Medicare cost?

[Simontucks]

Hi there,

I'm sorry if this has been asked many times before but is there any websites which shows the cost of medical insurance in Australia?. We are emigrating to Brisbane in April on residency visas and trying to find cost of it all,medical,dental,car and the like.

Thanks in advance

Simon

[Cheery Thistle]

You pay a Medicare levy which is 2% of your salary. I believe low earners qualify for a subsidy. You do need to pay some out of pocket expenses of which you can claim a percentage back. A lot of people have private policies on top of the Medicare. We have bypass in the UK which we are looking to ‘port’ over to Aus. 

[Nemesis]

6 hours ago, Simontucks said:

Hi there,

I'm sorry if this has been asked many times before but is there any websites which shows the cost of medical insurance in Australia?. We are emigrating to Brisbane in April on residency visas and trying to find cost of it all,medical,dental,car and the like.

Thanks in advance

Simon

When you say "Residency visas" do you mean temporary residency or permanent residency? Can make a big difference medically!

[InnerVoice]

11 hours ago, Cheery Thistle said:

You pay a Medicare levy which is 2% of your salary. I believe low earners qualify for a subsidy. You do need to pay some out of pocket expenses of which you can claim a percentage back. A lot of people have private policies on top of the Medicare. We have bypass in the UK which we are looking to ‘port’ over to Aus. 

All that's correct, but additionally you also have to pay the Medicare Levy Surcharge (MLS) if you earn over $93,000 and are single or over $186,000 as a couple, and you choose not to take out an 'appropriate level of private patient hospital cover'. The idea is to 'incentivise' higher earners to take out private healthcare because then they don't have to pay the MLS.

https://www.ato.gov.au/individuals-and-families/medicare-and-private-health-insurance/medicare-levy-surcharge/paying-the-medicare-levy-surcharge

How MLS is calculated can get quite involved, but in most cases it will be 1% of your salary. Check out the MLS income thresholds and rates for 2023-24 table in the following link.

https://www.ato.gov.au/individuals-and-families/medicare-and-private-health-insurance/medicare-levy-surcharge/medicare-levy-surcharge-income-thresholds-and-rates

 

@Simontucks as for dental you have to pay for everything because it isn't covered by Medicare, and it can be very expensive. If I was you I'd get literally everything you need doing (or might possible need doing to your teeth in the next 2-3 years) done on the NHS before you leave.

[Marisawright]

12 hours ago, Simontucks said:

I'm sorry if this has been asked many times before but is there any websites which shows the cost of medical insurance in Australia?.

Firstly, medical insurance companies in Australia offer two different types of policy. Their main policy, which most people think of as 'health insurance', is actually "Hospital Cover" -- it covers ONLY treatments in a hospital.   Their other policy is "Extras Cover", which covers dental, optical, physiotherapy and some other services depending on the company you choose. 

There is no insurance that covers medical treatment or prescriptions outside a hospital, e.g. visits to the GP (more on that later).

Because of the 'extras' name, many people think you have to take both covers together. You don't.  As a new arrival with kids, I'd recommend you to take Extras Cover as soon as you arrive, so you're covered for dentistry as soon as possible -- it is VERY expensive here.  Eye tests are covered by Medicare, but spectacles are not, and they're also expensive. 

As a new migrant, you've got a full 12 months from your arrival, to decide whether to take Hospital Cover or not (if you don't take it out within that time, there may be tax implications).  I'd advise you to take that time -- you'll have enough to do in your first few months here anyway.  

Coming from the UK, you may struggle to understand why Australians take Hospital Cover.   If you don't have it, you'll be treated in a hospital exactly like you'd be treated under the NHS.  Hospital Cover can let you skip the waiting list for elective surgery, and you'll get a private room instead of a bed in a big ward -- but if you didn't feel the need to go private in the UK, why would you feel the need in Australia?

As InnerVoice says, the main reason most people take Hospital Cover is that it lets them avoid the extra Medicare levy. Also if you don't take Hospital Cover while you're young, you'll be slugged a surcharge if you take it out when you're old.  But like I said, I wouldn't worry about it right now, you've got 12 months to work that out.  Bear in mind that if you have an accident or need emergency treatment in a hospital, that will always be covered by Medicare anyway (you just won't get that nice private room or get to choose your doctor).

Now for your day-to-day medical treatment.  It is covered by Medicare, which is Australia's equivalent to the NHS.  However, Medicare doesn't cover 100% of the fees.  There is usually a difference between what the doctors charge and what Medicare will pay, which is called the "gap".  Like I said, there is no insurance available to cover that gap, you just have to pay it.    The gap can be anything, it just depends what the doctor decides to charge ( doctors aren't employed by Medicare -- they have to run their own business, so it's up to them to decide how much to charge, like any self-employed person).   Depending where you live, some GPs may "bulk bill", which means they don't charge more than Medicare will pay. 

There is also a 'gap' when you get prescriptions.  For instance, my preventive asthma inhaler costs me $40.  

 

[rammygirl]

As above. But get used to asking the cost and shopping around, even for prescriptions as there is no fixed cost. Many GPs don’t charge a gap for children or other concession holders but is is now rare to get a free consult as an adult. I do find that compared to the UK the gap is worth it for a 15 minute consultation with a less stressed doctor!

[ramot]

2 hours ago, Marisawright said:

Firstly, medical insurance companies in Australia offer two different types of policy. Their main policy, which most people think of as 'health insurance', is actually "Hospital Cover" -- it covers ONLY treatments in a hospital.   Their other policy is "Extras Cover", which covers dental, optical, physiotherapy and some other services depending on the company you choose. 

There is no insurance that covers medical treatment or prescriptions outside a hospital, e.g. visits to the GP (more on that later).

Because of the 'extras' name, many people think you have to take both covers together. You don't.  As a new arrival with kids, I'd recommend you to take Extras Cover as soon as you arrive, so you're covered for dentistry as soon as possible -- it is VERY expensive here.  Eye tests are covered by Medicare, but spectacles are not, and they're also expensive. 

As a new migrant, you've got a full 12 months from your arrival, to decide whether to take Hospital Cover or not (if you don't take it out within that time, there may be tax implications).  I'd advise you to take that time -- you'll have enough to do in your first few months here anyway.  

Coming from the UK, you may struggle to understand why Australians take Hospital Cover.   If you don't have it, you'll be treated in a hospital exactly like you'd be treated under the NHS.  Hospital Cover can let you skip the waiting list for elective surgery, and you'll get a private room instead of a bed in a big ward -- but if you didn't feel the need to go private in the UK, why would you feel the need in Australia?

As InnerVoice says, the main reason most people take Hospital Cover is that it lets them avoid the extra Medicare levy. Also if you don't take Hospital Cover while you're young, you'll be slugged a surcharge if you take it out when you're old.  But like I said, I wouldn't worry about it right now, you've got 12 months to work that out.  Bear in mind that if you have an accident or need emergency treatment in a hospital, that will always be covered by Medicare anyway (you just won't get that nice private room or get to choose your doctor).

Now for your day-to-day medical treatment.  It is covered by Medicare, which is Australia's equivalent to the NHS.  However, Medicare doesn't cover 100% of the fees.  There is usually a difference between what the doctors charge and what Medicare will pay, which is called the "gap".  Like I said, there is no insurance available to cover that gap, you just have to pay it.    The gap can be anything, it just depends what the doctor decides to charge ( doctors aren't employed by Medicare -- they have to run their own business, so it's up to them to decide how much to charge, like any self-employed person).   Depending where you live, some GPs may "bulk bill", which means they don't charge more than Medicare will pay. 

There is also a 'gap' when you get prescriptions.  For instance, my preventive asthma inhaler costs me $40.  
 

 

Suggest ambulance cover straight away depending on which state you live in, you can be charged a hefty fee otherwise if needed without cover. 
We have an emergency Dr service locally now, it’s attached to a separate surgery, but separate Drs as it’s walk in and there if you need to see a Dr quickly and your surgery is full. I had to go recently, it Cost about the regular charge, then  had an ultrasound  at the same place and follow up consultation later, both of those were no charge. I don’t know how many of these places exist, but can’t fault my treatment.

