Adult circumcision: Medicare

[Indianinoz]

Hello,

 

If an adult wants to undergo circumcision, is this covered by medicare? If no, how much does it cost? Also, would you recommend any doctors in Sydney for the same?

[Keith and Linda]

I do not think elective surgery is covered, only if there is some medical reason for removal. Would have thought your own GP would be the first stop.

Good luck

[blossom]

Yeah, only if it was needed. They don't cover vasectomies so I'd think it would be the same.

[Parley]

I would have a differing opinion without knowing for sure.

 

It is unlikely an adult would decide on a whim to get circumcised.

If required as an adult it is almost certainly due to a medical necessity such as tight foreskin causing pain or other problems.

 

So I see no reason why it shouldn't be funded by Medicare.

[Indianinoz]

Thanks for the replies! What about initial consultancy with a doctor? Is it free because of medicare or do they charge?

[Parley]

You would start with a visit to your local doctor.

It depends on the doctor. Some bulk bill, meaning medicare covers everything some charge an additional fee perhaps up to a maximum of $40 or so.

 

The GP would probably refer you to a specialist who probably would charge you.

[Johndoe]

I would have a differing opinion without knowing for sure.

 

It is unlikely an adult would decide on a whim to get circumcised.

If required as an adult it is almost certainly due to a medical necessity such as tight foreskin causing pain or other problems.

 

So I see no reason why it shouldn't be funded by Medicare.

 

Not neccessarily. It may be on religious/cultural grounds or even purely for cosmetic reasons.

[Parley]

True. I guess it will be funded in a public hospital if deemed medically necessary.

[flybyknight]

Is religious or cultural surgery covered?

[Guest spela]

I hope not Anyway, I really doubt it.

[Indianinoz]

Any particular doctor that you'd recommend for adult circumcision(age: 28) in Sydney or Hobart? We're landing in Sydney and may go to Hobart. So I'd open for both cities.

[CaptainR]

Any particular doctor that you'd recommend for adult circumcision(age: 28) in Sydney or Hobart? We're landing in Sydney and may go to Hobart. So I'd open for both cities.

 

Probably too late, but I would imagine it would have been cheaper to have got it in done in India before setting off. People from Australia go to places like India as medical tourists to get cheaper treatment.

[Indianinoz]

Probably too late, but I would imagine it would have been cheaper to have got it in done in India before setting off. People from Australia go to places like India as medical tourists to get cheaper treatment.

 

Yes we're flying in 5-6 days so doesn't make sense to get one done now. But if its covered with medicare on medical grounds, am I right I won't have to pay a penny?

 

When I'm asking for a doctor, I'm doing so to ensure the treatment is done in trusted hands.

[Guest]

Yes we're flying in 5-6 days so doesn't make sense to get one done now. But if its covered with medicare on medical grounds, am I right I won't have to pay a penny?

 

When I'm asking for a doctor, I'm doing so to ensure the treatment is done in trusted hands.

 

If it is medical grounds then you may pay a small amount for a GP consultation if you don't go to a bulk billing GP so long as you request referral to a public hospital then it will not cost you anything. There could be quite a waiting list but it depends how urgent it is - my OH tore a ligament and his treatment at a public hospital was first class.

 

In the public system you don't get a choice of Dr., at a push you might get a choice of hospital but I really wouldn't worry, you will get 1st class treatment in any public hospital - it's unlikely you're going to get a recommendation on here as it is a rare procedure in adults.

[xxlornaxx]

My husband had adult circumscion last year. ..We went back to UK to have it as we felt more comfortable doing It there so timed it in with a period of living there...It was sort of medical reasons he felt but gp disagreed n we went private (gp won't refer you if they feel their are other options, surgery always last resort)...cost £700...He was advised he could go back to work after a week...He did this. .bent down to pick sumthing up quickly n his stitches ripped n his trousers were soaked through with blood...rushed to A&E..very painful n still has sum scarring from that so be careful n take plenty recovery time...but delighted with results In terms of resolving our issue n he says it's best thing he's done. Good luck

[Skani]

But if its covered with medicare on medical grounds, am I right I won't have to pay a penny?

