OZ medical care and insurance explained

[LaraBond]

I have been given a repeat prescription over the phone at no extra expense. However that may depend on a long relationship with your doctor.

 

Here is an extract from a typical GP surgery conditions of service:

 

'It is not possible to repeat prescriptions over the phone.

This ensures good standards of practice.

In exceptional circumstances , at the discretion of the treating doctor , collection may be possible, but will attract a fee and may not be ready until the following day'

 

see the full list here: http://www.marketstreetmedical.com.au/services.html

[fish.01]

Hi Lara,

 

I think you have hit the nail on the head with the system being complicated and it does confuse and does cost more in some situations. I might clarify some things you have raised though:

 

LaraBond: "exceeds $77,000 per single or $154,000 per family (plus $1,500 per additional child after the first child)"

 

- Trivial but the limits are now 80,000/160,000 for the surcharge in case someone is on the cusp.

 

 

LaraBond: "Despite what some members say about bulk-billing (free) GPs and doctors, they are like gold dust. There are certainly none in the city with some very rare exceptions for under 16-s, pensioners and those on benefits. There are some in underprivileged or rural areas but not in the cities."

 

- Govt stats show almost 80% of GP services in Brisbane are free. Rather than being a "very rare exception" providing free service to children, pensioners and low income families is wide spread. The 21% of visits that aren't bulk billed will most likely be working age adults but there are GP's across Brisbane who will bulk bill this group as well but it may involve a longer drive. Lower income areas do tend to have more as more price sensitive.

 

Had a quick google and here's a few I found in Brisbane that appear to bulk bill everyone. I tried to confirm they still currently bulk bill but could not do it for every one so should still ring to confirm as they change from time to time.

 

Medical Centre Beenleigh

Elizabeth St Medical Centre - Acacia Ridge

Algester Medical Centre

Medical Centre Inala

Medical Centre Marsden

Medical Centre Woodridge

Garden City Family Doctors

Grand Plaza Medical Centre

Ferny Grove Family Medical Practice

Kuraby Medical Centre

Chatswood Rd Medical Centre

Morningside Family Medical Centre

Victoria Point Medical & Dental Centre

Good Health Medical Centre at Mt. Gravatt

http://www.redcliffesuperclinic.com.au/

Springfield Superclinic

Millennium Medical Group Brisbane City

Redland Bay Surgery

Donald Road Family Medical Centre Redland Bay

Strathpine GP Superclinic

Auchenflower Medical Centre

 

There are others that keep the gap fee in the $10-$25 range. Many also no longer require you to pay upfront and claim later - instead you just pay the gap.

 

There are many many more that bulk bill children, pensioners and low income earners...

 

 

LaraBond: "You also pay for tests, x-rays and routine treatments"

 

- I don't pay for xrays or pathology. There are plenty of places that bulk bill if you ring around. There are some that charge a gap though so is important to check.

 

 

LaraBond: "Specialist doctors that you might be referred to also charge $150-200 per consultation with additional fees for tests and treatments, which will cost about the same again. You will get about half of it back through Medicare but there will almost always be a gap payment. This may not sound too bad for those fortunate ones who hardly ever visit a doctor but for those who are older or with chronic conditions this soon adds up!"

- These are private specialists you are talking about. Similar to the UK you pay for private specialists. If you want a free public specialist, like the NHS, you must ask your GP when being referred. Of course, like the NHS, you then sometimes have longer waiting times.

 

 

LaraBond: "Also, you need to visit a doctor for repeat prescriptions (and pay for a visit), they do not take it over the counter or over the phone. "

 

- You can get a set of repeats from one GP visit when first prescribed. The medicines that can have repeats and the number of repeats you can get is on the PBS website. If you run out of repeats and go back for another set you usually have to pay again if your GP doesn't bulk bill.

 

 

LaraBond: "There are no state funded dentists in Australia, they are all private, even for children and their prices appear to be unregulated. Their charges are extortionate and on average 3-4 times more than private dentists’ in the UK"

 

- There are various state funded dental schemes throughout Australia but far less than the UK - though some states are better than others. Free dental buses visit schools in many states. There is also a one off $100-200 voucher per year for teens. There is dental schools with extremely bad waiting lists though I have heard the odd person who doesn't wait too long - uni of qld I think? There is also free dental for dentistry for medical conditions.

 

From the examples I have seen over the last few years I estimate private dentist in Australia are about 1 - 2 times UK private dentists when using 2.2 cost of living exchange rate. Only very rough guess though based on examples posted.

 

 

LaraBond: "There is no separate dental insurance,"

 

- Not as common as getting it through "extras" policies but some insurers offer separate dental only insurance.

