work in Aus?

I know these are probably silly questions but we have been "deciding" to go for the last 6 years and I have now finally made the decision but am terrified of the implications for us with the health system.

Any advice would be greatly appreciated.
Many thanks,
Mags
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Old Jan 12th 2009, 12:36 pm
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Default Re: Medicare/hospital

Originally Posted by Maggiemoo View Post
HI there, we are hoping to moving to Adelaide in June 09. I am a Type 1diabetic of 25 years and our 9 year son has had open-heart surgery the last of which was carried out in April 07 and at present is being reviewed on an annual basis. We have a PR visa and wondered what we would need to do when we get to Adelaide. At present I am looked after for my diabetes at our local hospital; would it be the same in Adelaide or do they have clinics at the GP surgery. I have spoken to my son's consultant and they are happy to do a referral to a hospital in Adelaide. Do we just go into the one we think is appropriate with all his details?

I do not pay for prescriptions for my insulin in the UK. How will this work in Aus?

I know these are probably silly questions but we have been "deciding" to go for the last 6 years and I have now finally made the decision but am terrified of the implications for us with the health system.

Any advice would be greatly appreciated.
Many thanks,
Mags
Congrats on your visa. Cant help much on other stuff but my friend pays around $30 per month for his insulin. He is on some sort of government medical register that makes it cheaper. Hope i havent confused you even more OH!! and NO question is silly
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Old Jan 12th 2009, 1:05 pm
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Default Re: Medicare/hospital

Thanks Daunted. Is your friend an expat as well? Does he have some kind of additional insurance? Not really sure how it all works. From what I understand we are eligible for Medicare but people keep saying we will need to get additional insurance to cover our existing medical conditions?

Mags
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Old Jan 12th 2009, 10:53 pm
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Default Re: Medicare/hospital

Originally Posted by Maggiemoo View Post
HI there, we are hoping to moving to Adelaide in June 09. I am a Type 1diabetic of 25 years and our 9 year son has had open-heart surgery the last of which was carried out in April 07 and at present is being reviewed on an annual basis. We have a PR visa and wondered what we would need to do when we get to Adelaide.

At present I am looked after for my diabetes at our local hospital; would it be the same in Adelaide or do they have clinics at the GP surgery.
You would see your GP in Adelaide and if needed get a referral to an endocrinologist.

I have spoken to my son's consultant and they are happy to do a referral to a hospital in Adelaide. Do we just go into the one we think is appropriate with all his details?
Again, see your GP when you get to Adelaide and bring the letter from your son's cardiologist. Your GP will refer him to a paediatric cardiologist, probably at Women's and Children's Hospital in North Adelaide. It's a wonderful hospital, btw. I worked there in the paed. neurology dep't for a few months on a contract.

I do not pay for prescriptions for my insulin in the UK. How will this work in Aus?
You pay for your medications here, but if it's something on the PBS the cost is lower than non-PBS meds. Insulin would most likely be covered. Either way, it's essential, so you'll have to have it whether you pay or not, no?

I know these are probably silly questions but we have been "deciding" to go for the last 6 years and I have now finally made the decision but am terrified of the implications for us with the health system.

Any advice would be greatly appreciated.
Many thanks,
Mags
Overall the health care system in Australia is pretty good as far as I'm concerned. I know some people are less happy with it than the NHS, but my family has only had good experiences with it.
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Old Jan 12th 2009, 11:18 pm
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Default Re: Medicare/hospital

My daughter has been a type 1 diabetic since 12.

You do not get your prescriptions free here but you register on the National Diabetic Register and they give you a number so that you can get your pens, strips, etc cheaper from the diabetic supplies.

Visit the Diabetes Australia site http://www.diabetesaustralia.com.au/ and they will help you and there will be a branch in Adelaide.

Health insurance, you would have a waiting period because of your diabetes. We do not have health insurance we gave it up a long time ago. If my daughter had health insurance and went to hospital, every blood test she had they would charge extra for it. Health insurance covers you only for the hospital bed and the use of theatres in the private hospital, all medical costs of doctors etc come under medicare and you claim money back. People with private health pay gap because the doctors decide that they would like a bit more money than what medicare pays them so they up the bills and you pay the gap. You can have gap insurance I think with some funds but very expensive.

