By Doctor Bonnie Fraser

What is Medicare?

In Australia, the cost of medical care is subsidized by the government by a system called Medicare. This medical system which is meant to provide affordable medical services by doctors and in public hospitals, significantly reduces the cost of medical appointments and procedures to the patient.

Everybody who wants to be covered by Medicare must register in a Medicare Office. You are eligible to enroll for Medicare if:

· You are an Australian Citizen (an Aussie!)

· You hold a Permanent Residency Visa (also known as Aussie to Be!)

· You hold New Zealand Citizenship

· You are already and legitimately living in Australia and you have applied for Permanent Residency visa. To make sure that you are eligible you must contact Medicare.

If you are eligible, you will need to get a Medicare card.

To find out where is your nearest Medicare office, please visit THIS PAGE.

What is covered by the public health system, Medicare?

The services that you might receive from Medicare depend on your criteria and the amount of money that you pay to a doctor. In a nutshell, here are the items that Medicare covers:

· You will have a better access to Mental Health System, in terms of recognizing and addressing mental disorders.

· Consultation fees for doctors and specialists.

· Examinations, tests, X-rays and pathology tests that is needed to treat your health problem.

· Eye tests which are done by an optometrist.

· Some dental surgeries.

· If you are admitted in a public hospital and you are under the coverage of Medicare, you will not be charged.

· If you are admitted as a private patient in a public or private hospital, Medicare will cover 75% of your treatment expenses.

To see the complete list of the items that are, and ARE NOT covered by Medicare, please visit THIS LINK.

What is a general practitioner?

A general practitioner (GP) is a doctor who has experience and is trained in a wide range of medical conditions. General practitioners are called family physicians or local medical officers in some countries, and are usually the first place many people go to get medical care.

In Australia, you can choose which general practitioner you would like to go to. A GP is able to organize for you to have tests such as blood tests and x-rays, and can give you a prescription to get medicine from the pharmacy if needed.

If a medical problem requires more detailed knowledge, a GP can refer you to a specialist in that area of.

What is “the gap” and “bulk-billing”?

The Government has a set amount that it pays under the Medicare system. Just like any other business, medical practices can set their own fees, and most will charge the amount recommended by the Australian Medical Association. The difference between what the government pays and what the medical practice charges is known as “the gap”, and is paid by the patient when they have an appointment with a general practitioner. If you have private health insurance, this gap or a portion of it may be paid by the insurance company.

Some general practices are known as “bulk-billing” practices. This means that the practice can send the request for payment for many patients at once to the government, which means a lot less paperwork for the practice. However, because the practice is doing less administration, the government will only pay 75% of its set amount (above), and so many practices choose not to bulk bill.

Some practices are “mixed billing” practices where they will charge most patients the gap, but if the patient is (for example) a child, student, pensioner or on a health care card they will bulk-bill so that there is no charge to the patient.

It varies from practice to practice whether they are completely bulk billing, completely private billing or if they are mixed billing (and if so, who they bulk bill). The easiest way to find this out is to ask when you ring up to make an appointment.

What is private health insurance?

You can choose to be covered by a private health insurance. A private insurance will cover costs for you being treated as a private patient in a private or public hospital. It also will include some services that Medicare does not cover, such as dental care, optical care and ambulance transport.

Private health insurance companies offer a wide range of funds and coverage. So, before choosing a private insurance plan, it’s very important that you compare the funds.

How to visit a doctor?

In order to visit a doctor, you must make an appointment at least one or two days in advance. If you are an urgent patient but not an emergency case, you can call a doctor and the doctor will most probably see you in a couple of hours.

If for any reasons you need to be visited at home, doctors may see you in your place, but they might charge you extra money.

How to visit a specialist?

If you are covered by Medicare, you must be referred to a specialist by a GP. For example if you need to see an eye doctor, you must visit your GP first. If your GP refuses to refer you to a Specialist, you can see another GP. If no GP is willing to refer you to a specialist, you will be able to visit a specialist as a private patient.

If you have a private health insurance, your insurance company may pay the expenses. However, some private insurance companies expect you to be referred to the specialist by a GP. You must read your contract with the private health insurance company carefully.