 

 

Skani: "Surely they can access free medical care through the Paediatrics or Rheumatology Clinics at the public hospital? All the children I know who have chronic medical conditions are able to do this." - LaraBond: "Obviously not otherwise their GP would have told them about this?"

 

- Not necessarily - you will be often be referred to a private specialists unless you ask to be referred to a public specialist. Public hospitals would almost certainly offer this treatment for free. See list of Brisbane's daily free paediatric rheumatology services on page 2 of this document: http://www.arthritis.org.au/content/Document/Winter%2010%20Story%20JIA%20Clinics.pdf

 

 

LaraBond: "With regards to GPs it seems situation in Melbourne is much better than in Brisbane."

 

- MovingToMelbourne's post shows that Melbourne's bulk billing rate is almost identical to Brisbane. Canberra is the low one (and some country areas).

 

 

LaraBond: "but you have to understand that people who used NHS all their lives would just assume that if there is a state health system it would be similar to NHS with free consultations and treatments"

 

- It does have free consolations and treatments. Sounds like they have possibly accidently gone the private route and are regularly paying a private specialist. I have seen quite a few on this site who didn't even realise they were at private specialists and realise public ones were available. I think because medicare pays some of the private specialists fees they get confused.

[fish.01]

I think the UK NHS dentist was subsidized, but not free. Seem to remember paying about 20 pounds for a check up and 60-80 pounds for a filling.

 

I had a wisdom tooth extracted once, but it was done in a hospital. Would that be free here in the same circumstances?

 

I know someone in Victoria who had a wisdom tooth extracted in hospital and they said medicare helped with the day bed costs and the anaesthetic so do get some back it seems.

[JoandJon]

If you want more info about health insurance check out this site:

http://www.privatehealth.gov.au

 

It's the official ombudsman website, so not 'sales pitches', it also has a link to Dental prices.

 

I know it's slightly Off topic, but it is related...

[Guest Guest31881]

Without answering every single item mentioned, this is my experience of Australian Health care.

 

GP bulk bills never paid for a consultation.

Wife attends vascular clinic at Brisbane Women's Hospital, all tests examinations and treatment has been free,

Wife had cortisone injection in her shoulder Cost $45 got rebate from medicare.

I have a mild heart condition, have to take warfarin and have regular blood tests, Blood tests are bulk billed so I do not pay. Warfarin is charged as a normal prescription would be.

I am under a cardiologist for my heart condition who flies into the town every 4 weeks, I have seen him twice and never been asked to pay for anything. That includes echo cardiograms and various other tests.

 

refereed to hospital dentist because of the warfarin, had two extractions and not been charged.

[LaraBond]

Had a quick google and here's a few I found in Brisbane that appear to bulk bill everyone. I tried to confirm they still currently bulk bill but could not do it for every one so should still ring to confirm as they change from time to time.

 

Thank you for your comprehensive answers Fish, this is really appreciated. On the bulk billing doctors, however, I don't want to mislead people. I have done my research too. I personally rang the GPs practices from the list supplied by a previous poster and they said bulk billing is only for children, pensioners and concession card holders - despite what they say on the website. The practices you have listed are all but one not in Brisbane but in fact 15-25 km from CBD. This would mean for a working person taking half a day off work to see a GP - not possible for many working in the city, especially for patients who need to see a doctor often.

 

There are other problems with bulk billing clinics, such as long waiting times, poor medical service (judging by patients reviews). And the last but not least, these bulk-billing practices make a small percentage of all GP practices in the area. If bulk billing medical centres were so widely available, then the private ones would be out of business whereas, in fact, they are in vast majority.

 

I have to repeat again that bulk billing seems to be a privilege at a doctor's discretion, most likely for the old patients but not for the new patients and possibly only for some types of appointments but not all.

[LaraBond]

If you want more info about health insurance check out this site:

http://www.privatehealth.gov.au

 

It's the official ombudsman website, so not 'sales pitches', it also has a link to Dental prices.

 

I know it's slightly Off topic, but it is related...

 

Thanks JoandJon this link was already provided in my thread including dental prices

[heyyu]

Seems we have a raw deal in Brisbane as nothing seems free here and everything I have stated I have experienced personally. Does it vary in different areas/states? Can anyone from Brisbane itself comment on this?

i pay nothing xrays scans and all ancilliarys are free ,dental i use the state free service just got to ring up,by 8.30am if cant get in ring next day.i live in Brisbane.had to wait 12 months for a non life threaten ing hernia op,free i attend the Sthrathpine super clinic doctors from around the world uk ireland india sth africa and australia have been very happy with service no rush .dental QLDhealth lawnton or stafford,there was one in the heart of the city teaching clinic not sure of the address no probs there either[previso im pensioner although all children from 4yrs to grade 10 are free]

[fairystar32]

In the UK, all the dentists in my area went private, it was impossible to get a NHS one. Here we have extras and its a bargain for our family.

