Just Landed - Medicare & Doctors

[oliver27]

Hi all,

After months / years of anticipation, I landed in Australia yesterday. What an emotional rollercoaster the past week and especially yesterday, but feel better today after a good sleep in a bed after the long flight!

Anyway... I’m looking to understand how MediCare works. I’m on a subclass 100 partner visa, so I’m entitled to join. Do I do this at a centrelink?

I have a prescription medication I need to take. The doctor in the U.K. provided bulk prescription before I left which should last a while, but would rather sort out new prescription in Aus sooner rather than later, so how do I go about finding a doctor? Is there a website or something? And do I need to wait till Medicare sign-up is complete before I can do this?

Any help appreciated (looks like this forum is going to be invaluable not only at visa application stage, but also for things like this too - a great place for advice!)

[VERYSTORMY]

Google Medicare and the name of where you are. There will be a Medicare centre near you. You pop in with your ID, fill in the form and they will provide a temporary number you can use until your card arrives.

for doctors, again, just google the doctors near you. It isn't like the UK, you can just go to any. Pop in or call them and ask for an appointment. As a new patient you will just fill in a form on arrival about your medical history. Do be aware that there are two types of doctors, known as bulk billing and none bulk billing. If they bulk bill, then there is no out of pocket cost to you. If they don't bulk bill, then you will pay a fee - usually about $70 from which you get about half back from Medicare 

[ali]

Give Medicare a few working days .. we turned up a couple of days after arrival and weren't in the system.

[scubacam]

Google Medicare and the name of where you are. There will be a Medicare centre near you. You pop in with your ID, fill in the form and they will provide a temporary number you can use until your card arrives.
for doctors, again, just google the doctors near you. It isn't like the UK, you can just go to any. Pop in or call them and ask for an appointment. As a new patient you will just fill in a form on arrival about your medical history. Do be aware that there are two types of doctors, known as bulk billing and none bulk billing. If they bulk bill, then there is no out of pocket cost to you. If they don't bulk bill, then you will pay a fee - usually about $70 from which you get about half back from Medicare 

VeryStormy, you have a wealth of helpful info, I’m starting to look into this too! Do you mind me asking when u left UK? How do you find the health system compared? I don’t understand Medicare very well and plan on getting to grips with it. If you get bulk billing and u don’t pay then why when not bulk billing do you only get half back?

[VERYSTORMY]

8 hours ago, scubacam said:

 

 

VeryStormy, you have a wealth of helpful info, I’m starting to look into this too! Do you mind me asking when u left UK? How do you find the health system compared? I don’t understand Medicare very well and plan on getting to grips with it. If you get bulk billing and u don’t pay then why when not bulk billing do you only get half back?
 

 

 

First, thank you. It's probably why I am one of the moderators (as is ali).

we left the UK in May 2008 after a VERY mad month that I will never forget (I forgot at the time we were emigrating until the day before!). We spent eight years in Australia and returned to the UK in 2016. But are now Australian citizens. 

we found the health system very good, but, it can be expensive. It is not the NHS. A number of things we had to pay for. For example, I needed some tests which were not available via Medicare and had to pay. Also prescriptions can be a fair bit more. I have inhalers and these were about $70 a month. 

With the bulk billing, it is access to it. For the first five years, there wasn't a bulk billing doctor anywhere near where we lived. So no choice. They are thin on the ground in some areas. 

Do look at the private insurance as not only can it be important not just for needing the cover, but there are big tax implications. Basically the government has set up a system to encourage private health which can result in paying extra income tax if you don't take it. Also, there are other things private is needed for, for example, dental work can be VERY expensive - easy to see a 4 figure bill. Also, some states, ambulances are private and can result in big bills - I had the cheapest possible bill for an ambulance and it was still $700+. Hence many people have it, though a reasonable number of employers include it as part of salary. 