 

When I'm asking for a doctor, I'm doing so to ensure the treatment is done in trusted hands.

 

I just want to clarify how the system works here.

 

Firstly, even if you had the name of a recommended specialist, you would first have to go to a local GP (General Practitioner) who would then refer you to a specialist.

 

Medicare doesn't pay 100% of every medical procedure. If you were referred to a specialist in private practice you would likely receive only partial reimbursement of the cost.

 

If you were unwilling or unable to pay a part of the cost you would be referred to a specialist working in the public hospital system...but, as Lady Rainicorn mentioned, you would be treated by any one of the hospital staff doctors...you can't nominate which doctor you want.

 

The public hospital system gives first priority to accident, emergency and life threatening cases. So there is usually a waiting period for any other cases. This can be quite lengthy according to the particular hospital and how well they are resourced/staffed. Quite commonly you may have to wait weeks or months for an appointment to see a specialist, then maybe months for the actual procedure.

[Indianinoz]

@Skani: Thank you for the detailed response of the system. So as I understand:

I will first goto a General Practitioner who won't charge anything due to Medicare(am I correct?). He would then recommend me to a specialist who may charge partial amount to me and partial to medicare. Then if he recommends surgery on medical grounds, the surgery will be free but subject to queue if done through public hospital through medicare. If I choose to go for a private hospital that would be immediate but very expensive.

 

Is my understanding correct? Also, just wanted to check if the medicines prescribed by the doctor are covered by medicare especially when its expensive?

[JockinTas]

You will have to pay for prescribed medication/medicines. They are not covered by Medicare.

[fish.01]

@Skani: Thank you for the detailed response of the system. So as I understand:

I will first goto a General Practitioner who won't charge anything due to Medicare(am I correct?). He would then recommend me to a specialist who may charge partial amount to me and partial to medicare. Then if he recommends surgery on medical grounds, the surgery will be free but subject to queue if done through public hospital through medicare. If I choose to go for a private hospital that would be immediate but very expensive.

 

Is my understanding correct? Also, just wanted to check if the medicines prescribed by the doctor are covered by medicare especially when its expensive?

 

You're not quite there yet.

 

General Practitioner

----------------------

 

These are private businesses. Medicare pays them a set fee to see you. Some will charge a gap on top of this set fee. Some won't. Some will charge no gap for low income, children and elderly but will charge working adults a gap ($10-$50).

 

If they don't charge you a gap it is said that they "bulk bill" using medicare language. It is up to you whether you hunt out a GP that charges a gap or not. Some cities have more than others and lower socio-economic areas usually have far more than expensive areas.

 

Specialists

------------

 

Whichever GP you go to "you" can ask to be referred to a 100% free public hospital outpatient specialist or to a private specialist where you will pay gap. Your choice.

 

If you choose a free public hospital specialist you can't choose your specialist (though you can ask to change if you don't like them) and you usually wait longer for an appointment. You usually attend the specialist rooms attached to a public hospital.

 

If you ask your GP to refer you to a private specialist it will often be in a suburban medical centre (though not always). It will usually be quicker and you can research which doctor you wish to see (or ask your GP). Medicare pays some of the private specialist fee as well but you will be left with a gap..often the 1st appointment has a larger gap than subsequent appointments.

 

Hospital Treatment

---------------------

 

If you opt to go to a public hospital for your surgery and your condition is deemed to be an elective surgery that is for medical reasons it will be 100% free for both hospital costs and your specialist/surgeons costs. Your specialist will put you on the public hospital waiting list at your local public hospital. You can look up the average wait times for your type of elective surgery at your particular hospital here: http://www.myhospitals.gov.au

 

If you decide to go private you will want to use a private hospital that is a preferred supplier for your private hospital insurance. When you first take out private insurance waiting periods apply for some of the cover so you may not be able to use it straight away. Private hospital treatment has two components to the bill. One is the hospital accommodation, the other is the doctors fees. The private hospital accommodation is often fully covered except for the policy excess you signed up for. Private doctors gap fees can often be significant, sometimes in the thousands even with private insurance and even though medicare covers some of it.

