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Medicare...Prescriptions


marynyho

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I'm hoping the good people on here can help me out with a question regarding medicare/prescription costs. In the UK, children get free medical treatment as do adults and children also get free prescriptions, is that the case in Australia? The reason for needing this advice is because my son will need repeat prescriptions for his medical condition and if I have to pay, does anyone know the cost?

 

Thanks for any advice that you can provide

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When my son had earache I had to pay full amount, nearly died at price! For repeats I think there may be a cap on what you pay, there is for the elderly so maybe something similar?

Each drug is priced differently unless you have a medicare assistance card for earning under a certain threshold

Edited by nic1171
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Nope you will be paying up to $36 per drug per month so, two drugs up to $72 pm. There is a threshold (around $1250?) pa beyond which you get a discounted rate of around $5 per fill for the remainder Of the year. A doctor's visit will probably cost you around $36 for a GP (unless you follow the general Pommie migrant predilection for bulk billing GPs) as well - they will generally only give 6 months of repeats then you need to see them again. Specialists cost more

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Thank you all for your responses. So my son's meds don't seem to exist on the chemist warehouse site! So there are 2 repeats that are needed each month, which I'd have to pay $72 pm, once I hit $1250, I pay $5 for any subsequent refill? Is that right? So when I get to Melbourne, I should register with a GP, and then get referred to a paediatric gastroenterologist, which I assume will cost an arm and a leg?! I thought the medicare card would help to contribute towards costs and children wouldn't have to pay, how naive!!

 

Nope you will be paying up to $36 per drug per month so, two drugs up to $72 pm. There is a threshold (around $1250?) pa beyond which you get a discounted rate of around $5 per fill for the remainder Of the year. A doctor's visit will probably cost you around $36 for a GP (unless you follow the general Pommie migrant predilection for bulk billing GPs) as well - they will generally only give 6 months of repeats then you need to see them again. Specialists cost more
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Thank you all for your responses. So my son's meds don't seem to exist on the chemist warehouse site! So there are 2 repeats that are needed each month, which I'd have to pay $72 pm, once I hit $1250, I pay $5 for any subsequent refill? Is that right? So when I get to Melbourne, I should register with a GP, and then get referred to a paediatric gastroenterologist, which I assume will cost an arm and a leg?! I thought the medicare card would help to contribute towards costs and children wouldn't have to pay, how naive!!

 

How much you pay will depend on the cost of the drugs and if they are on the PBS list. If they are on the PBS you will pay the full cost of the drug up to a maximum of $36. The drugs may not cost as much as $36 though - my OHs meds cost $17.95 for 30 tablets for example. If the drugs are not on the PBS you will pay the full price of the drugs, what ever that is. It might be worth doing some research about the availability of the drug here and possible alternatives.

 

I would ensure when you come over you have a good supply of your sons drugs and go off and see a GP as soon as possible to get a referral. If you see someone on the public system it won't cost anything, although there may be a waiting list to see someone. If you see someone privately you will have to pay for it but you should be able to see someone pretty quickly.

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My meds cost me around $130 per month but every third month up to $185 because some are not on the PBS, and some of the meds last 3 months i.e. 90 pills in the bottle. GP average cost is $60 but then providing you have a medicare card your rebate from medicare can be put straight back on to your card. You will be asked to show your medicare care at the chemist, if you dont have one you will pay full price for all perscriptions.Specialist set there own fee, some are very high some less so. The first visit is always higher than susiqent visits. Going "public" depending on where you live and how long the wait list is could take years not months to see a public specialist and you wont get a choice of doctor. I have been waiting now for 3 years and still way down the list, so have no choice but to go private. Medicare card is one of the first things you need to arrange once you arrive.

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Thank you all for your responses. So my son's meds don't seem to exist on the chemist warehouse site! So there are 2 repeats that are needed each month, which I'd have to pay $72 pm, once I hit $1250, I pay $5 for any subsequent refill? Is that right? So when I get to Melbourne, I should register with a GP, and then get referred to a paediatric gastroenterologist, which I assume will cost an arm and a leg?! I thought the medicare card would help to contribute towards costs and children wouldn't have to pay, how naive!!

 

All my specialist treatment and appointment at the hospital are free , i use the public system and have had minor ops and varying procedures, all covered by Medicare, so seeing a gastroenterologist wont necessarily cost you anything if you request to go public and wait to get on the system. (i waited around 7 months for first appointment). Whilst there i also get them to write my prescriptions so i dont have a separate trip to a GP,, it works for me. If blood checks are required ,these again are done free at your local hospital.

Any childhood inoculations are free ,even catch up ones when you first arrive to bring UK children in to line with Aussie recommendations.

 

If you are on a PR visa you will also get $1000 per child towards Dental treatment, so this also really helps.

 

Cal x

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X Rays are an intersting one. There are private X Ray centers where you pay, then there are public X Rays at the public hospital, but depends on the hospital if it is free or not, seems some x rays centers in the hospital are privately owned. My local hospital wanted $99 for a Cat Scan but I chose to drive 90km to a larger town where the x ray at the hospital was free. Sounds silly due to petrol costs, but there was a chance after the X ray I may then need a MRI which was around $500 at the local hospital and free are the other one, so may be a good idea to check before having x rays.