[scubacam]

First, thank you. It's probably why I am one of the moderators (as is ali).
we left the UK in May 2008 after a VERY mad month that I will never forget (I forgot at the time we were emigrating until the day before!). We spent eight years in Australia and returned to the UK in 2016. But are now Australian citizens. 
we found the health system very good, but, it can be expensive. It is not the NHS. A number of things we had to pay for. For example, I needed some tests which were not available via Medicare and had to pay. Also prescriptions can be a fair bit more. I have inhalers and these were about $70 a month. 
With the bulk billing, it is access to it. For the first five years, there wasn't a bulk billing doctor anywhere near where we lived. So no choice. They are thin on the ground in some areas. 
Do look at the private insurance as not only can it be important not just for needing the cover, but there are big tax implications. Basically the government has set up a system to encourage private health which can result in paying extra income tax if you don't take it. Also, there are other things private is needed for, for example, dental work can be VERY expensive - easy to see a 4 figure bill. Also, some states, ambulances are private and can result in big bills - I had the cheapest possible bill for an ambulance and it was still $700+. Hence many people have it, though a reasonable number of employers include it as part of salary. 

Wow ; lots to take in and understand and also understand what’s included and not included in salary etc, so what to look out for - I’m not good at reading and understanding insurance / any type of important documents where they use jargon I don’t understand . Are you going back to Australia ?

[Marisawright]

3 hours ago, scubacam said:

Wow ; lots to take in and understand and also understand what’s included and not included in salary etc,

 

 

"What's included in salary" is easy.  Everyone gets paid a salary.  On top of the salary, the employer has to pay money into a pension fund on your behalf (called 'superannation', or "super" for short).  It's calculated as a percentage of the salary figure.

When you see a job advertised, it will either say  "Salary is X plus superannuation at X%",  or "Salary is X including X% super".   If it doesn't say, it's important to check which one it is.

People in more senior positions are more likely to be offered a "salary package".  Basically, it's still just salary and superannuation - but part of the salary is converted to benefits, to reduce the employee's income tax.   Which benefits you get depends on what you negotiate, nothing is fixed (though some employers have their own rules).   

Obviously, the more benefits you choose, the less money you get paid as actual salary.

This link explains it:

https://www.moneysmart.gov.au/managing-your-money/income-tax/salary-packaging

Edited October 17, 2018 by Marisawright

[VERYSTORMY]

7 hours ago, scubacam said:

 

 

Wow ; lots to take in and understand and also understand what’s included and not included in salary etc, so what to look out for - I’m not good at reading and understanding insurance / any type of important documents where they use jargon I don’t understand . Are you going back to Australia ?

 

 

I won't be going back to live. Am 48 now (nearly 49) and need to settle once and for all. 

[scubacam]

"What's included in salary" is easy.  Everyone gets paid a salary.  On top of the salary, the employer has to pay money into a pension fund on your behalf (called 'superannation', or "super" for short).  It's calculated as a percentage of the salary figure.
When you see a job advertised, it will either say  "Salary is X plus superannuation at X%",  or "Salary is X including X% super".   If it doesn't say, it's important to check which one it is.
People in more senior positions are more likely to be offered a "salary package".  Basically, it's still just salary and superannuation - but part of the salary is converted to benefits, to reduce the employee's income tax.   Which benefits you get depends on what you negotiate, nothing is fixed (though some employers have their own rules).   
Obviously, the more benefits you choose, the less money you get paid as actual salary.
This link explains it:
https://www.moneysmart.gov.au/managing-your-money/income-tax/salary-packaging

Thank you; I understand the pension super bit but it’s whether or not you’re entitled to an ambulance in your health package etc etc

[scubacam]

Basically the government has set up a system to encourage private health which can result in paying extra income tax if you don't take it.

Might sound like a silly question but will I know with my contract if I’m going to end up paying extra income tax if I don’t take it ?

[Quoll]

3 minutes ago, scubacam said:

 

 

Might sound like a silly question but will I know with my contract if I’m going to end up paying extra income tax if I don’t take it ?