 

You can ask your private specialist to treat you as a "no gap" patient. It is up to them whether they do. If they agree your doctor will not charge you a gap above what medicare pays. I have had quite a few say yes but ymmv.

Edited November 28, 2015 by fish.01

[fish.01]

You will have to pay for prescribed medication/medicines. They are not covered by Medicare.

 

Medicare doesn't make them free but it does cover all costs of medicines that cost more than a set maximum that you must pay.

 

The maximum price you pay is currently set at a maximum of $37.70 per prescription (or $6.10 if low income). Medicare pays everything above this.

[Indianinoz]

Medicare doesn't make them free but it does cover all costs of medicines that cost more than a set maximum that you must pay.

 

The maximum price you pay is currently set at a maximum of $37.70 per prescription (or $6.10 if low income). Medicare pays everything above this.

 

Thanks for the detailed explanation! What exactly do yo mean by low income? We're coming on a PR and don't have a job offer yet. Will we be low income or is there some criteria for that?

[fish.01]

Thanks for the detailed explanation! What exactly do yo mean by low income? We're coming on a PR and don't have a job offer yet. Will we be low income or is there some criteria for that?

 

 

"To qualify for a Low Income Health Care Card your income must be below the limit that applies to you for the 8 week period ending on the day you lodge your claim."

[TABLE=width: 686]

[TR=bgcolor: #EEEFF0]

[TH=bgcolor: #C2CACC]Status[/TH]

[TH=bgcolor: #C2CACC]Weekly income[/TH]

[TH=bgcolor: #C2CACC]Income in an 8 week period[/TH]

[/TR]

[TR=bgcolor: #EEEFF0]

[TD]Single, no children[/TD]

[TD]$531.00[/TD]

[TD]$4,248.00[/TD]

[/TR]

[TR=bgcolor: #F6F8F8]

[TD]Couple combined, no children[/TD]

[TD]$919.00[/TD]

[TD]$7,352.00[/TD]

[/TR]

[TR=bgcolor: #EEEFF0]

[TD]Single, one dependent child[/TD]

[TD]$919.00[/TD]

[TD]$7,352.00[/TD]

[/TR]

[TR=bgcolor: #F6F8F8]

[TD]For each additional child, add[/TD]

[TD]$34.00[/TD]

[TD]$272.00[/TD]

[/TR]

[/TABLE]

 

See this page for full explanation: http://www.humanservices.gov.au/customer/services/centrelink/low-income-health-care-card

[fish.01]

Medicare doesn't make them free but it does cover all costs of medicines that cost more than a set maximum that you must pay.

 

The maximum price you pay is currently set at a maximum of $37.70 per prescription (or $6.10 if low income). Medicare pays everything above this.

 

Note a medicine has to be on the PBS list to be covered by this scheme.

[xxlornaxx]

Also you don't necessarily need to go thought the GP, you can contact circumcision clinics direct and refer yourself, but obviously you would pay private fees for any procedure...but often their first initial consultation is bulk billed.

[fish.01]

Also you don't necessarily need to go thought the GP, you can contact circumcision clinics direct and refer yourself, but obviously you would pay private fees for any procedure...but often their first initial consultation is bulk billed.

 

Correct me if Im wrong but I always thought you had to get a GP referral in order for medicare to subsidise your specialists visits...would there not be bigger fees to pay overall when visiting the specialist if you don't get a referral first ?

 

 

Found this:

 

"One does not actually need a GP referral to see a specialist in Australia, however if the patient requires Medicare to pay them a rebate to assist covering the cost when visiting a specialist, a GP referral needs have been obtained by the patient first."

From here: http://www.panaceum.com.au/referral/