On side note many schools have free dental vans for the children, well worth using them as dental work is expencive over here.

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You may well find your sons meds are just call something else over here. One of the meds I take is called something totally different in the US. Best thing to do is ask Chemist warehouse if they have what you need. I find they are the cheapest for scripts, they also have generic meds, same as the expencive brand just a different name. Another med I have to take is not standard stock, but I just ring them tell them I need a repete of my script and it is delivered the following day, ready for me to collect. You can leave your repete scripts at C W and they keep a record of what you have spent. Oh also if you end up with private health cover, you may find you can make a claim on some meds and get some of the cost back from the health fund, but you will need to ask CW for a printed receipt, not just a till receipt so you can make a claim.

Do you know what state you are heading for ?

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X Rays are an intersting one. There are private X Ray centers where you pay, then there are public X Rays at the public hospital, but depends on the hospital if it is free or not, seems some x rays centers in the hospital are privately owned. My local hospital wanted $99 for a Cat Scan but I chose to drive 90km to a larger town where the x ray at the hospital was free. Sounds silly due to petrol costs, but there was a chance after the X ray I may then need a MRI which was around $500 at the local hospital and free are the other one, so may be a good idea to check before having x rays.

On side note many schools have free dental vans for the children, well worth using them as dental work is expencive over here.

 

Just to add to this there are also private X-rays centres where you don't pay for many services so like most things in the Australian health system you have to shop around and get to know the system unfortunately. e.g. one in Brisbane: http://www.savagexray.com.au/benefits.html

Edited by fish.01
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Just to add to this there are also private X-rays centres where you don't pay for many services so like most things in the Australian health system it pays to shop around. e.g. one in Brisbane: http://www.savagexray.com.au/benefits.html

Hi Fish, thanks for that ! Not down here in Vic, well not my area, we will eventually be going back to Qld to live so I will be checking that out ! I know Qld now has large bulk billing centers as well, again very few down here that are anywhere near me, but yes I admit we are rural.

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I fly fly out to melbourne in January. I just wanted to sort out my sons meds or at least look into it before getting out there. Thanks for the advice. So far is seems like CW for price and advice. Thanks all.

 

You may well find your sons meds are just call something else over here. One of the meds I take is called something totally different in the US. Best thing to do is ask Chemist warehouse if they have what you need. I find they are the cheapest for scripts, they also have generic meds, same as the expencive brand just a different name. Another med I have to take is not standard stock, but I just ring them tell them I need a repete of my script and it is delivered the following day, ready for me to collect. You can leave your repete scripts at C W and they keep a record of what you have spent. Oh also if you end up with private health cover, you may find you can make a claim on some meds and get some of the cost back from the health fund, but you will need to ask CW for a printed receipt, not just a till receipt so you can make a claim.

Do you know what state you are heading for ?

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I fly fly out to melbourne in January. I just wanted to sort out my sons meds or at least look into it before getting out there. Thanks for the advice. So far is seems like CW for price and advice. Thanks all.

 

Hi Mary,

 

What are the names of the medications? I work in Pharmacy here and can advise on price and whether there are alternatives over here. Happy to help if I can.

 

There's lots of good information here but I'd like to elaborate on some points:

 

* The PBS is basically a list of medications the government will subsidise, anything on the list will cost no more than $36.90 for general patients, or $6 for concessions. Anything listed on the PBS will have a PBS quantity (usually 30 days though some medications come in larger quantities) and PBS number of repeats - Generally you'll get 30 days supply and 5 repeats (6 months on each script)

* Many drugs cost less than $36.90, generics (not the original brands) will cost less - many drugs for chronic conditions will cost $6-$20 (per month) - Always Choose Generic!

* The 'cap' for medication costs (medications covered by the PBS that is is called the 'safety net' and for 2014 is set at $1421.20 - This is a cap set for the family unit (husband, wife, children under 16 or <25yrs and in full time education)

 

* There is a brand culture for medicines I've noticed in doctor prescribing. for example: In the UK if you have reflux you may be prescribed Omeprazole, over here doctors will prescribe Nexium...net cost for Omeprazole = $9, Nexium = $25-$36.90 The difference between the drugs themselves is negligible for 99% of patients. I'd advise to have an awareness of what you're prescribed and always enquire with the doctor or pharmacist whether there are alternatives (direct generics or alternatives in same class of drug).

 

Hope that helps.

 

Jamie

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Thank you Jamie for the advice. My son has been prescribed budesonide nebules and generic syrup to mask the taste. It's for my sons EoE. Thanks in advance.

 

Hi Mary,

 

What are the names of the medications? I work in Pharmacy here and can advise on price and whether there are alternatives over here. Happy to help if I can.

 

There's lots of good information here but I'd like to elaborate on some points:

 

* The PBS is basically a list of medications the government will subsidise, anything on the list will cost no more than $36.90 for general patients, or $6 for concessions. Anything listed on the PBS will have a PBS quantity (usually 30 days though some medications come in larger quantities) and PBS number of repeats - Generally you'll get 30 days supply and 5 repeats (6 months on each script)

* Many drugs cost less than $36.90, generics (not the original brands) will cost less - many drugs for chronic conditions will cost $6-$20 (per month) - Always Choose Generic!

