Understanding Medicare

[Sylvian]

Right, I need to bite the bullet and get my head around the Medicare thing. We are reaching the point where we need to look properly at how things will work out for us financially, and Medicare is a big black cloud of uncertainty hovering over our heads.

 

Can anyone point me to an internet resource that actually makes sense (I've read quite a few now and am none the wiser) or to a decent Medicare thread on the forum?

 

Arghhh... qualifying 457 private policies... automatic Medicare salary deductions... Medicare Surcharge Levies... prescription costs... ambulance cover... my brain is starting to do somersaults...

[PatP]

At the end of the tax year you put a tax return in and at the same time the Medicare levy is taken Into account on your tax return

some people on low income don't pay the levy and get a bigger tax refund Not sure if I have explained that correctly

ambulance cover is paid for seperately from private medical cover

Look at I think it's St Johns ambulance cover

each visit to a gp has a fee Medicare pays a certain amount you pay the gap fee if a doctor bulk bills you don't pay a gap ( think that's sort of right too )

prescriptions you pay for at what ever rate the chemist charges some charge more than others THe Chemist Warehouse seems to be good value

[Sylvian]

Just when I though I might be starting to possibly get my head around Medicare... I stumble across something called the 'Lifetime Healthcare Loading'.

 

Don't panic, I think to myself, it says new immigrants over 31 years of age have 12 months to take out a qualifying private plan and avoid this surcharge. But then it says healthcare packages taken out by temporary residents (as on a 457 visa) do NOT qualify for exemption under the Lifetime Healthcare Loading rules?!

 

Blimey. I might just go down the pub...

[PatP]

Driving you to drink maybe

I must admit I don't understand the Visa system now so don't know what your entitled to with Medicare

When your tax return is done it does ask about private health insurance if you have not got private health insurance your annual tax refund ( most people get something back ) will be a bit lower

I only hope I have explained this properly I know it's hard when trying to look up systems your not sure of

Workers are covered at work for accidents , strain injuries etc by WorkCover now called Return to work SA which is a different system from Medicare all together

[NicF]

If you are from the UK you are entitled to reciprocal cover from Medicare and therefore you will not need the 457 qualifying health insurance. I believe you still need to get it for the purposes of getting the visa though. I've read plenty of posts from people on Poms in Oz that have taken out the insurance to get the visa and then cancelled it once in Australia and registered with Medicare. I think you should also then be able to take out regular private health cover should you feel the need. You don't have to have this but if your earnings are over a certain limit then it will exempt you from the additional Medicare levy that you would have to pay. I'm not completely sure about the rules for 457 visa holders though so things may be a bit different to my understanding.

 

I would recommend taking out ambulance cover as a minimum. How much other cover you decide to have once you are here is up to you. In terms of the costs associated with Medicare there is a levy that everyone pays that is automatically deducted from your pay (a bit like national insurance in the UK) then there is an additional levy that you pay if your earnings are above a certain amount. Medicare is a bit like the NHS except a lot of providers are private and can charge what they want and Medicare pays a set level for different consultations. When you visit a practitioner (eg GP) if they charge more than the Medicare amount then you pay the full charge and Medicare give you back the amount they pay for that consultation. If the practitioner only charges the Medicare amount then you don't pay anything and the doctor claims the rebate directly from Medicare. This is referred to as bulk billing. Treatment at public hospitals is free although for none emergency treatment there may be a waiting list for an appointment. Treatment at a private hospital will cost you. Even if you have private health cover there is often a gap to pay.

 

Perscriptions are charged at cost, so you pay the cost of the drug you have been perscribed. If the drug is on the PBS (list of subsidised drugs) then you will pay a maximum amount of about $37 (can't remember the exact amount). If it's not on the list you will pay the full amount unless you have health cover that covers the cost of drugs. It's worth shopping around for perscription drugs as different pharmacies charge different amounts for the same drug. Chemist Warehouse seems to be the cheapest for most things. My OH's drugs are $6.10 from chemist warehouse but the cheapest we found elsewhere was $15.

[Blossom]

The reciprocal health care card actually covers you for most things. I was on it for five years, and going to bulk billing Drs, I never had to pay for anything other than prescriptions. Ambulance cover is a must really. It's going up from April to about $140 per year for a family. You can cancel your health cover once here.

