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An idiots guide to ~ Medicare


cartertucker

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Please help ~ I know that once we arrive, we need to register

 

But what im confused about is:

 

What are we expected to pay :confused:

 

Say for an example (all I can think of) How much would a typical 10 minute Doctor appointment about a possible throat infection cost?

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Please help ~ I know that once we arrive, we need to register

 

But what im confused about is:

 

What are we expected to pay :confused:

 

Say for an example (all I can think of) How much would a typical 10 minute Doctor appointment about a possible throat infection cost?

 

hey kelly .....if u manage to find a doctor that bulk bills then u wouldnt have to pay anything up front ....if however they dont bulk bill u pay there and then ....approx $50 and then claim it back from medicare .....u only however get a percentiage back ..never done it this way so not sure how much ...u then would need to pay for ur prescription ....which can vary in price ....antibiotics are approx $20 ....u cant claim this on medicare but i have just found out u can claim against on ur tax return ....i recently had to go for xrays .....i could have had them bulk billed ...but would need to travel about 10ks ...opted for the nearest dept ....paid $139 upfront and claimed $89 back from medicare ...hope this is easy to understand ...believe u me its quite complicated ...and then theres private cover ....well thats a whole other story :twitcy:

mrs keily

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I think the rebate amount is about $33 or so. Our GP charges $60 (we're in the ACT) for a short consultation and $100 for a longer one. Getting appointments is relatively easy but if we cant get one, we always have the option of CALMS (Canberra After-Hours Locum Medical Service?). They charge more and I think the same applies in other cities/states. If your annual expenditure exceeds a certain amount, you can claim the excess against your tax. If you are on a l(very) ow income then you should be eligible for rebates on medical expenses and prescriptions.

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Medicare is definately one of the hardest things to get your head around here,lol

This is what ive found -

- A fee of $60 is charged by my Dr as she does not bulk bill. Medicare instantly refund me $33. I take the kids to a different bulk billing practice and pay nothing, but we are not always seen by the same Dr.

 

- If you need ''referring' to a specialist of any kind ,you will be referred to a private one UNLESS you request you go public. The first time, before i found this out i paid around $125 for a specialist appointment at a lovely provate hospital,, ever since (last 3 years) i have used the public system and paid for nothing, 6 mthly appointments, scans, x-rays,biopsy's, blood tests etc . The only drawback is if i need bloods taking i have to go to the hospital (25 mins away) and not one of the 'blood shops' normally found near a Drs surgery (5 mins away).

 

- Scripts can quickly add up so always ask for generic brands where possible, the chemists are pretty good and normally tell you if its cheaper to buy over the counter rather than via script.

 

Hope this helps

Cal x

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Guest cazbeckham

Our Doctor bulk bills, can usually get an appointment really quick and I see the same Doctor every time. Presciptions for both our Blood Pressure and High Cholesterol tablets are very very expensive but we have to have them.

Not sure if you can get medicare help with prescriptions - have to check that one out.

 

Caz

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Our Doctor bulk bills, can usually get an appointment really quick and I see the same Doctor every time. Presciptions for both our Blood Pressure and High Cholesterol tablets are very very expensive but we have to have them.

Not sure if you can get medicare help with prescriptions - have to check that one out.

 

Caz

do you pay the PBS lower price as you have reciprocal care agreement? Are they still expensive?

thanks

Cal

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Im wondering if for example your child had tonsilitus (a common childhood infection) would you be paying for treatment?

 

And what if, they needed to have them out? :confused:

 

Same as NHS....free hospitals, free public specialists...just pay gap payment at some GP's or if you decide to use a private specialist rather than one at a public hospital.

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Prescription charges are up to $34.20 each - but that reduces to a $5.60 maximum if you spend more than $1,317.20 on prescriptions in a year (the PBS safety net). There is similarly a cap on the amount each family has to pay for "out-of-hospital" expenses (the medicare safety net).

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Oh really :wideeyed:

 

So do you not have to pay for the children then? :confused:

 

No, you don't have to pay for anyone....free hospitals and free public specialists.