Edited December 28, 2023 by ramot

[Ken]

1 hour ago, ramot said:

Suggest ambulance cover straight away depending on which state you live in, you can be charged a hefty fee otherwise if needed without cover. 
We have an emergency Dr service locally now, it’s attached to a separate surgery, but separate Drs as it’s walk in and there if you need to see a Dr quickly and your surgery is full. I had to go recently, it Cost about the regular charge, then  had an ultrasound  at the same place and follow up consultation later, both of those were no charge. I don’t know how many of these places exist, but can’t fault my treatment.

The OP is moving to Brisbane. Ambulance cover isn't necessary in Queensland.

[ramot]

19 minutes ago, Ken said:

The OP is moving to Brisbane. Ambulance cover isn't necessary in Queensland.

I mentioned it as general information 

what happens if you live in qld but are visiting another state and need an ambulance, are you still covered?

Edited December 28, 2023 by ramot

[Nemesis]

29 minutes ago, ramot said:

I mentioned it as general information 

what happens if you live in qld but are visiting another state and need an ambulance, are you still covered?

Yes, you're covered by your Queensland cover, same as if you are resident in a State where you need to pay for cover, that paid cover is country-wide. 

[Ken]

49 minutes ago, ramot said:

I mentioned it as general information 

what happens if you live in qld but are visiting another state and need an ambulance, are you still covered?

If you get a bill from another state, you send it to the Queensland government, and they pay it.

Incidentally I always had ambulance cover when living in Victoria. If cost about $23 per quarter for the family. Well worth the peace of mind. You don't want to be wondering "do I really need an ambulance" in an emergency just because of the expense.

Edited December 28, 2023 by Ken

[Cheery Thistle]

Thank you for all of this info guys, which I am absorbing as a bystander to the OP. If we can afford it we’ll be going full cover straight away. 
You actually seriously can’t get an ambulance in the UK any more - I had to transport my husband 25 miles in the back of our car with one of his discs pressing on his spinal cord (required an emergency operation). Then, when we got to A and E there were no wheelchairs. 
Our daughter also needs braces which I know will be £££. 

[Nemesis]

6 hours ago, Cheery Thistle said:

Thank you for all of this info guys, which I am absorbing as a bystander to the OP. If we can afford it we’ll be going full cover straight away. 
You actually seriously can’t get an ambulance in the UK any more - I had to transport my husband 25 miles in the back of our car with one of his discs pressing on his spinal cord (required an emergency operation). Then, when we got to A and E there were no wheelchairs. 
Our daughter also needs braces which I know will be £££. 

Not in your area maybe, but as with every part of the NHS it varies. Resident in my block of flats needed an ambulance Boxing Day, turned up in minutes, as it seems has been the case for others around here. Family have needed ambulances often this year and live out in rural Wales - sometimes a wait due to the remoteness but they turn up. 

Braces will be even more XXXy in Australia if you don't have cover than in the UK, btw

[Cheery Thistle]

11 minutes ago, Nemesis said:

Not in your area maybe, but as with every part of the NHS it varies. Resident in my block of flats needed an ambulance Boxing Day, turned up in minutes, as it seems has been the case for others around here. Family have needed ambulances often this year and live out in rural Wales - sometimes a wait due to the remoteness but they turn up. 

Braces will be even more XXXy in Australia if you don't have cover than in the UK, btw

Just recounting my own traumatic experience and explaining why we’ll be taking full cover.
 

My next door neighbour (and friend) also had a stroke (aged 43) 5 years ago and we waited 6 hours on that ambulance. We live a 5 minute drive from a hospital. The one where I had to drive my husband he was actually already at A and E in our local hospital and they said he would have to wait 12 hours for a transfer to Edinburgh RI. After me driving him through they sent him home, only for him to be transferred in 23 minutes the following day and operated on immediately for what they originally missed. How an A and E can have no available wheelchairs in a first world country in 2021 I will never understand. 
My reference to the ££ for the braces was for Australia (should have been $$ maybe) as it’s looking like she’ll have to wait until we get there for them. She would get them free here. 
My experience is real and valid. 
 

[Blue Manna]

2 hours ago, Cheery Thistle said:

Just recounting my own traumatic experience and explaining why we’ll be taking full cover.
 

