Medicare yellow

[ajavaid92]

Hi, will be entering Oz soon on a 482 Visa as a Doctor. Does reciprocal healthcare (yellow Medicare) cover GP and specialist visits? Additionally, does it pay out a certain percentage for treatment in a private hospital, or is this only reserved for members of full Medicare benefits (Aussie citizens)?

[Quoll]

Australia has a co-pay system so most Australians pay for GP and specialist visits. If your treatment is necessary then you will pay the same as any other Australian  under the reciprocal arrangement. Medicare doesn’t  cover private hospital other than the standard Medicare rebate for the item number which goes nowhere close to covering the fees. It rather depends on whether your treatment is deemed necessary or elective - if necessary then the reciprocal arrangement will cover you, if elective then you won’t get anything for it. 
As you’re likely to be in the high salary range, being a doctor, it’d probably be financially worth your while to get private health insurance and avoid the Medicare Levy Surcharge

Edited July 24, 2021 by Quoll

[ajavaid92]

6 hours ago, Quoll said:

Australia has a co-pay system so most Australians pay for GP and specialist visits. If your treatment is necessary then you will pay the same as any other Australian  under the reciprocal arrangement. Medicare doesn’t  cover private hospital other than the standard Medicare rebate for the item number which goes nowhere close to covering the fees. It rather depends on whether your treatment is deemed necessary or elective - if necessary then the reciprocal arrangement will cover you, if elective then you won’t get anything for it. 
As you’re likely to be in the high salary range, being a doctor, it’d probably be financially worth your while to get private health insurance and avoid the Medicare Levy Surcharge

Thanks. When I look up yellow Medicare, it appears it will only cover emergency presentations. If I were to attend a GP for a non-emergency reason, would Medicare pay up to the MBS value (let’s say this particular GP bulk-bills) or would it not pay at all since this is not an emergency presentation? It doesn’t appear very clear on the website.

Unfortunately, oveeseas healthcare cover doesn’t cover MLS. Only Oz citizens who purchase private health insurance exempts them from the MLS. As someone from overseas, you need to get another policy to cover the MLS (absolutely useless policy - can’t claim on it, it’s just for tax savings) on top of the private health insurance. This appears to be my understanding from all the research I’ve done.

[Quoll]

I think the wording for reciprocal cover is “necessary” rather than emergency. Some of the policies I just googled for temporary working visas include GP and specialist visits (some have an annual max spend) so when you choose the private cover that you need to evidence for your visa, you can get one with that level of cover. 
I don’t know why UK expats are so hung up on bulk billing - it was designed to ensure that low income earners weren’t deterred from seeking medical intervention. The rest of us understand it’s a co-pay system and the rebate for a GP visit is only around $39 these days. 

[ajavaid92]

46 minutes ago, Quoll said:

I think the wording for reciprocal cover is “necessary” rather than emergency. Some of the policies I just googled for temporary working visas include GP and specialist visits (some have an annual max spend) so when you choose the private cover that you need to evidence for your visa, you can get one with that level of cover. 
I don’t know why UK expats are so hung up on bulk billing - it was designed to ensure that low income earners weren’t deterred from seeking medical intervention. The rest of us understand it’s a co-pay system and the rebate for a GP visit is only around $39 these days. 

The only reason I mention bulk-billing was for ease of argument. I guess I’m comparing between policies that include GP/specialist cover and those that don’t - if yellow Medicare will cover the usual MBS fee percentage, then I can stay away from more expensive policies offering GP/specialist cover.

[Marisawright]

10 hours ago, ajavaid92 said:

Hi, will be entering Oz soon on a 482 Visa as a Doctor. Does reciprocal healthcare (yellow Medicare) cover GP and specialist visits? Additionally, does it pay out a certain percentage for treatment in a private hospital, or is this only reserved for members of full Medicare benefits (Aussie citizens)?

Officially, reciprocal cover is available for essential treatment only.  If the treatment could wait for you to return to your home country and have the treatment there, then it's not supposed to be covered.  

In practice, that doesn't seem to happen, and you'll be covered for the equivalent of a full Australian resident.  There are special health insurance policies available for those who have reciprocal cover.

I assume you've checked that you are eligible for reciprocal cover.

[Ken]

6 hours ago, ajavaid92 said:

Thanks. When I look up yellow Medicare, it appears it will only cover emergency presentations. If I were to attend a GP for a non-emergency reason, would Medicare pay up to the MBS value (let’s say this particular GP bulk-bills) or would it not pay at all since this is not an emergency presentation? It doesn’t appear very clear on the website.

Unfortunately, oveeseas healthcare cover doesn’t cover MLS. Only Oz citizens who purchase private health insurance exempts them from the MLS. As someone from overseas, you need to get another policy to cover the MLS (absolutely useless policy - can’t claim on it, it’s just for tax savings) on top of the private health insurance. This appears to be my understanding from all the research I’ve done.

It's hospital cover insurance that exempts you from the MLS not anything else that might be bundled in. If you get hospitalised in a public hospital then Medicare claim the Medicare rate from the insurance company. If you get hospitalised in a public hospital and don't have hospital cover then Medicare can't recover anything which is why you have to pay more tax if you are a higher earner. If you've got a very basic hospital cover only policy you might not see any benefit other than the tax saving but that doesn't mean the policy isn't doing anything.