 

 

Yes. It depends on your income - once you are over the threshold you pay the Medicare surcharge if you don't take out private health insurance so if you earn less than 90k or your family earns less than 180k there will be no surcharge.  Everyone pays the Medicare levy as part of the deductions from salary. 

As for ambulance cover - all states do it differently https://www.gmhba.com.au/help/health-insurance/ambulance-cover

[Marisawright]

15 minutes ago, scubacam said:

Thank you; I understand the pension super bit but it’s whether or not you’re entitled to an ambulance in your health package etc etc

 

 

There's no such thing as a "health package" as part of your salary. You might decide to include health insurance as a benefit, but usually it will be up to you to decide which type of cover you want.

Same goes for when you buy health insurance individually.  Each health insurer has several different types of cover and they all include different things.  It's all super-confusing and you'll find there are services like Choosi, iSelect and CompareTheMarket who offer to work out which one is most suitable for you.  You'll probably decide, eventually, that you're cheaper to work it out yourself - but those services can be useful at first, because it can be mind-boggling.

Edited October 17, 2018 by Marisawright

[can1983]

We are operating our own "private" medical health policy hospital and extras. We have paid $400 into a separate account each month we have lived in Australia. Every time we use something which is eligible to be claimed we withdrawn from it less the excess that applies (its based on a medibank policy).

After 3 years the balance is over $10,000. If you are young and less likely to claim its worth considering. By the time we hit an age where claiming is more likely we hope to have 40-50k saved up. Its a risk of course but i'm confident we will gain long term

Obviously private medical insurers make vast profits and pay wages, shop running costs, call centres, etc so over the whole population hardly anyone gets good value..

[VERYSTORMY]

Also, do consider other things that aren't covered by Medicare, dental and optical come to mind. Dental, can be very expensive without insurance. 

[Marisawright]

15 hours ago, can1983 said:

We are operating our own "private" medical health policy hospital and extras. We have paid $400 into a separate account each month we have lived in Australia. Every time we use something which is eligible to be claimed we withdrawn from it less the excess that applies (its based on a medibank policy).

After 3 years the balance is over $10,000. If you are young and less likely to claim its worth considering. By the time we hit an age where claiming is more likely we hope to have 40-50k saved up. Its a risk of course but i'm confident we will gain long term

Obviously private medical insurers make vast profits and pay wages, shop running costs, call centres, etc so over the whole population hardly anyone gets good value..

That's a legitimate strategy.  My oh agrees with your approach.  In the insurance game (which he is), you'd be called "self-insured".  He has never had private health insurance as he's always been happy to use the public system, and paying if he needs to go private.  

I think Brits are better able to understand that strategy than Australians.  Australians have been bombarded with marketing by the health insurers, telling them they need to "choose their own doctor", have a private room, and get their hip replacement done pronto.   Whereas British people wouldn't think twice about being treated in a public ward, by whatever doctor's on duty - and though long waiting lists are a pain, in Britain they are simply accepted, what choice do you have?  

The only snag is when you get old, and that's starting to worry my oh now.  He has already had to pay about $20,000 for a couple of operations in the last few years. He could have had those done on Medicare, but there would have been delays.  For the first op, he was in a LOT of pain and couldn't bear to wait. The second op was for a melanoma and he didn't want to risk any delay.  It's far too late to take out health insurance now, as he'd pay a penalty of (I think) an extra 40% on top of the annual premium - as if that wasn't already eye-watering enough. 

As for me, I've been dutifully paying for health insurance for years, basically because I got scared into it by the campaign about loadings and tax penalties.  I wear glasses and contact lenses, and use physiotherapists and massage therapists because of my dancing, so I do make some claims every year, which makes me feel slightly better about it - but still, my husband used to scoff.    I must say, I did feel better about it two years ago, when I had to have a double spinal fusion, which cost $35,000.