mechanical430

Hello,

I recently got my Medicare card but still confused how it works? If I'm ill, should I visit any hospital or doctor, show my card and won't be paying anything or what? Please clarify

Thanks

ABCDiamond

Hope this helps:

katietops01

Generally, you visit the doctor, pay the bill, and get a rebate from Medicare, though it won't be for the full amount. For example, I went to the doctor last week, paid $65 for the appointment and got (I think) $32.50 back from Medicare. As I have registered for their automatic rebate service, this payment was processed at the Doctor's and paid straight into my bank account. However, I still had to hand over the full $65 to the doctor.

Some doctors bulk bill, where you don't pay anything, but I've never used one. Maybe someone else can tell you how this works.

ABCDiamond

That's easy, you see the doctor, sign a bit of paper and walk out, and never pay anything

renth

I've been here 7 years and still don' know how it works. OK, for a Dr's visit I get but if you need tests, referral to specialist etc... It's a total guessing game as to whether your tests are covered by Medicare or you need to shell out hundreds.

I'll never understand it.

Kingseat

It is a bit complicated but that's probably because I am still new.

My surgery does bulk bill but only so far for treatment my son has needed. As the previous poster said you just sign and leave.

You have to pay for prescriptions though and from what I have experienced you don't get any money back for that. Last prescription which was anti-biotics for my son was around $19.50.

AlliF

There is also a safety net -which means once you have paid a certain amount of out-of-pocket costs in a calendar year you will usually get a bigger percentage of any further out-of-pocket costs for that year refunded. There is a safety net for prescriptions too - it covers the whole family and runs on a calendar year basis too.
Also on your yearly tax return you can claim back a percentage of your out-of-pocket medical costs over a certain threshold back as a tax offset -that applies to private health-care/dental optical too so keep all your receipts!

It is very confusing...

slipshot

Plus the fact that when we arrived in Jan, we looked at loads of surgeries and not a single one bulk billed here in Melbourne. There may be some but they are or were hard to find and thus you end up paying. Not a lot you can do about it...

ABCDiamond

It could be worse, you could live in Canberra...

quoll

Yes, I did a straw poll at work the other day because I just dont "get" why the Poms are always on about needing to find a bulk billing doctor - not one of my colleagues went to bulk billing doctors and none expected to be bulk billed. Many were annoyed that people would actively seek out doctors to avoid the co-payment. The whole process was meant as a safety net for people who couldnt afford to pay.

I work in a charity and we have connections with a range of other agencies and you cannot get a decent bulk billing doctor even for folk who have not two cents to their name - and many of them need good continuity of care which they just cannot access. I must say that I am surprised the figure is as high as 50% - I would have thought it much less.

Vindy

Hi my understanding of bulk billing is that there is a cost saving and you benifit if your doctor does it not just for the people on low earnings.

Vindy

Loch Lomond

I don't agree that the Medicare system is a system for people who can't afford to pay for medical assistance. Anyone who pays the Medicare Levy is entitled to expect free health and medical care.
If the Australian Government has decided that the fair price of a visit to the Doctor is $XX, why are the Doctors not held to that?
My Doctor works in a Medical Centre where all Doctors Bulk Bill, so if they can do it why not all Medical Centres?
The medical payment system in Australia is overcomplicated and those that pay for private health cover should quite rightly feel ripped off when they are expected to pay the "GAP".

quoll

Initially bulk billing was designed to ensure that people who couldnt afford the co payment were still covered. Medicare was a pseudo universal health care system (I think it always had a co-payment expectation) - there has been a levy for many years now but unless that levy were to increase significantly it would be too expensive to pay doctors what is actually needed for them to maintain their practices, attract new doctors and make a profit. The commitment to bulk billing is declining because they just cannot make ends meet on the BB payments. Most of the medical centres who do bulk bill dont promise continuity of care and, for many patients, that is better care than a casual drop in to a doctor you have never seen and will never see again.

Whilst the government may think it is offering a reasonable fee for service with the bulk billing rate the doctors think differently - as is their right. They need to be sure that they are able to keep their practices going and also (heaven forbid) like any other business, make a profit.

I dont know why people get so hung up on not forking out the co-payment - it's only $30 for heavens sake. Every time someone hits a bulk billing doctor just because they dont want to pay the co-payment that means that someone who is UNABLE to afford it is not able to access that doctor. In Canberra certainly we have a number of people who are struggling financially who cannot find a bulk billing doctor because their lists are all full.

ABCDiamond

I agree fully with most of what you say, but:
Even the ACT has gone from 50.6% to 52.2% !
NSW 84.5% up to 84.8%.

I do feel that many of the Bulk Billing doctors are relatively newly arrived doctors from overseas, and will take on bulk billing, as it helps them to get established faster.

Most lower socio-economic areas have very high % bulk billing, but in areas where people are better off, they tend to have very few.
eg: Mosman, NSW probably has none, but Inala in QLD is probably 100% bulk billed.

NickyC

I worked for the Health Insurance Commission in Canberra when Medicare was first introduced. I can't recall reading anywhere that stated that bulk-billing was designed for poor patients only. Can't see the attraction for doctors of bulk-billing for some (poor) people but charging more for the rest.

From memory, the advantage of bulk-billing for doctors was supposedly:

1. Straightforward to claim
2. Speedy payment by HIC.
3. No need to collect any money or cheques from patients
4. Less staff required in surgeries to administer payments so lower wages bill.
5. No bad debts

The downside was, of course, that they would only ever receive 85% of the scheduled fee as payment. But if the 15% reduction in fees was less than the cost of administering payments and debts, then the doctor would be in front by bulk-billing.