Explained: Help with health costs

If you have a chronic illness that is expensive to treat, the government has a few ways it can help you meet your medical costs.

The first port of call is to claim a benefit from Medicare and apply for any healthcare and concession cards you may be eligible for.

Next, you should register for the Medicare Safety Net. If you are single, you are automatically registered. But if you are part of a couple or family, then you need to register in order for Medicare to pool the medical bills of everyone in the household.

This helps a family with more than one member needing healthcare to achieve the threshold sooner. Once you have hit this threshold, the rebates Medicare pays are increased so that you are not left out of pocket as much, or at all, from subsequent health costs for the remainder of the calendar year.

There are three main types of safety net, and they apply to out-of-hospital costs only:

    • for non-concessional card holders, an extended general threshold applies. Once you reach the threshold of $2184.30, for the rest of the calendar year you’ll get the Medicare benefit plus either 80 per cent of the out-of-pocket cost or
    • holders of Commonwealth concession cards, such as a Pensioner Concession Card, a Health Care Card or a Commonwealth Seniors Card, can trigger extra rebates after they reach the threshold of just $697.00
    • certain procedures under the Medicare Benefits Schedule – more than 500 of them – do not contribute to thresholds and in those cases, patients will instead receive a capped amount.

Extra Medicare benefits are available for certain treatments for a chronic illness under a health plan drawn up by your GP. This plan can be for treatment by one practitioner or by a number of different practitioners working as a team.

The plan’s medical services must be directly related to your chronic medical condition. Generally, the plan will allow you a certain number of visits to a practitioner per calendar year at a discounted price, once extra rebates are applied.

If your chronic illness requires major surgery or another procedure in a hospital that will leave you with a big bill from a specialist, there are two other means to access funds:

    • In certain circumstances, you may be able to dip into your superannuation savings if you have not yet reached retirement age but require expensive medical treatment for a terminal condition or acquired physical incapacity.
    • If you own real estate and are an age pensioner or a self-funded retiree, you can apply for extra fortnightly payments under the Pension Loan Scheme. This scheme works as a type of reverse equity mortgage on your property.

If you are still unsure about what rebates for medical care you may be entitled to, visit Centrelink’s Payment and Service Finder. By answering a series of questions, this site can identify benefits you may be eligible to apply for.


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