They say Australia is the “lucky country” and in many sense of the word we are. We have a beautiful country that has many natural resources, we are multi-cultural, most Australians have a great nature, our government although not well liked does try to take care of us and we have Medicare. Thank goodness for Medicare!
I never really appreciated Medicare until recently when I was diagnosed with this rare bleeding disorder. Before this I hardly ever went to the doctors or needed any medical treatment. Even when I was sick I would stay clear from the doctor’s office and would basically rest and recover myself naturally. However things have since changed and because I have been diagnosed with “chronic ITP” means that I now have many visits to the hospital and treatment for my condition may be required if my platelet levels get too low. However some of those treatment options I just wouldn’t be able to afford on my salary. For example I asked my doctor how much it would cost to complete rituximab treatment, she had advised if I was to pay not Medicare it would cost me approx. $5000. Now I don’t know about you but I don’t have a spare $5K lying around. Plus knowing that ITP treatment is just a Band-Aid solution imagine the cost of treatment over one’s lifespan. Crazy $$$$$
Therefor today I thought it would be great to shed some light on Medicare and what it does;
Basically Medicare is Australia’s health care system that covers many health care costs for those eligible in Australia. Costs that it may cover are Medical, Hospital and Pharmaceutical.
Medical
Most medical centers are bulk billed which means you can go visit your GP and not have to pay anything. Some however you will have to pay the full fee and claim 100% back from Medicare meaning you get your money back once you put through a claim. Although if it’s a specialist you can only claim back 85% of the fee.
What Medicare covers;
Tests completed by doctors (eg. X-rays, pathology, eye tests)
Most therapeutic and surgical procedures done by doctors
Some surgical procedures completed by dentists
Specific items for (EPC) enhanced primary care, Cleft Lip and Plate Scheme and Chronic Disease Management plan.
Medicare does not cover;
Superannuation and exemptions for life insurance
Occupational therapy, speech therapy, most physiotherapy, eye therapy, chiropractic services, psychology services, most acupuncture services
Glasses, contact lenses, hearing aids and other appliances
Home nursing
Hospital
Even if you have private insurance you still have the option to be treated as a public patient. Public patients are covered by Medicare and what that means is when you go into a public hospital you get a doctor appointed by that hospital at no charge. You may not have a choice of when you are admitted or will not be able to choose who your doctor will be.
What Medicare does not cover?
Ambulance services
Hospital visits that are not clinically necessicary (eg. Cosmetical)
Overseas hospital visits
Private hospital costs (eg. Accommodation and theatre fees).
Pharmaceutical
PBS is Medicare Pharmaceutical Benefits Scheme and what that means is part of the costs of your prescription medicine is covered by Medicare when you present your Medicare card. Therefor the amount you pay may vary depending on the type of medicine or if you are a pensioner etc. However you will not have to pay the full fee.
These are just the basics of medicare however if you want to learn more click here and to learn more about my recent medical expenses (those that have been covered by Medicare and those that have not). Be sure to check out my blog – The cost of sickness.