* The 'cap' for medication costs (medications covered by the PBS that is is called the 'safety net' and for 2014 is set at $1421.20 - This is a cap set for the family unit (husband, wife, children under 16 or <25yrs and in full time education)

 

* There is a brand culture for medicines I've noticed in doctor prescribing. for example: In the UK if you have reflux you may be prescribed Omeprazole, over here doctors will prescribe Nexium...net cost for Omeprazole = $9, Nexium = $25-$36.90 The difference between the drugs themselves is negligible for 99% of patients. I'd advise to have an awareness of what you're prescribed and always enquire with the doctor or pharmacist whether there are alternatives (direct generics or alternatives in same class of drug).

 

Hope that helps.

 

Jamie

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Budesonide is available under the brand name pulmicort nebules. This is available on PBS for "severe asthma not able to take inhaled steroids via other routes", private cost approx $50-55month. I'm sorry EoE is not an acronym I recognise so can't advise if he falls into the PBS catagory - this is quite important as GPs are audited and if they are found to have prescribed medication on PBS outside the specific indication they can be personally liable for the full cost of the medication. Hope this helps.

 

Nemo (GP in Tas)

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Budesonide is available under the brand name pulmicort nebules. This is available on PBS for "severe asthma not able to take inhaled steroids via other routes", private cost approx $50-55month. I'm sorry EoE is not an acronym I recognise so can't advise if he falls into the PBS catagory - this is quite important as GPs are audited and if they are found to have prescribed medication on PBS outside the specific indication they can be personally liable for the full cost of the medication. Hope this helps.

 

Nemo (GP in Tas)

 

Just to highlight what the doc said - the quoted part means it must be prescribed under authority, i.e. gp gains the authority to prescribe the medication on the PBS (the doctor applies for this authority over the phone, in some cases this can be done using a code 'streamlined authority') of which your son may or may not meet the criteria.

 

If he doesn't meet the criteria for an authority prescription you'll pay the above private cost (you may be able to get it from $34-45 - this is for a quantity of 30).

 

There is no budesonide syrup available in australia.

 

A quick google found:

 

http://www.ausee.org/

 

and

 

http://www.allergy.org.au/images/stories/aer/infobulletins/2014/AER_Eosinophilic_Oesophagitis_2014.pdf

 

It looks like the approach over here is rather different as both documents only mention using inhaled steroids (swallowed, not inhaled) of which you'd be looking at anything from $18-$36.90 a pop.

 

 

Hope that helps.

 

Jamie

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Hi sorry EoE stands for eosinophilic esophagitis. It's asthma of the gullet. His gastro has prescribed it to be taken orally with a syrup to mask the taste. It's not really recognised by GPs in Sheffield, but his paediatric gastro says it's the best way to control his inflammation.

 

Im hoping when I get out to Melbourne my son gets referred as soon as possible. Also would anybody know how much medication I can come out with? I'll be getting a months worth but hoping I can being more as I don't know where in Melbourne I'll end up.

 

Thanks

 

Mary

Budesonide is available under the brand name pulmicort nebules. This is available on PBS for "severe asthma not able to take inhaled steroids via other routes", private cost approx $50-55month. I'm sorry EoE is not an acronym I recognise so can't advise if he falls into the PBS catagory - this is quite important as GPs are audited and if they are found to have prescribed medication on PBS outside the specific indication they can be personally liable for the full cost of the medication. Hope this helps.

 

Nemo (GP in Tas)

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Thanks Cal, I was hoping to do the same and get a letter from my sons paediatrician to state what it is for.

 

Mary

 

I kept putting repeats in ,in the month before we left and brought around 3 months supply of meds,prescribed creams etc with me. Just carry a script with you ,to show its your medication 'if' you are stopped and asked.

 

Cal x

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Thanks Cal, I was hoping to do the same and get a letter from my sons paediatrician to state what it is for.

 

Mary

 

Just to put your mind at rest. We flew out and my wife brought 9 months of her pill. We filled in the declaration to say so and we also had codeine tablets. Immigration were totally uninterested (They're more interested in anabolic steroids, pseudoephedrine, stronger painkillers etc - if you were legitimately prescribed any of these and had a photocopy of the prescription there'd be no issues though as they are prescribable here too, just more likely than other meds to be diverted/sold).

 

If you were to get a photocopy of the prescription I wouldn't see there being any issues if you brought out as much as possible especially considering you can't half of his current treatment on the PBS (If you push you doctor they may write 6 months worth, I would imagine if you explained to your paediatrician the situation here in Aus they'd want your kid to have amply supply whilst you settle, find a doctor, explore treatments here etc).

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I would approach your UK GP and ask for copies of all the specialist letters, this is likely to take a few days vs weeks if approaching your Consultant. If leaving the UK you can ask for 3 months supply on the NHS and potentially a further 3 months on private script. HTH.

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