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Private Patient - how much does medicare reemburse?


AnnaUK

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Hi there,

 

quick question, when it says

Our doctors are prepared to accept the Medicare rebate for Pensioners, Veterans, Healthcare Card holders and children under 16 years of age. An AMA approved fee is charged for private patients. Part of this can be claimed back from Medicare

 

Sooo.. how much will I end up paying? Other doctors quote a fixed amount for a consultation, is the medicare contribution fixed and I pay everything above? In case I need x-rays, does medicare cover them full or partly?

 

Always been to our bulk billing doctor but she is unavailable, grateful for any advice :)

Thanks!

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Hi there,

 

quick question, when it says

 

Sooo.. how much will I end up paying? Other doctors quote a fixed amount for a consultation, is the medicare contribution fixed and I pay everything above?

 

 

Yes, everything above. Most GP's are private businesses so if the fee is not on their website the standard way to find out is to ring the receptionist. The length, number of complaints/complexity of the consultation can change the fee.

 

In case I need x-rays, does medicare cover them full or partly?

 

 

Some bulk bill, some don't. Just ask your GP to refer you to a bulk billing practice.

 

For example here in Brisbane: http://www.savagexray.com.au/benefits.html

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Yes, everything above. Most GP's are private businesses so if the fee is not on their website the standard way to find out is to ring the receptionist. The length, number of complaints/complexity of the consultation can change the fee.

 

 

 

Some bulk bill, some don't. Just ask your GP to refer you to a bulk billing practice.

 

For example here in Brisbane: http://www.savagexray.com.au/benefits.html

 

Ok thanks. But how much exactly does medicare cover? Is it a fixed contribution or percentage?

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Ok thanks. But how much exactly does medicare cover? Is it a fixed contribution or percentage?

 

Fixed amount set for each length of consultation. An example taken from a GP website is below. Each GP sets their own fees as a private business. Some see everyone for free (bulk bill), many bulk bill low income, children and pensioners, but charge a gap to working people, and a few charge a gap to everyone.

 

"Consultations

For a standard consultation of less than 20 minutes our fee is $71.00. A medicare rebate of $34.90 is available for this type of consultation making the out of pocket cost for this consultation $30.10.

Our fee for a longer consultation (more then 20 minutes but less that 40 minutes) is $110.00 and the applicable medicare rebate is $67.65 making the out of pocket cost for this type of consultation $42.35."

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Ok thanks. But how much exactly does medicare cover? Is it a fixed contribution or percentage?

Medicare pays a fixed amount --again this varies depending on the type of consultation. A private billing GP usually charges 65-70 dollars for a normal consult upto 20 minutes for which medicare rebate is about 35 dollars or so. If the type of consult varies the medicare rate also goes up --so I would expect there to be a gap of about 30-40 dollars anyhow. The receptionist may be able to tell you more about the different rates. Again as someone mentioned there are bulk billing and non bulk billing radiology services--and sometimes even reported by the same doctor who covers for both establishments --so its worth asking.

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