How does Medicare work?

[Guest Frank44122]

Hi, I'm new to this site and just starting the visa process. Can anyone explain to me,( in simple terms!!) how Medicare works? Getting a bit confused when I've read up about it, sometimes you pay sometimes you don't depending on the dr etc? We have 3 children under 16 so also want to know what we will have to pay out for them health wise as obviously at the mo, in uk, nothing except orthodontist stuff.

If anyone could explain to me step by step how it all works I would really appreciate it!

 

frank and co:smile:

 

Ps we are applying for PR

[guspjmh]

Basically children consultations are free with a GP, as are adults if they bulk bill (most don't, so you pay a smallish fee). Prescription charge of up to around $36 is also payable, depending on cost of medicine. If it is pbs listed (like nice approved in uk) then anything over that cost is paid by government.

[Guest Frank44122]

Thanks mate, nice and clearly explained that even I can understand!!

[cliffy]

I think that simplifies it too much.

Not all children's consultations are free, depends on the doctor. Same as billing, bulk billing can apply to children or pensioners but not necessarily all family members, depends on the practice policy.

My daughter choses to go to a particular doctor for their family and pays around $35 more per consultation than the medicare rebate she receives.

I get bulk billed as a pensioner at my gp and normally only pay the gap when I see a specialist.

My husband saw his heart specialist today and paid nothing, the doctor just claims from medicare for the tests and consultation.

As pensioners, we pay $6 for most scripts. My daughter pays around $30, full PBS cost, if the drug is over that, or the cost of the drug if it is less. That is per item, which means it is really expensive to go to the dr. and get 2 items, in her case, almost $100.

It is always wise to enquire about Practice procedure re billing before you make an appointment.

[Guest Frank44122]

Which system do you prefer, the uk nhs or oz Medicare?

[Blossom]

NHS for sure!!

GPs here don't seem to have the same knowledge base as those in the ok. Maybe I've just been unlucky over the last six years, but I've never found a good one, which is probably why so many people are happy to pay the extra if they find a good one.

 

I'm currently pregnant and waiting for an nt scan. Mine is being bulk billed, but from looking on forums it seems I am hugely in the minority. People are paying anything from $50-$500 for the same scan! So you end up having to worry about shopping around.

[guspjmh]

NHS for sure!!

GPs here don't seem to have the same knowledge base as those in the ok. Maybe I've just been unlucky over the last six years, but I've never found a good one, which is probably why so many people are happy to pay the extra if they find a good one.

 

I'm currently pregnant and waiting for an nt scan. Mine is being bulk billed, but from looking on forums it seems I am hugely in the minority. People are paying anything from $50-$500 for the same scan! So you end up having to worry about shopping around.

 

 

Congratulations on the imminent new arrival!

 

From having experience working in both systems you get really poor GP's in the UK as well - along with excellent ones. I've spoken to a number of UK doctors out here with experience of both systems and I'd say opinion is split as to which system is superior (the NHS probably edges it in their opinion, but you'd expect that as it's what they are used to.)

 

The good thing here is that if you are unhappy with your provider, you can just go elsewhere. The bad thing is that medical records aren't stored on a national server (excepting vaccinations I believe), so your records won't follow you unless you request them.

[kadina]

Things have changed a hell of a lot then since I had my two here, I paid nothing for scans, blood tests etc all through the hospital, I never saw a Doctor once just the hospital GPS/ midwifes I had several short stays in hospital too during this time for monitoring, I received the best treatment ever in the hospital. Also in a previous comment about Bulk Billing there always used to be a lot of Doctors that bulk billed.

 

NHS for sure!!

GPs here don't seem to have the same knowledge base as those in the ok. Maybe I've just been unlucky over the last six years, but I've never found a good one, which is probably why so many people are happy to pay the extra if they find a good one.

 

I'm currently pregnant and waiting for an nt scan. Mine is being bulk billed, but from looking on forums it seems I am hugely in the minority. People are paying anything from $50-$500 for the same scan! So you end up having to worry about shopping around.

[Guest Guest12727]

Plenty of practices in our area that Bulk Bill. We haven't ever paid to see a GP in 10 years. There are a lot of GP clinics where you don't need to make an apt, just turn up and they bulk bill. OK if you are happy to see any Dr and wait. You can choose to see a particular DR, but the wait may be longer.

 

At present, dental is not in the Medicare system, but this is under discussion with a big push for it to be included by many sectors. the Labor govt were seriously considering it - don't now know what Abbott will do. Nothing I expect.

 

There is free routine dental care for school aged children available. We get sent a voucher from the Govt. every year for our son. (Again, Abbott may stop this, labor brought it in). As we have private dental cover,we don't use it. Our dentist doesn't charge a gap, for child dental, so we don't pay any extra for our son, the dentist gets whet the private ins pays him. Routine check-up and clean is fully covered by our private dental cover for all of us.

 

Specialists outside of hospitals come under medicare, so even if you have private insurance, it is likely you will need to pay a gap (maybe $100). This bit I find weird and very different from UK, where seeing a Specialist was covered under private health ins.

 

All healthcare in a public hospital as a public patient is covered by Medicare - no gaps.

 

Medicare levy is only 2-3% of income - a lot less the UK NI.

[Blossom]

Things have changed a hell of a lot then since I had my two here, I paid nothing for scans, blood tests etc all through the hospital, I never saw a Doctor once just the hospital GPS/ midwifes I had several short stays in hospital too during this time for monitoring, I received the best treatment ever in the hospital. Also in a previous comment about Bulk Billing there always used to be a lot of Doctors that bulk billed.

I'm going to flinders and they won't even see you for a first appointment until 13 weeks. The first scan they do is at 19 weeks. They told me if I wanted an nt scan I had to go to a gp to get a referral as they don't do it.

I had a search around and found a bulk billing scan place, but most of them don't seem to. Some people have had their gp write 'bulk bill' on their referral and the scan place still wouldn't. I was pretty surprised that you have to shop around.

[Guest Guest12727]

Blossom, if the GP refers you, won't Flinders then do it? I expect they just don't do the nt scan routinely not that they won't do it at all.

 

I looked up some research on the topic and there doesn't seem to be any evidence for first trimester scan being better or worse than 18-20 weeks, except of course in putting the mum's mind at rest. It seems a few abnormalities can go undetected on the earlier scans, but not significantly. Perhaps this is why they wait.

 

Why don't you just get the referral from your GP?

[Blossom]

Blossom, if the GP refers you, won't Flinders then do it? I expect they just don't do the nt scan routinely not that they won't do it at all.

 

I looked up some research on the topic and there doesn't seem to be any evidence for first trimester scan being better or worse than 18-20 weeks, except of course in putting the mum's mind at rest. It seems a few abnormalities can go undetected on the earlier scans, but not significantly. Perhaps this is why they wait.

 

Why don't you just get the referral from your GP?

I have got a referral, but no, they won't do them at the hospital, you have to go to another scan place. It says on their website they do nt scans, but when I phoned them they said no they don't.

The main reason for the 12 week scan, other than checking for downs, is to make sure your dates are right and you haven't had a missed miscarriage (one with no symptoms). The scan and blood test for downs has to be done between week 10-13 weeks.