How does healthcare work?

[twinkletoes35]

Hi all

 

This is probably goping to sound like a silly question, understand that the healthcare system is part public part private, but could someone explain how it actually works? Read up on the internet but would kind of like it jargon free.

 

Any help is much appreciated

 

Cheers

 

TT x

[Quoll]

You pay for medicare along with your taxes - 1.5% of your taxable income is the levy. If you are a high income earner and you dont have private insurance then you pay another 1% of your taxable income as surcharge.

 

Generally you can go to a hospital and be treated as a public patient for free.

 

If you go to a GP you might be expected to pay a co-payment (usually about $30) - there are several ways of doing this but the most common way is to pay the whole bill up front then take the receipt along to the Medicare office and get a rebate of around $31 leaving you having paid the gap.

 

Some people on here (and it seems to be a matter of concern to them) move heaven and earth to find a bulk billing doctor - bulk billing means that the doctor just charges medicare the going rate and charges you nothing. Such doctors are usually in big medical centres and usually you dont get continuity of care. As bulk billing was originally conceived to be a way of ensuring that low income earners werent avoiding medical treatment because of the cost, there really is no reason to hunt for one, most Australians who can afford the copayment will pay just a little bit for the continuity of care.

 

The private health system is for hospital procedures and the advantages of taking out private health cover include lower waiting times on elective procedures, choice of practitioner, private rooms in hospital etc. There is usually some sort of "gap" payment required in that the private insurance rarely covers the full cost of the private treatment although you can pay more and get smaller gap payments. Private health cover does not cover GPs or treatment outside of hospitals unless you also get ancillaries cover which will pay for things like orthodontics, dentist, optician, physio, etc

 

Medications are usually covered by the pharmaceuticals benefits scheme which means you pay a max of $31(ish) per fill (usually a month or a full cycle of whatever medication). Low income earners entitled to a health care card will pay less (about $5 per fill I think) and for everyone there is a safety net so above a certain amount in a year you will pay the concession rate. If you have a med which is not on the PBS but you have private health insurance you can get a percentage of the difference back through insurance.

[Guest ragdoll annie]

You pay for medicare along with your taxes - 1.5% of your taxable income is the levy. If you are a high income earner and you dont have private insurance then you pay another 1% of your taxable income as surcharge.

 

Generally you can go to a hospital and be treated as a public patient for free.

 

If you go to a GP you might be expected to pay a co-payment (usually about $30) - there are several ways of doing this but the most common way is to pay the whole bill up front then take the receipt along to the Medicare office and get a rebate of around $31 leaving you having paid the gap.

 

Some people on here (and it seems to be a matter of concern to them) move heaven and earth to find a bulk billing doctor - bulk billing means that the doctor just charges medicare the going rate and charges you nothing. Such doctors are usually in big medical centres and usually you dont get continuity of care. As bulk billing was originally conceived to be a way of ensuring that low income earners werent avoiding medical treatment because of the cost, there really is no reason to hunt for one, most Australians who can afford the copayment will pay just a little bit for the continuity of care.

 

The private health system is for hospital procedures and the advantages of taking out private health cover include lower waiting times on elective procedures, choice of practitioner, private rooms in hospital etc. There is usually some sort of "gap" payment required in that the private insurance rarely covers the full cost of the private treatment although you can pay more and get smaller gap payments. Private health cover does not cover GPs or treatment outside of hospitals unless you also get ancillaries cover which will pay for things like orthodontics, dentist, optician, physio, etc

 

Medications are usually covered by the pharmaceuticals benefits scheme which means you pay a max of $31(ish) per fill (usually a month or a full cycle of whatever medication). Low income earners entitled to a health care card will pay less (about $5 per fill I think) and for everyone there is a safety net so above a certain amount in a year you will pay the concession rate. If you have a med which is not on the PBS but you have private health insurance you can get a percentage of the difference back through insurance.[/quote

 

 

Some people on here might be low income earners...thats why its important to us to get bulk billers.

Annie x

[deb8181]

Also on the subject of Private hospital cover, all new migrants have 12 months to take out this cover from when you apply for your Medicare card. After that you have to pay a percentage loading on the premium which can be quite costly.

 

Ozzies attract this loading once they reach 30 (or might be 31) so if you want private health insurance make sure you get it within 12 months of landing here, even if its the basic band.

[Guest iwazawhingingpom]

I have lived in Oz now for over 5 years my husband is Australian.

Lived in QLD & NSW.

 

If you go to a Drs you will have to pay a fee (cash/eftpos or credit facility) which you can then take receipt to a MEDICARE office (usually situated within a 'WESTFIELD' Shopping Centre)

You also go to one of these offices on arrival to claim a MEDICARE card (take ID & passport with your visa in)

 

You will need MEDICARE card on you at all times as you need to show for DRS, HOSPITALS SCANS X-RAYS EYE TEST etc..

 

BULK BILLING DRS do not charge a fee & they can also ask for BULK BILLING if you need scan x-ray done by referral by them. (when looking for local DR just ask receptionist if they Bulk Bill, some do some do not !

 

If there is an emergency and you need to go to A & E you can just go to any public hospital for free (need to show medicare card)

 

Ambulance charge here for calling them out (In QLD you pay for this with your Elec/Gas Bill)

 

Perscriptions are just over $5 (must be on PBS list) if you have health care card or around $30 for others, again though if not covered by PBS some medicine can cost $100's but you can ask for 'generic' brand from chemist if they are on PBS list so cheaper..

The Drs here also do not do the 'Quit Smoking' like Drs in UK so if you smoke and want to quit it will cost you $100's for patches etc..

Same for Dieting (perscription diet pills here around $120 per one script !!

 

Dentist is a whole nother story!!!!

No BULK BILL expect to pay $$$$$$

Public Hospitals have Dentist if you have HEALTH CARE card from Centrelink

(like UK-DHSS)

But !!!!!!!!! My daughter (24) has one and went to hospital dentist for free only to be told they will not cover back teeth molars for Root Canal or take out tooth, you have to PAY PRIVATE !

I had Root Canal done 3 years ago in Brisbane.. $1000.. :arghh:

So how they expect people managing on low income to manage?????

 

I WILL NEVER MOAN ABOUT NHS AGAIN !

 

Or you can pay into a private Health Fund but like insurance companies you purchase then find out what it does not cover at your time of need !!

BUT if you earn over $73 thousand a year your best to have Private Health Cover or the TAX man stings you big time!

 

Anyway hope in someway this has helped?

 

Also i might ad.. we are going home for good at Christmas and i for one cannot wait, love some things about Oz but other things drive me up the wall

:hug: