For Australian citizens and permanent residents, public health care is provided by Medicare – a universal health scheme administered by the Federal and State Governments of Australia. This service provides access to a range of health services at little or no cost to those who avail the service.
How to Apply For Medicare?
To apply, you need to fill up the Enrollment Form and submit it in person (please carry your overseas passport and visa grant letter with you) at your nearby Medicare center. The form is available at all Medicare centers. Click here to locate the nearest center from you. You may also download and print the form.
This form has a section to enter your bank account details. So if you have a bank account in Australia, make sure you have your account details when you fill the form.
After you submit the Form, you will receive a receipt that has your medicare number on it. Your medicare card will arrive by post within a few days after applying. Until you receive your Medicare card, you can show the receipt at hospitals and avail medicare benefits.
I am unwell and I need to visit a doctor. How can I avail Medicare benefit?
When you visit a doctor, Medicare reimburses the listed MBS (Medicare Benefits Schedule) fee. This fee is 100% for General Physicians (or GP) and 85% for specialists.
If your doctor does bulk billing (where they bill Medicare directly), you do not need to pay anything. All you need to do is, show your Medicare card at the reception, and see the doctor. If you are unsure, it is always good to ask before availing any services whether the doctor (or hospital) is “bulk-billed”.
What services are covered by Medicare?
What are the benefits?
- Consultation fees for doctors, including specialists.
- Tests and examinations by doctors needed to treat illnesses, such as x-rays and pathology tests.
- Eye tests performed by optometrists.
- Most surgical and other therapeutic procedures performed by doctors.
- Some surgical procedures performed by approved dentists.
- Specific items under the Cleft Lip and Palate Scheme.
- Specific items under the Enhanced Primary Care (EPC) program.
- Specified items for allied health services as part of the Chronic Disease Management Plan.
To learn more about specific subsidised health services, visit MBS Online.
What services does Medicare NOT cover?
- Examinations for life insurance, superannuation or memberships for which someone else is responsible (for example, a compensation insurer, employer or government authority).
- Ambulance services.
- Most dental examinations and treatment.
- Most physiotherapy, occupational therapy, speech therapy, eye therapy, chiropractic services, podiatry or psychology services.
- Acupuncture (unless part of a doctor’s consultation).
- Glasses and contact lenses.
- Hearing aids and other appliances.
- Home nursing.
- Private patient hospital costs (for example, theatre fees or accommodation).
- Medical and hospital costs incurred overseas.
- Medical services which are not clinically necessary, or surgery solely for cosmetic reasons.
Does Medicare cover Hospitalisation Expenses?
Under Medicare you can be treated as a public patient in a public hospital. A doctor appointed by the hospital will treat you at no extra charge. Even if you have private insurance, you can choose to be treated as a public patient.
As a public patient, you cannot choose your own doctor. You also may not have a choice about when you are treated. Public hospital waiting lists operate on a priority basis. This may sometimes lead to a situation where after waiting for your operation, your procedure might be postponed because of the more urgent needs of other patients.
Are Medicines also covered by Medicare?
The Pharmaceutical Benefits Scheme (PBS) subsidises a wide range of pharmaceutical medicines . Consequently, for most prescription medicines bought at pharmacies, you’ll pay only a portion of the cost, and PBS will pay the remainder amount.
You need a valid Medicare card to avail this benefit. The amount subsidised varies depending on the type of medication.
I am Covered By Medicare. So Do I Still Need Private Insurance?
Medicare does not cover many medical services and treatments. Although they might not seem important to you at present, you or your family may need them desperately in the future. These procedures could even be expensive later on.
Private health insurance may help cover some of these costs. Private health insurance has several advantages over the public system. The main advantage is that you won’t have to go through public hospital waiting lists and can avail medical treatment at a private hospital.
What Does Private Health Insurance Cover?
If you have private hospital cover, you can choose your own doctor. Moreover, you can also choose whether to be treated at a public or private hospital. Your choice of hospital will decide which hospital costs are covered by your policy.
Medicare will cover 75% of the MBS fee, while your private health insurer covers the remaining 25% (provided you have the right policy). If the treatment costs more than the MBS fee, you have to pay the remainder. This is called “gap payment”.
There are other costs that your private health insurance policy might not pay for. You could be charged for some elective surgeries and optional hospital treatments; depending on the extent of your cover.
General treatment cover
General treatment policies cover some health services which Medicare does not cover. You may purchase this cover on its own, or together with hospital insurance.
Depending on the type of policy you choose, some of the services include:
- Ambulance Service
- Dental checkups and treatment
- Physiotherapy
- Podiatry
- Prostheses
- Occupational, eye and speech therapies
- Home nursing
- Psychological consultations
If you have any more queries, then do not hesitate to contact Chalo Australia today.