If our family go to hospital we pay nothing. We do pay of course medicare levy which is deducted from our wages. My daughter has been in intensive care once when she had gastro and paid nothing, they are wonderful to diabetics here. Well they have been in our case.

To try to explain our health system I will tell you the scenario of my dad.

Full private health insurance, very ill, admitted to a top private hospital, had an operation. That evening surgeon no idea who he was says we cannot look after him in this hospital he will have to be transferred to the public hospital. He was and he stayed there and unfortunately died and my mum got bills from specialist doctors for months after, doctors she had never seen, never known about etc. It was the gap fees for his care in the public hospital. They were quite large and mum could not afford them so I had to deal with it for her.

If you do take insurance check the policy thoroughly some people think they are covered when they are not.

My friend's son an anaesthetist and intensive care specialist says go to the public. That is good enough for me.
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Old Jan 12th 2009, 11:53 pm
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Default Re: Medicare/hospital

Originally Posted by Petals View Post
It was the gap fees for his care in the public hospital.
If anyone goes into a Public hospital, and has private insurance, do NOT tell them that you have it.

I learned that in my first year here. Hospital staff actually told me about it.

As a patient without Insurance, everything is 100% covered by medicare in a Public Hospital.

As a patient WITH insurance, they charge full rates, and the insurance often does not cover everything, hence "the gap" being paid by the patient.

I never bothered renewing my insurance after that, and have been happy with Public Hospital service so far. However, I am now getting a bit older, and sometimes I wonder... "What if"....
Oh well, I have saved about $30k in insurance premiums over the years.
 
Old Jan 13th 2009, 2:13 am
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Default Re: Medicare/hospital

Originally Posted by ABCDiamond View Post
If anyone goes into a Public hospital, and has private insurance, do NOT tell them that you have it.

I learned that in my first year here. Hospital staff actually told me about it.

As a patient without Insurance, everything is 100% covered by medicare in a Public Hospital.

As a patient WITH insurance, they charge full rates, and the insurance often does not cover everything, hence "the gap" being paid by the patient.

I never bothered renewing my insurance after that, and have been happy with Public Hospital service so far. However, I am now getting a bit older, and sometimes I wonder... "What if"....
Oh well, I have saved about $30k in insurance premiums over the years.
Dont worry about being older my mum gave up her insurance after what happened to Dad I mean they were paying a lot of money every year and the treatment they received was bad, he could not say to the public hospital I do not have health insurance. I think that might change sometime soon too with the computers the way they link people up.

Anyway Mum has been in hospital quite a few times over the years and never had a problem with the public system the last time at Easter this year when she had a heart attack, she had a private room an ensuite what more can you ask. Excellent care.

My daughter has had the best of care with all her conditions they pull out the old "doctor of your choice" most people have no clues who they want when my daughter fell down and was taken to hospital with a brain tumour she did not say oh just a minute I need to have so and so operate on me urgently.

Its a farce and more money should be put into public health because that is where the health care is provided to private and public patients.

You have to pay the surcharge for every year you are over 31 and I resent that as I originally came before Medicare when we had to have it and we did have it for quite a few years and now we are to be penalised if we want it. Not fair when they take my taxes to pay for others but not me.

I cannot believe who thought it up, stupid bow down to private enterprise, why should all the taxpayers subsidise health for some in private rooms with wine etc lot of hooey.

As we age the health care companies do not want us anyway.

As I said to my son if you are hurt in a car accident motor ac will cover your care, if you are hurt at work, work cover will cover your care now that is really cutting down the odds for a young person to need to use their insurance.

Sorry I am going on this is my hobby horse.

I had to have an op a few years ago and I said to the surgeon I suppose I will have to wait a long while, he said I hope not, three weeks I waited. Its hips hearts and knees that have the longest lists and I can stand a bit of pain.