My DD recently had dental work done free att he school dentist and my son has his front teeth fixed which were damaged at the school dentist for free too.

 

Our doctors bulks bills, even at weekends for the entire family, we also have 3 surgeries nearby which all bulk bill the kids and costs about $35 for us. So I take the kids to whoever can get us in first and I go to the bulk billing one..

I had kidney issues last year and never paid a penny, I got checked by renal and it was all free.

[RockDr]

I will point out that rents are far higher in the CBD. If people working in the CBD want the convenience of being able to pop out from work to see a doctor, they have to expect to be paying a gap. The doctors have to charge this extra to cover the increased rent costs of being in the CBD. If they didn't they wouldn't make ends meet and would have to close, and then you wouldn't even have the choice of going to a CBD practice.

[Guest The Pom Queen]

Thank you for your comprehensive answers Fish, this is really appreciated. On the bulk billing doctors, however, I don't want to mislead people. I have done my research too. I personally rang the GPs practices from the list supplied by a previous poster and they said bulk billing is only for children, pensioners and concession card holders - despite what they say on the website. The practices you have listed are all but one not in Brisbane but in fact 15-25 km from CBD. This would mean for a working person taking half a day off work to see a GP - not possible for many working in the city, especially for patients who need to see a doctor often.

 

There are other problems with bulk billing clinics, such as long waiting times, poor medical service (judging by patients reviews). And the last but not least, these bulk-billing practices make a small percentage of all GP practices in the area. If bulk billing medical centres were so widely available, then the private ones would be out of business whereas, in fact, they are in vast majority.

 

I have to repeat again that bulk billing seems to be a privilege at a doctor's discretion, most likely for the old patients but not for the new patients and possibly only for some types of appointments but not all.

 

Firstly you won't tell us the area where you live so we can't help if it's 15km out of the way and believe me 15km isn't far at all.

Long waiting lists for bulk billing gp's how do you work that out (especially as you haven't been to one) I could call up now and be seen within 30minutes, ok that wouldn't necessarily be my own Dr he is in high demand most patients have to wait a week but I can be seen within 24 hours.

Bulk Billing is at a private Dr's it's not a case of having separate clinics one for public one for private.

I think it is quite insulting to say if they bulk bill they offer a poor service, it's a load of crap, I had a wonderful specialist who gave me his own mobile number and told me to ring him whenever I wanted, he even called me late Saturday night and Sunday morning whilst watching his kids at football practice to check on me. Now I'm sorry but I never had that in the UK.

As for my Dr's surgery they are all from the UK and are excellent Dr's.

[LaraBond]

I was not talking about them being in CBD but somewhere in the city. Those are well outside the city, in fact, in other towns.

[fairystar32]

Our bulk billing surgey has private doctors in too, so you can pick

 

great service if you ask me... The private doctor also sees kids free under 16..

[Guest The Pom Queen]

Something else to consider is if the GP has the Medicare Easy Claim system, so you pay the Dr and then immediately claim it back whilst at the Dr's saves the hassle of going to Medicare. All Dr's charge differently but doing it this way you should be between $6 and $12 out of pocket which isn't a lot.

http://www.medicareaustralia.gov.au/public/claims/easyclaim.jsp#N1012A

[fish.01]

...The practices you have listed are all but one not in Brisbane but in fact 15-25 km from CBD. This would mean for a working person taking half a day off work to see a GP - not possible for many working in the city, especially for patients who need to see a doctor often.

 

So when you said "Brisbane" you actually were just talking about the CBD?

 

For the record every single GP I listed is in a Brisbane suburb or the CBD. I know very few people who select a GP to be next to their work in the city centre rather than their home in the suburbs.

 

As for location I agree as I said before there is definitely more in the lower income outer suburbs then the inner suburbs. Though GP's that bulk bill children, pensioners and low income people are spread throughout.

 

I was not talking about them being in CBD but somewhere in the city. Those are well outside the city, in fact, in other towns.

 

Oh so you weren't just talking about going during work in the CBD then? In that case your geography of Brisbane is a little off....guess it's hard when you're new. Like almost all Australian cities the Brisbane City Council borders are not the border of the city. Brisbane encompasses many continuous council areas of endless suburbs to make up its 2 million population. Hardly any of these contain other "towns" so I'm not sure what you mean by that?