The lifetime loading I think you have one year from the time you become PR to avoid it.

[snifter]

I use a bulk billing GP and so never pay for seeing one. I've not had to wait for appointments either. My one you phone and make an appointment as and when. If its urgent they do have spots available for on the day.

 

Medication has been explained well above. Its a case of shopping around if you have the same medication on a regular basis to get the best deal. Most of the time for the one off things I just go to our local pharmacy.

 

Ambulance cover is important. You may never use it but if you do need a trip in one for any reason it will cost a chunk. I'd rather have the cover than fork out $1000 or whatever it may be billed at at a crappy time.

 

The loading I think is as Blossom said, its one year from when you gain PR. I think on a 457 it won't matter if you then went over to PR and then applied for it later on.

 

I am PR and we got cover 11 months after we arrived to avoid the loading. We have private medical insurance (that Medicare levy makes it worthwhile for us to have some form of cover and our ambulance is included in that). We did have a higher cover policy for the first year, 18 months or taking it out but then we decided to go a lower level of cover and save the $90 a month on the policy.

[kyliedonut]

Saw someone mention a NHS card in regards to reciprocal medical cover.....any ideas? I work in NHS, and have never heard of this card!?

[KennyKen]

Reciprocal Medicare. You walk into centre link of whatever the name is... Show them your visa documents and wham you have a Medicare card... It's not that hard so don't look at it like Pandora's box! Just concentrate on getting settled and look for a job pronto!!!

[PatP]

Saw someone mention a NHS card in regards to reciprocal medical cover.....any ideas? I work in NHS, and have never heard of this card!?

I have a NHS card we had to renew it when we moved back the the UK but to get a temporary medicare card whilst on holiday all you need do is apply show tickets UK passport etc

[PatP]

Reciprocal Medicare. You walk into centre link of whatever the name is... Show them your visa documents and wham you have a Medicare card... It's not that hard so don't look at it like Pandora's box! Just concentrate on getting settled and look for a job pronto!!!

You can get a temporary card if your on holiday on Oz but when we moved back to Oz in 2006 we had to show we had taken up residency again to get the card It wasn't hard just showed bills for shipping furniture etc

[kyliedonut]

ah ok...it's the medicare card - I have had one previous when on WHV. No worries, getting myself confused re: NHS card. Cheers!

[Sylvian]

Thanks again guys. Lots of stuff here... much of it I think I've finally got my head around, some of it new. It really is tricky to get a proper understanding of the level of cover you have to put in place before arrival, and then keep in place once you are in Oz (over and above any Medicare permitted under the 'reciprocal agreement' between the UK and Australia.).

 

For instance all the government sites I've read say that you need 'Overseas Visitors Health Cover' - or what a lot of the insurers refer to a overseas 'Hospital Cover' - in place for the entire duration of your 457 visa, NOT just to get the visa itself: cancel this cover any time before you get permanent residency and the 457 visa can be withdrawn (the insurer notifies the Dpt. of Immigration that cover has been stopped). Yet lots of people from the UK say they cancelled all their private cover and relied solely on Medicare within weeks of arriving.

 

PLUS it seems you then need to keep a certain level of cover in place even if you are granted a Permanent Residents visa, or you will have to pay the Lifetime Healthcare Loading (after 12 months) and, if you are lucky enough to be a high earner, the Medical Levy Surcharge. What's more this level of cover is not just basic 'Hospital Cover' (or OVHC) - it has to include lots of expensive 'Extras' to negate these two surcharges. Government web sites are quite forceful on this point.

 

Then there's the rebate on private health care premiums - this only applies once you have Permanent Residency, so will not be relevant for us for at least two years... assuming that's the minimum period for getting a permanent visa, which isn't entirely clear either!

 

Of course this stuff can make a big difference: I think we are looking at around AU$1800 per year if the OVHC policy is all you need, but nearer AU$6,000 if we need to include all the extra bits and pieces. Needless to say all the insurers I've contacted thus far insist that the 'extras' are, in fact, 'essentials'!

 

Hmmm.

