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Medicare - can anyone provide an overview?


Guest libbysmum

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Guest libbysmum

Hello all, I'm fairly new to this site, hoping to spend alot more time on here now our 176 visa has been granted (usually a PIO frequenter). I was wondering if anyone can give an overview of the medicare system.

 

I have read a bit but am a little confused as to what you need to pay for, what doesn't need to be payed for, in the event of a visit to the docs, or worse a hospital visit / operation etc etc. I've seen reference to bulk billing and a "gap payment" and was wondering what these are.

 

I am aware of the need of ambulance cover as a definite must upon arrival, but what else in terms of health insurance would people advise having? Is the public medicare system sufficient or is it worth investing in private health cover, what difference would it make if we did have health insurance?

 

Sarah

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If you visit a GP then you either pay up front and claim back a portion of fee from Medicare or the GP bulk bills in which you pay nothing or your GP charges you a copayment on top of what is bulkbilled. A visit to the GP can cost $0 - around 60. Most large GPs clinics bulk bill for kids upto 16 and for those on benefits. The government sets what it will pay the GP for your visit, but the GP can charge extra. If you are referred to a specialist by the GP you will have to pay any difference between what medicare will pay and the specialist's fee or pay upfront and claim back what medicare will pay.

 

If you are under 30 you could get away with just extras cover, this covers dental, physio etc as none of these are covered by Medicare. You could also get away with no private health cover, it just means that you go on waiting lists etc for the public system and you are just assigned your doctors. If you don't have private cover by the age of 30 then the premiums get more expensive as the government rebate less. If you have it by 30 then the rebate percentage is fixed. Some private HFs will cover your single at home kids until they are 25. The public hosps are excellent and many docs work in both anyway..

 

All hospital care in public hosps is free under medicare.

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