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Old Jan 13th 2009, 2:32 am
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Default Re: Medicare/hospital

Originally Posted by Maggiemoo View Post
HI there, we are hoping to moving to Adelaide in June 09. I am a Type 1diabetic of 25 years and our 9 year son has had open-heart surgery the last of which was carried out in April 07 and at present is being reviewed on an annual basis. We have a PR visa and wondered what we would need to do when we get to Adelaide. At present I am looked after for my diabetes at our local hospital; would it be the same in Adelaide or do they have clinics at the GP surgery. I have spoken to my son's consultant and they are happy to do a referral to a hospital in Adelaide. Do we just go into the one we think is appropriate with all his details?

I do not pay for prescriptions for my insulin in the UK. How will this work in Aus?

I know these are probably silly questions but we have been "deciding" to go for the last 6 years and I have now finally made the decision but am terrified of the implications for us with the health system.

Any advice would be greatly appreciated.
Many thanks,
Mags
Mags - regarding your son's care. The children's hospitals in Australia have public outpatients clinics. When you arrive, go to a GP and get them to write a referral and send directly to the Childrens Hospital, along with your son's medical records. The hospital will put your son in the system (usually takes about a month from your GP visit) and they will call you to make an appointment (or you may just receive a letter with an appointment date). It will all be covered under the Medicare system. If you haven't heard from the hospital after a month, just phone and check if all the information was received. Good luck.
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Old Jan 13th 2009, 9:50 am
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Default Re: Medicare/hospital

Thank you all so much. You have really put my mind at rest, especially regarding my son. His health has been one of the main things keeping me from making the decision to go. Not that he is unwell but the fact that if he did become unwell would he be as well looked after there as he is by the wonderful doctors here.

I have started looking at some of the hospitals in Adelaide, especially the Womens and Childrens hospital and can see that it has an established Paed Cardiology department which is a great relief.

I have been to Australia many times and have seen how wonderful the hospitals actually are but when it comes to your children it is sometimes hard to think rationally!!!!

Many thanks,
Mags
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Old Jan 13th 2009, 9:57 am
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Default Re: Medicare/hospital

Not just the childrens hospitals have the care for children my daughter never went to the childrens hospital she went to the nearest hospital which had a clinic for diabetic children. So just go to your GP and they will set it all up for you and give you the form for Diabetes Australia so that you can be registered as a diabetic.

My daughter was looked after by a paediatrician and Frankston Hospital initially and then she went to the Monash Medical Centre in Melbourne which runs an adolescent diabetic clinic. They also run a research clinic there too. Now she is an adult she has her own specialist and a diabetic educator from the hospital keeps an eye on her but of course being young she does not bother with her now.
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Old Jan 13th 2009, 10:01 pm
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Default Re: Medicare/hospital

Originally Posted by ABCDiamond View Post
If anyone goes into a Public hospital, and has private insurance, do NOT tell them that you have it.

I learned that in my first year here. Hospital staff actually told me about it.

As a patient without Insurance, everything is 100% covered by medicare in a Public Hospital.

As a patient WITH insurance, they charge full rates, and the insurance often does not cover everything, hence "the gap" being paid by the patient.

I never bothered renewing my insurance after that, and have been happy with Public Hospital service so far. However, I am now getting a bit older, and sometimes I wonder... "What if"....
Oh well, I have saved about $30k in insurance premiums over the years.
We had similar worries to you. But there are other benefits as we see it.

We are getting on (not quite 50) and avoid health care loading if we decide on it later (which can add a lot to premiums if over 30). Family of 3 for $200 a month ($3600 a year). Wife is working, so does not pay 1.5% medicare levy. If I get a job it will save me that as well, so on $50k each, that is $1500. If we go over the threshold (is it $100k ??), pay an extra 1% again on top ie another $1000. Plus get 2 'free' dental check up and clean a year, adverts says this saves $900. I need new glasses and will get a $200 pair for 'free'. So I make that $3600 'saved'. Even if I am out with calculations, you certainly save a fair bit of it.

We went for minimum hospital cover and full blown extras to get the dental and optical. If any of us go into hospital for emergencies we will go for free public care (I am frightened of potential gap costs). But if there is something niggling that needs fixing (especially later in life), might consider private. The secret is you must ask up front what it wil cost and they have to tell you. For elective procedures you then have the time to make a decision and might get it sorted much quicker. I guess you could see a private consultant, then sit on a public waiting list if it is not too long or painful.

