When we’re struggling with health or medical issues, the last thing we need is financial stress as well.
Medicare is Australia’s universal health insurance scheme designed to ease the burden. Medicare provides essential healthcare services to all Australian residents, regardless of their age, income, or employment status.
What is covered by Medicare?
Medicare covers a range of medical services, including visits to general practitioners (GPs) and specialists, treatment in public hospitals, eye tests performed by optometrists, X-rays, blood tests, MRIs, and CT scans. However, there can still be some out-of-pocket expenses.
To see if your test or service is covered by Medicare, check the Medicare Benefits Schedule (MBS). The MBS is a list of medical services and procedures that Medicare covers.
What Medicare Doesn’t Cover
Medicare doesn’t cover everything. Some things you might need to pay for out-of-pocket include: doctor/specialist excess fees that Medicare, private hospital accommodation, dental and optical services, and some other things.
Eligibility for Medicare
To be eligible for Medicare, you must be an Australian or New Zealand citizen or be a permanent resident, or a temporary resident covered by a Ministerial Order. You also have to enrol in Medicare to receive the benefits.
If you are visiting from a country where Australia has a reciprocal health care agreement, such as the United Kingdom or several others, you may be also entitled to Medicare benefits.
Bulk billing
Many doctors and specialists offer bulk billing, which means you don’t have to pay anything out-of-pocket for your medical services. To find a bulk-billing doctor, you can ask your GP or check online directories. Most doctors do not offer bulk billing, or only offer it for certain patients, such as children or people receiving a pension.
Medicare Safety Net
The Medicare Safety Net helps with out-of-pocket costs if you’ve reached a certain threshold. You can check your Medicare Safety Net balance online or by calling Medicare to learn what your threshold is and how close you are to reaching it.
When you reach the safety net threshold, the Australian Government will pay for some or all additional costs, alleviating your hardship.
Couple and Families
If you have a partner or are in a family, it’s also recommended that you register as a couple or family for your Medicare Safety Net.
Medicare costs are worked out each calendar year, that is from 1 January to 31 December. Medicare will tally your combined medical costs and enable you to reach the threshold sooner.
To find out, Login to Services Australia. and look under Medicare for the the Safety Net information.
Medications and the Pharmaceutical Benefits Scheme (PBS)
Many prescription medications are subsidised through the Pharmaceutical Benefits Scheme (PBS). The PBS helps keep the cost of prescription medications down. Many medications are listed on the PBS, which means you pay a significantly reduced price if you need them.
Private health insurance can provide additional coverage for things like private hospital accommodation, dental, and optical care. However, it can be expensive, so weigh up the benefits against the cost. Shop around for the right cover if you choose to get it.
Ambulances are NOT covered by Medicare
It’s a common misunderstanding that ambulances are covered by Medicare. This can lead to nasty bill shock when you least need it.
The cost of an ambulance is different in each state and territory. Even if you don’t have private health insurance, it can be worthwhile to invest in ambulance cover. Shop around for the best deal.
Generic medications
The difference between a brand-name drug and a generic version is the patent protection, marketing, and higher cost.
Both brand-name and generic drugs undergo rigorous testing and approval processes to ensure they are safe and effective.
Both are considered therapeutically equivalent, meaning they have the same medical effects.
Government assistance: If you’re struggling to afford medical costs, you might be eligible for government assistance programs. Services Australia has a Payment Finder tool that allows you to see what you could be eligible for, such as the Disability Support Pension, Veteran’s Card, or other payments.
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