Medicare

Medicare is Australia’s health care system that ensures all Australians have access to low-cost medical, optometrical and hospital care. YOURLifeChoices Medicare page provides you with the latest news and updates including covered health services and programs.

Medicare benefits simplified

As of 1 May 2010, 15 measured will be implemented that should help simplify the Medicare Benefits Schedule, remove red tape and encourage preventative care.

Of the changes to be implemented, the one which will have the most impact is the benefit of longer consultations, with doctors receiving a higher fee.  The process of claiming has also been simplified for doctors, giving them more time to treat patients.

For more details of on the Medicare reforms, visit health.gov.au.

What is Bulk Billing?

Bulk billing is when your doctor bills Medicare directly, accepting the Medicare benefits as full payment for a service. This means if your doctor bulk bills, you cannot be charged a booking fee, administration fee, a charge for bandages, record keeping or a charge by your doctor’s company.

Many doctors bulk bill some of their patients such as pensioners or health care cardholders. If your doctor bulk bills you will be asked to sign a completed form after the service and will be given a copy.

There are circumstances where more than one service can be provided at the same visit and your doctor is not required to bulk bill each service.

What happens if my doctor dosn’t Bulk Bill?

If your doctor charges you a fee, you can:

* pay the account and then claim the benefit from Medicare
* claim your unpaid account from Medicare and receive a cheque made out in the doctor’s name which you give to your doctor along with any outstanding balance

Medicare usually pays:

* the full Schedule fee for GP services
* 85 per cent of the Schedule fee for other out-of-hospital services
* 75 per cent of the Schedule fee for in-hospital services

The Schedule fee is a fee for service set by the Australian Government and not what your doctor charges you.

The Federal Government 30% Rebate

Families and individuals that pay private health insurance premiums are eligible for the Federal Government 30% Rebate on private health insurance. Anyone who pays hospital and/or ancillary private health fund premiums to a registered health fund can get a 30% reduction on the cost of their private health insurance. If you pay the cost of the premiums and you are the policy holder, then you are eligible for the Federal Government 30% Rebate; even if you are not personally covered by the policy, for example if the policy is for your children. However, the policy must cover people that are eligible for Medicare.

On 1 April 2005 new Rebate amounts were introduced. These applied to persons aged 65 and over. This meant that people aged from 65 to 69 are eligible to receive a 35% Rebate and people aged 70 and over are eligible to receive a 40% Rebate.

The Federal Government 30% Rebate is not means tested. It does not matter how much you earn or the level of your family income. If you have hospital and/or ancillary private health insurance with a registered health fund, you can claim the Federal Government 30% Rebate.

Regardless of whether you pay your premiums monthly, yearly in instalments or in advance, there are three ways to claim the Federal Government 30% Rebate.

1. From your fund

Ask your fund to provide the Rebate as a premium reduction, reducing your upfront costs. To claim the Federal Government 30% Rebate as a premium reduction you will need to register with your health fund, who will send you a form or advise you what you need to do.

2. From a Medicare office

Where you have paid the full, upfront cost, you can receive a cash payment from the Government through your local Medicare office or by lodging the claim form by post. To claim the Federal Government 30% Rebate as a cash payment you need to fill in a claim form below (or available at your Medicare office) and attach a special receipt from your registered health fund. If claiming at a Medicare office, a cash limit applies. If your benefit is over the cash limit, you will get a cheque payment instead.

3. From the Australian Taxation Office

The Federal Government 30% Rebate may be claimed back on your annual income tax return if you have paid the full, upfront cost. Your health fund will give you a statement at the end of the financial year to help you complete your tax return.