Last edited by carlap; Jan 13th 2009 at 10:05 pm.
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Old Jan 14th 2009, 2:34 am
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Default Re: Medicare/hospital

Originally Posted by carlap View Post
We had similar worries to you. But there are other benefits as we see it.

We are getting on (not quite 50) and avoid health care loading if we decide on it later (which can add a lot to premiums if over 30). Family of 3 for $200 a month ($3600 a year). Wife is working, so does not pay 1.5% medicare levy. If I get a job it will save me that as well, so on $50k each, that is $1500. If we go over the threshold (is it $100k ??), pay an extra 1% again on top ie another $1000. Plus get 2 'free' dental check up and clean a year, adverts says this saves $900. I need new glasses and will get a $200 pair for 'free'. So I make that $3600 'saved'. Even if I am out with calculations, you certainly save a fair bit of it.

We went for minimum hospital cover and full blown extras to get the dental and optical. If any of us go into hospital for emergencies we will go for free public care (I am frightened of potential gap costs). But if there is something niggling that needs fixing (especially later in life), might consider private. The secret is you must ask up front what it wil cost and they have to tell you. For elective procedures you then have the time to make a decision and might get it sorted much quicker. I guess you could see a private consultant, then sit on a public waiting list if it is not too long or painful.
Much of what you say, I have run through my mind also, and if I was younger, I 'may' reconsider. But with the loading I would pay, it would be very to expensive.

You mentioned not not paying the 1.5% medicare levy. You WILL still pay that. That one is not exempted, it is only the Medical Levy Surcharge (MLS) that is not payable in some cases.

If you earn UNDER $140,000 per year, for a family, then you do NOT even need to pay the 1% Medical Levy Surcharge.
If you are a single person, earning more than $70,000 per year, or a family earning more than $140,000 per year combined, then a correctly chosen Private Medical Insurance Policy will save you from paying the extra 1% Medical Levy Surcharge (MLS).
I pay $115 for a dental check up and clean, so that would be $690 per year for 3 of us.
With another $200 for specs, and we would get back about $900 per year.

My premium would be $317.60 pm ($3,811 for the year), although I have just found another, for $219.80 pm ($2,600 pa), that I may just check out. I am older than you...
 
Old Jan 14th 2009, 4:23 am
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Default Re: Medicare/hospital

Thanks for correcting me - shame you don't get the levy off as well, I just thought that was a big reason for taking it out.

I got my calculations wrong anyhow, 12 months would be $2400 at $200 (actual premium is $192). Would not let me edit the post, I guess because you had replied.
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Old Jan 14th 2009, 5:06 am
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Default Re: Medicare/hospital

I looked at the cheaper policy that I saw, and the annual limits with the excesses, just didn't do anything for me.

It also has a condition that states:
Medicare rebates 75% of the Medicare Schedule Fee for in- hospital medical charges, and Latrobe rebates the remaining 25%.
No gap, or known gap cover for in-hospital medical charges higher than the Medicare Schedule Fee
But this does NOT seem to give any cover for fees higher than the Medicare Schedule Fee, and most fees are higher than that.

That is something for people to beware of with cheaper policies.
 
Old Jan 14th 2009, 6:26 am
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Default Re: Medicare/hospital

Originally Posted by ABCDiamond View Post
I looked at the cheaper policy that I saw, and the annual limits with the excesses, just didn't do anything for me.

It also has a condition that states: But this does NOT seem to give any cover for fees higher than the Medicare Schedule Fee, and most fees are higher than that.

That is something for people to beware of with cheaper policies.

Myself and my GF have cheap policies, and we both view them as an additional levy that we have to pay to lessen our tax burden by not having to pay the full amount of the required MLS. Nothing more than that.

There is certainly nothing to be gained by having a more complete policy, as the gap fees end up wiping out the savings. If the insurance policies worked to cover you for the entirety of the charges then they would be better value.

The irony is that some of the international policies offered by people like Bupa and American Express offer much better cover than the Aussie health funds, and diminish the financial load on Medicare but aren't considered qualifying policies for the purposes of the MLS. The system is sadly rubbish, and seems to be the government allowing healthfunds to profiteer in return for no service at all.


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