 

S

[PatP]

I think if your a resident the reciprocal agreement doesn't enter into the equasion its only when people are on holiday it depends on the Visa you have to live in Oz

I am not 100% certain on that I hope someone will clarify

[Blossom]

I think if your a resident the reciprocal agreement doesn't enter into the equasion its only when people are on holiday it depends on the Visa you have to live in Oz

I am not 100% certain on that I hope someone will clarify

It applies to anyone from the UK on a temporary visa (which the op would be).

[Blossom]

I used to get some kind of rebate on my health insurance when I was on a student visa at tax time (you are a resident for tax purposes when on a 457).

Some people have had their 457 visas approved by showing that they have travel insurance through their credit cards which covers them until they arrive and the reciprocal care kicks in.

They word the visa like that as many people come from countries who don't have any reciprocal arrangements, or limited ones (like Ireland where only hospital treatment is covered).

[Sylvian]

Hmmm... very difficult to get a definitive answer to some of the trickier aspects of all this Medicare malarky, though I have to say the people at 'Frank' have been doing a pretty good job of helping me through it (even if they are keen to get me to buy something!).

 

The bit confusing me at the moment is the 'Lifetime Healthcare Loading'... ah heck, let's be honest, all of it still confuses me.

 

As for 'Frank' - they seem to have good customer feedback compared to a lot of the private providers. Anyone ave experience with them, good or bad?

 

S

[Blossom]

I've never even heard of frank. :-/

[snifter]

Hmmm... very difficult to get a definitive answer to some of the trickier aspects of all this Medicare malarky, though I have to say the people at 'Frank' have been doing a pretty good job of helping me through it (even if they are keen to get me to buy something!).

 

The bit confusing me at the moment is the 'Lifetime Healthcare Loading'... ah heck, let's be honest, all of it still confuses me.

 

As for 'Frank' - they seem to have good customer feedback compared to a lot of the private providers. Anyone ave experience with them, good or bad?

 

S

 

If you are on a temp 4 year visa I didn't think the lifetime loading would apply. Its only when you are PR and then you have a year from taking up residence in Aus to take it out.

 

If you are on a temp visa, don't worry about the lifetime loading now. Can get here, settle in and so on and then investigate further if you do need to take it out or not.

[NicF]

I've never even heard of frank. :-/

 

Me neither.

[snifter]

Me neither.

 

Nor me.

 

But they do exist. I googled them

[Sylvian]

Thanks guys. The Lifetime loading is very confusing - lots of government sites mention that it does apply to part-time residents and that the normal overseas healthcare policies do not get you out of paying it. But you're right... the thing to do is take out what's essential for the visa and then sort it out with Medicare when we arrive.

 

Frank is part of GMHBA Medical Insurance, which apparently has its roots in a hospital scheme started by cement factory works in Geelong in 1927. So there you go! They do have some pretty good reviews online (certainly compared to some of the better known providers, including BUPA).

 

S

[NicF]

Have a look at this site http://www.privatehealth.gov.au. It has answers to most of your questions on private health and Medicare. Particularly check out the FAQs as there is a question in there about lifetime loading and becoming a permenant resident.

[Sylvian]

Thanks Nick.

 

The only thing I'm struggling with is the period 12-24 months after you arrive. During this time the Lifetime Health Cover loading comes into force if you are over 30, and so does the Medicare Levy Surcharge - if you are lucky enough to earn enough. Yet the only hospital policy you are allowed to have if you are a temporary resident (Overseas Voluntary Health Cover) doesn't cancel either of these things out.

 

You need a 'domestic' hospital policy to get rid of the LHC and MLS charges - but you can only have one of these if you a permanent resident, and permanent recency normally takes two years to obtain!

 

So, between 12 and 24 months there are two potential loadings you cannot possibly avoid... unless you somehow obtain permanent residency by the end of the first 12 months.

 

Hence my confusion. Well, some of it anyway.

 

S

[NicF]

The idea that PR takes two years to obtain is wrong. If you qualify for a skilled visa you can apply for one immediately. There is also no automatic direct path to PR from a 457 after two years. It is possible for an employer to sponsor you for a PR visa immidiately, although a lot won't for various reasons. The two years thing is simply that your employer can sponsor for PR without you needing a skills assessment.