 

Even given this 10 of the clinics I listed are within the Brisbane City Council borders. You are using a dodgy map :biggrin:

 

are all but one not in Brisbane but in fact 15-25 km from CBD

 

Lara you need to throw away that map you are using...are you sure you live here :biggrin: Five of the clinics I listed are within 15km of the CBD:

 

Garden City Family Doctors (12km)

Morningside Family Medical Centre (5km)

Good Health Medical Centre at Mt. Gravatt (10km)

Millennium Medical Group Brisbane City (CBD)

Auchenflower Medical Centre (2km)

 

There are other problems with bulk billing clinics, such as long waiting times, poor medical service (judging by patients reviews). And the last but not least, these bulk-billing practices make a small percentage of all GP practices in the area. If bulk billing medical centres were so widely available, then the private ones would be out of business whereas, in fact, they are in vast majority.

 

 

All GP's are private. Some bulk bill everybody where a lot just bulk bill pensioners, children and low income earners and then a few who bulk bill nobody. On average bulk billing clinics can be worse but still lots of very happy customers as well.

 

Last time I checked govt stats showed roughly 78% of GP services are bulk billed in Brisbane. I agree that if you are a working adult and not in a low income area you are far more likely to fall into the 22% of people who pay a gap for GP services (though you children will still often be free)….I guess pensioners, children and low income earners go to the GP more often so they bump up the free quota. This is an important point you have made and people should take note.

 

I have to repeat again that bulk billing seems to be a privilege at a doctor's discretion, most likely for the old patients but not for the new patients and possibly only for some types of appointments but not all.

 

Bulk billing is definitely at the GP's/practice managers discretion. But most "we bulk bill everybody" practices advertise as such so do not refuse you when you walk in. Many others advertise on their website that they definitely bulk bill for pensioners, children and low income earners. The minority might only allow it if you ask. Of course some may stop taking patients sometimes but this does not mean they all do.

[Jurls]

I'm a little unsure which direction this thread is taking now. Do we want to focus on the Medicare system or do we want to focus on bulk billing doctors available in Brisbane?

 

I don't know anything about the second, but I did go to Medicare to put in some claims today. We have reached our medicare safety net threshold (3 months into the financial year). Our threshold is $578.60 as we are a medicare safety net family and we claim FTB part A. For the remainder of the financial year, we will now receive back 80% of our out of pocket costs. :biggrin:

[LaraBond]

In that case your geography of Brisbane is a little off....guess it's hard when you're new. Like almost all Australian cities the Brisbane City Council borders are not the border of the city. Brisbane encompasses many continuous council areas of endless suburbs to make up its 2 million population. Hardly any of these contain other "towns" so I'm not sure what you mean by that?

Well I did not know that Logan city was a part of Brisbane. In my understanding, all of these are suburbs. I live 13 km from CBD and regard it as the edge of the city.

 

Last time I checked govt stats showed roughly 78% of GP services are bulk billed in Brisbane. I agree that if you are a working adult and not in a low income area you are far more likely to fall into the 22% of people who pay a gap for GP services (though you children will still often be free)….I guess pensioners, children and low income earners go to the GP more often so they bump up the free quota. This is an important point you have made and people should take note.

 

These figures are for the number of GP services, i.e. number of visits, not number of patients, so your ratio of 78:22 would quite different considering that the majority of people who have time to go to the doctors are those who are not working and a lot of them will be pensioners and low income earners.

 

Bulk billing is definitely at the GP's/practice managers discretion. But most "we bulk bill everybody" practices advertise as such so do not refuse you when you walk in. Many others advertise on their website that they definitely bulk bill for pensioners, children and low income earners. The minority might only allow it if you ask. Of course some may stop taking patients sometimes but this does not mean they all do.

 

I am glad that we have clarified now about these mysterious bulk billing doctors and their discretion. It is important for newcomers to understand this and have the real picture. As the last poster suggested, perhaps we can now move back to the broader subject of health care provision?

[JoandJon]

I'm glad we identified some bulk-billing GPs in the Brisbane area for you - even in the inner Brisbane area.

 

[fish.01]

Well I did not know that Logan city was a part of Brisbane. In my understanding, all of these are suburbs. I live 13 km from CBD and regard it as the edge of the city.

 

 

Yes, FYI Logan, Redlands, Ipswich, Moreton and Scenic Rim (part) council areas are all part of the Brisbane metropolitan area and constitute the boundaries of the city. Don't agree with Ipswich being included myself as it actually has a separate town but not up to me sadly