Confused by health care/medicare/private health insurance

[Kbobs]

The more I read about the health care costs etc the more Im confused about it all. Is anybody living out there with a similar situation to mine?

Is there somewhere I can email for advice?

Myself, my husband and our 2 daughters are in the early stages of applying for a skilled Permanent Resident Visa to emigrate from England to Sydney.

Im reading lots of information online but want to be 100% sure on the health care side of things.

My husband was diagnosed with Leukaemia in 2012. Treatment went well and he has been in remission 3 years, will be 4 years by the time we would emigrate.

Would we be entitled to the standard Medicare? I wondered if Cancers had to be in remission a certain amount of time before they are no longer classed as pre-existing?

Also for the near future he will be having 6-12 monthly check ups. Would this just continue under Medicare?

 

We want to know we have all bases covered and what the costs could be.

I hope those questions make sense.

 

[Suzukiscottie]

Yes, he'll be covered under medicare. Medicare doesn't refuse you treatment because you've had an ailment previously. Private health insurance possibly would depending on timescales etc.

 

Your husband will need to get "into the system" prior to continuing with his regular checkups. Probably best done through your GP once you get here. I guess your GP will refer your husband on to the appropriate department for continuing care.

 

If you're in the early stages of applying for PR, then the medicals will also flag up the issue. Further supporting evidence from your current medical care team will be requested. The info provided by my oncology team can be summarised best as "he presented with xxx, diagnosed as xxx, we did surgery involving xxx, no further action required other than checkups". That type of thing. At the time, I was in remission and my visa was granted shortly after the medicals.

[pommekate]

Assuming your husband passes the medical for the Visa then I don't see any reason why he wouldn't be entitled to medicare. However healthcare over here is not totally free. There are a lot of bulk bill GP's in medical centres where you don't pay anything and they send the bill to medicare, but you don't always get the same GP. In your husbands situation you would probably want one GP to follow things up it will probably be important to have continuity of care. Lots of GP's charge a rate mine is about $80 which I have to pay then I can claim some back from medicare, not all of the $80. Your GP can then refer your husband to an Oncologist for the necessary follow up, this too can cost money some of which you can claim back from medicare. If finances are difficult you can ask the Oncologist if they bulk bill. If you also have private health insurance they too pay a portion of the costs. Any hospital admissions and tests such as bloods and X-rays as an impatient are free, as an outpatient you do have to pay some of the tests. Lots of the cities and towns do have bulk billing pathologists. I know a lot of people complain about the NHS, but when you live in other countries it really does make you appreciate what we did have in the UK.

[Guest The Pom Queen]

Assuming your husband passes the medical for the Visa then I don't see any reason why he wouldn't be entitled to medicare. However healthcare over here is not totally free. There are a lot of bulk bill GP's in medical centres where you don't pay anything and they send the bill to medicare, but you don't always get the same GP. In your husbands situation you would probably want one GP to follow things up it will probably be important to have continuity of care. Lots of GP's charge a rate mine is about $80 which I have to pay then I can claim some back from medicare, not all of the $80. Your GP can then refer your husband to an Oncologist for the necessary follow up, this too can cost money some of which you can claim back from medicare. If finances are difficult you can ask the Oncologist if they bulk bill. If you also have private health insurance they too pay a portion of the costs. Any hospital admissions and tests such as bloods and X-rays as an impatient are free, as an outpatient you do have to pay some of the tests. Lots of the cities and towns do have bulk billing pathologists. I know a lot of people complain about the NHS, but when you live in other countries it really does make you appreciate what we did have in the UK.

Just a quick one here, private health only covers inpatient treatment, so if you see a specialist you will either be bulk billed by Medicare or pay around $160 and get a percentage paid back.

 

Believe me I still find the system complicated and I should be the expert by now.

If you go in to the public hospital you don't pay a penny if you have no private health, all X-rays, blood tests etc are free. Just don't mention you have private.

The downside of going to the public system is that you may have long waiting lists, depending on the urgency, and you can't choose your surgeon.

 

Private hospital, you have to be refered usually by a private specialist (which you pay for as above) before being admitted you need to check what the gap fees are, not only for the surgeon but his assistant and the anesthetist. I have had a number of anethetists bulk bill me but mainly because I'm a local on the table. If they don't I would say fees are around $1800 but each one is different. Then you have your excess to pay. In regards to blood tests, X-rays etc, I have always been charged extra and usually get a bill from sullivans after. One of my ops it was very tricky so they needed to have scans taken throughout, I got billed a $1,000 for this.

 

If you have a day procedure they usually class you as an inpatient so you can claim.

 

As an outpatient I have only once paid for an MRI and that was done with another study it cost me $1000 and I got $300 back.

 

You do have a safety net where all the families out of pocket expenses are clubbed together and depending on your circumstances once you reach the threshold you will either receive the full amount back or 80%. For example I saw my specialist today it should have cost me $170 or cost me something like $10. I'm not sure why I received more than the 80%.

[Guest The Pom Queen]

 

@Kbobs if you are moving to a large city ie Melbourne or Sydney I wouldn't bother with private health, I never had it whilst in Melbourne.

[Kbobs]

Thank you everyone, thats really helpful.

[Teejams]

Hi Pom Queen, based on your experience would you recommend taking the private insurance then?

[Marisawright]

Hi Pom Queen, based on your experience would you recommend taking the private insurance then?

 

You'll notice she said that if she was living in Melbourne, she wouldn't bother. So it partly depends where you are.

 

For many people, private health insurance is a must - not because of health, but because you'll suffer tax penalties if you don't have it. Most professionals in Australia have it for that reason alone (but you can get special minimum-cover policies from the health funds if that's what you want).

 

Medicare in Australia is not really that different from the NHS If you're sick, you'll get good treatment in an open ward in a public hospital, and have a specialist chosen for you. If you need an operation, you'll get the operation. Like the NHS, if it's not considered urgent, you may have a long wait.

 

The difference is that Brits just accept all that. It doesn't occur to British people to join BUPA unless they're wealthy. But the health care providers have done a great job of convincing Aussies that's not how it should be. Sleep on a big open ward - horrific! Be treated by any old specialist - appalling! Wait six weeks for an op - disgraceful! Take out health insurance and you can choose your specialist, stay in a nice private room and have your operation when you choose.

 

They don't mention that it will end up costing you money. Get treated in a hospital under Medicare and it's free. Get treated in a private hospital and there is always an excess to pay - and it can be substantial. You have to pay the doctor, the anaesthetist, the pathologist, the radiologist, and the hospital - plus extras like phone calls or satellite TV or wifi or special food.

 

If you've got a serious medical problem then having insurance does feel good - you feel much more in control. But it doesn't mean you're necessarily getting better or faster treatment.

 

A couple of years ago I had a spinal fusion. I was glad I had private insurance because it was done within a few weeks, my specialist was one of the top men in his field, and the outcome was excellent. It cost about $35,000 of which I got about $25,000 back from the health fund. I thought it was worth it.

 

Then my friend's father had the same problem. I was so worried about him because he had no insurance. Six weeks later he had his op, on medicare, done by one of the top men in the field. His outcome was excellent. It cost him nothing!!