huggesy

Medicare

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    So I still do not understand the medicare system and not convinced I ever will.:eek:

     

    My OH had a doctors appointment this week who referred him to a private specialist who advised he needed surgery, but they couldn't do it because we don't have medical insurance other than ambulance & dental.......... so they referred him to go straight to A&E at Queen Elizabeth hospital who then did the surgery on medicare.

     

    To say I'm confused would be an understatement, but then I never had any experience of hospitals in the UK to compare to.

     

    Is there a simple way to understand the medical care system?

     

    But I have to say the nursing staff who dealt with my OH where totally fantastic and I can not fault the care that they provided him especially seeing as he has a phobia of needles they had their hands full!

     

    He's home save and recuperating and probably not getting as much sympathy as he should be:nah:

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    I kind of understand it, but not sure if I can explain it to someone else. In this case though the private specialist could have operated without you having insurance but you would have had to pay the full costs. By going to A&E you were able to have it done on the public system. Which is not the same as Medicare but could be partly or fully funded by Medicare (public hospitals are state run and Medicare is federal).

     

    Medicare is basically a federal government way of paying towards public health care for people. Some providers will charge more than the listed Medicare amount and in this case you will pay the provider the full fee and Medicare will give you the listed amount as a rebate. Some providers will only charge the Medicare list amount and in these cases they will claim the amount direct from Medicare and you will pay nothing. This is referred to as being bulk billed. These providers will usually see you outside of a hospital, although you may also see someone in a hospital setting where this appllies as well.

     

    Public hospitals are run and funded by the state government. When you are seen at a public hospital as a public patient there is nothing to pay. Sometimes you may be seen at a public hospital for something that is also covered by Medicare and in these instances you may be asked to consent to being bulk billed. This simply means that the state funded hospital can claim some extra funding from the Federal government.

     

    Private hospitals are run by private companies. They are funded by each interaction with the user/patient being paid for either partly or wholly from private health funds or from the user/patient. They also may provide services that are covered by Medicare, although I suspect in most cases they would charge more than the Medicare amount so you would pay the full cost and be reimbursed for part of it by Medicare. It is possible though for a private provider to bulk bill some services as well.

     

    @Blossom I can explain childcare benefit and childcare benefit and family tax benefit A and B, but the rest centerlink is a bit of a mystery to me as well.

    Edited by NicF

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    @NicF you are better than the people who work there then. I have been told so many conflicting things it's not funny.

     

    I certainly like to think I am :wink:.

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    He's home save and recuperating and probably not getting as much sympathy as he should be:nah:

     

    Sorry to hear your OH has been sick, but glad he's home safe.

     

    Please give him our best wishes, 'cos he seems a great guy. :wubclub:

     

    As for the sympathy...would he get more if he were a big, fluffy animal, hmmmm? :biggrin:

     

    LC

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