 

 

Some people do pay of course, like the NHS, as they use a private specialist instead of the public specialists....like the NHS the waiting period depends on the speciality and where you live and this influences some people's decision whether to pay a private specialist or wait.

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Just what needs to be paid for....and what doesnt??? :unsure:

 

There is big difference between what "needs" to be paid for vs what you could pay for.

 

If you want cheap as possible you could:

- find a GP who bulk bills (almost 80% of GP visits Australia wide are bulk billed but some places like Canberra only have 50%)

- ask to be referred to a free specialist at the public hospital outpatient clinic - GP's will refer you to a private specialist by default so you usually need to ask.

- be treated at a free public hospital.

 

Dearest option might be:

- Use a GP with a big gap payment.

- Be referred to a private specialist - medicare still gives some back even though it is a private specialist but you will be significantly out of pocket.

- Be treated in a private hospital - you would only do this if you had private hospital insurance and this may still involve co-payments.

 

So your main extra costs over the NHS might be:

- no free dental...or not much anyway...there is a free school dental bus scheme for the kids. Depends whether you trust a NHS dentist with your dentistry at the moment as to how much extra it will cost.

- using private specialists - I get the impression people use private specialists here more than the uk but could be wrong.

- prescriptions roughly twice the price of England.

 

On the bright side you'll live longer ;)

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  • 8 months later...

Just to add,, the first time when you paid, if you didnt have Medicare linked to your account and didnt take your receipt to a Medicare outlet you wont have got the Medicare refund of aprrox $38. If you still have the receipt take it in,, id also link it to your bank account so it automatically gets done next time.

 

Cal x

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Thanks Cal, yes, the first appointment was a booking in ~ so that could well be why

 

So, will i get a bill for the other visits???

 

No if they tell you there is nothing to pay , thats it and Medicare pay.. One of our local Dr's bulk bills for kids and not adults so if i go ,i pay , if the kids go its free..If you arent fussed about seeing the same Dr ,find one that bulk bills for everyone all the time.

 

Cal x

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  • 1 month later...
Guest sadiesmum

Hi All

 

Just looking through as we are due out in september. Can someone explain what "bulk Bill" means?

 

Also do you have to pay for oral contraceptives?

 

finally do you have to pay for childrens vaccinations etc?

 

I was under the impression that medicare was exactly like the NHS with no fees to pay for appointments etc, and just a nominal payment for prescriptions?

 

Sorry last questions, is there an equivalent to NI payment taken from wages to fund medicare?

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Hi All

Just looking through as we are due out in september. Can someone explain what "bulk Bill" means?

 

 

It means free. The govt sets a scheduled fee for each type of service. If a doctor charges the same as this fee, ie no gap, then it is called bulk bill.

 

Also do you have to pay for oral contraceptives?

 

 

Yes

 

finally do you have to pay for childrens vaccinations etc?

 

 

My wife said she has never paid. You also get two payments from the govt as you fulfill the prescribed immunisations up till the age of 4 (total $250).

 

I was under the impression that medicare was exactly like the NHS with no fees to pay for appointments etc, and just a nominal payment for prescriptions?

 

 

The main differences are that some GP's charge a gap so if you don't find a bulk billing GP (which are more common in low socio economic areas) you will pay a gap. For example some GP's charge working adults a gap but bulk bill children or pensioners. See each GP website for details. You can swap between GP's freely anywhere across the city.

 

Another difference is GP's will generally refer working adults to private specialists by default. You have to ask if you want to see a free public specialist at a public hospital outpatients clinic. I get the impression this is more the default in the UK so less go to private specialists?

 

Sorry last questions, is there an equivalent to NI payment taken from wages to fund medicare?

 

Medicare is funded from a 1.5% charge which comes out of your pay packet. It is usually not shown separately on your payslip - just incorporated by the payroll dept into the general "tax" amount so you often don't notice it. If you earn over $160,000 as a couple or $80,000 as a single (+ $1500/child after first) then you must pay an extra 1% at the end of the year in your tax return. This is waived if you have private hospital insurance.

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