My next door neighbour (and friend) also had a stroke (aged 43) 5 years ago and we waited 6 hours on that ambulance. We live a 5 minute drive from a hospital. The one where I had to drive my husband he was actually already at A and E in our local hospital and they said he would have to wait 12 hours for a transfer to Edinburgh RI. After me driving him through they sent him home, only for him to be transferred in 23 minutes the following day and operated on immediately for what they originally missed. How an A and E can have no available wheelchairs in a first world country in 2021 I will never understand. 
My reference to the ££ for the braces was for Australia (should have been $$ maybe) as it’s looking like she’ll have to wait until we get there for them. She would get them free here. 
My experience is real and valid. 
 

I was going to query that as my youngest was offered them free in the UK. 

[Cheery Thistle]

1 hour ago, Blue Manna said:

I was going to query that as my youngest was offered them free in the UK. 

They are free if they deem the issues severe enough that they will affect bite/chewing. My daughters are quite bad so fairly sure they’d be free. I am hearing of people waiting 12-18 months for the orthodontist though, so I suppose to a point you get what you pay for? Anyway, not wanting to hijack the Medicare post!! 

Edited December 28, 2023 by Cheery Thistle

[Tulip1]

4 hours ago, Cheery Thistle said:

Just recounting my own traumatic experience and explaining why we’ll be taking full cover.
 

My next door neighbour (and friend) also had a stroke (aged 43) 5 years ago and we waited 6 hours on that ambulance. We live a 5 minute drive from a hospital. The one where I had to drive my husband he was actually already at A and E in our local hospital and they said he would have to wait 12 hours for a transfer to Edinburgh RI. After me driving him through they sent him home, only for him to be transferred in 23 minutes the following day and operated on immediately for what they originally missed. How an A and E can have no available wheelchairs in a first world country in 2021 I will never understand. 
My reference to the ££ for the braces was for Australia (should have been $$ maybe) as it’s looking like she’ll have to wait until we get there for them. She would get them free here. 
My experience is real and valid. 
 

Why would anyone wait 6 hours for an ambulance when someone could drive them to the hospital just 5 minutes away? With a stroke that could be the difference between life or death or normal life/severely comprised.  You say ‘we waited’ so I don’t understand why someone didn’t drive the neighbour/organise a taxi.   

[Cheery Thistle]

45 minutes ago, Tulip1 said:

Why would anyone wait 6 hours for an ambulance when someone could drive them to the hospital just 5 minutes away? With a stroke that could be the difference between life or death or normal life/severely comprised.  You say ‘we waited’ so I don’t understand why someone didn’t drive the neighbour/organise a taxi.   

She couldn’t walk and we didn’t know it was a stroke. She was just saying she couldn’t get out of bed. She was 43 and is a yoga instructor, therefore very fit/healthy. She was assessed on the phone by NHS staff (via the cleaner who called before I was involved) at the time who did not suspect stroke due to her age and medical history. We were told to sit tight and wait. With hindsight it was obvious it was a stroke, but at the time with no prior health issues and with medical staff saying it’s not, plus how do you safely get an adult who can’t walk down the stairs and into a car? That’s what ambulances, paramedics and equipment are supposed to be for? Her cleaner went in to do the weekly clean at 9am and found her on the bedroom floor, managed to get her back into bed (with difficulty) and called the ambulance. After a couple of hours wait she knocked on my door for assistance. The ambulance arrived at 2.30pm. Thankfully she has made a more or less full recovery, they traced the cause of the stroke to an undiagnosed hole in the heart which they operated on. She has been through a lot but is back running her yoga studio and teaching. 

It was the same for my husband when we got to A and E and there were no wheelchairs, he had to wait in agony in the back of the car until staff found one (40 minutes wait btw) as I had no way of safely getting him in to the hospital. It’s not easy to shift 14.5 stone of Scottish muscle!! 

I’m not sure who it serves to question this, and it makes me feel rather uncomfortable that someone seems to think I would make something like this up. Unfortunately it’s all true! 

[InnerVoice]

53 minutes ago, Tulip1 said:

Why would anyone wait 6 hours for an ambulance when someone could drive them to the hospital just 5 minutes away? With a stroke that could be the difference between life or death or normal life/severely comprised.  You say ‘we waited’ so I don’t understand why someone didn’t drive the neighbour/organise a taxi.   

Has it occurred to you that the patient may have been partially or completely incapacitated? The standard procedure when someone is suspected of having a stroke is to call 999 straight away, and given the seriousness of the condition I think we'd all expect an ambulance to turn up pretty quickly.

 

[Cheery Thistle]

Exactly. 

[InnerVoice]

21 hours ago, Marisawright said:

Eye tests are covered by Medicare, but spectacles are not, and they're also expensive.

That used to be the case and I'd always replace my glasses whenever I was back in the UK, but I've found Specsavers very competitive recently. I just took advantage of their 2 pairs for $199 deal. I had an anti-reflective tint added and that brought the price up to about $250, but it was still a really good deal. The glasses are nice too, and don't make me look like either John Lennon or Jarvis Cocker.

https://www.specsavers.com.au/special-offers/2-pairs-from-199-including-sunglasses

Edited December 28, 2023 by InnerVoice

[Philip]

10 hours ago, InnerVoice said:

That used to be the case and I'd always replace my glasses whenever I was back in the UK, but I've found Specsavers very competitive recently. I just took advantage of their 2 pairs for $199 deal.

Interesting that glasses are cheaper for you in the UK.

After I moved to the UK, I was still on my parents' private health insurance for a number of years. So my dad "forced" me to get new glasses frequently, the co-pay was around $150 in 2013.

Looking at what my wife was paying in the UK, I decided I wouldn't get new glasses until we moved back to Australia, but it took much longer than expected until we were ready to do so, which meant I had no choice but to pay £580 in the UK around when covid started.

Obviously there has been inflation but last month an optometrist in Australia told me a new pair with the same sort of features as my current glasses would be around $600-700.

[InnerVoice]

6 minutes ago, Philip said:

Interesting that glasses are cheaper for you in the UK.

After I moved to the UK, I was still on my parents' private health insurance for a number of years. So my dad "forced" me to get new glasses frequently, the co-pay was around $150 in 2013.

Looking at what my wife was paying in the UK, I decided I wouldn't get new glasses until we moved back to Australia, but it took much longer than expected until we were ready to do so, which meant I had no choice but to pay £580 in the UK around when covid started.

Obviously there has been inflation but last month an optometrist in Australia told me a new pair with the same sort of features as my current glasses would be around $600-700.

I was talking retrospectively about buying glasses in the UK. They have Specsavers in Australia now, which is where I bought my last pair a few months ago.

[Marisawright]

On 29/12/2023 at 19:53, InnerVoice said:

I was talking retrospectively about buying glasses in the UK. They have Specsavers in Australia now, which is where I bought my last pair a few months ago.

Specsavers is good if you just need basic glasses.  Just wait for their special offers and you can get great deals.  I got two-for-the-price-of-one reading glasses there last year, and that was fully covered by my health insurance.  However if you need something more complicated, the price shoots up.

I needed new multifocals and I waited until they had a "multifocals for $199" offer. All seemed well until I sat down with the 'consultant' to complete the order.  She told me the special offer lenses were very basic and wouldn't be suitable for me as I'd be annoyed by the blur (???).   I would need the next level lenses, plus a few other 'essential' features.   She did the sums and hey presto, my $199 glasses were suddenly $850.  I walked out.

[ramot]

1 hour ago, Marisawright said:

Specsavers is good if you just need basic glasses.  Just wait for their special offers and you can get great deals.  I got two-for-the-price-of-one reading glasses there last year, and that was fully covered by my health insurance.  However if you need something more complicated, the price shoots up.

I needed new multifocals and I waited until they had a "multifocals for $199" offer. All seemed well until I sat down with the 'consultant' to complete the order.  She told me the special offer lenses were very basic and wouldn't be suitable for me as I'd be annoyed by the blur (???).   I would need the next level lenses, plus a few other 'essential' features.   She did the sums and hey presto, my $199 glasses were suddenly $850.  I walked out.

As I really like my frames, I have new lenses put in them, much cheaper