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Understanding the health system and Medicare


budeman

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So we are heading over to Perth on the 17th of next month and one of the many things on the to do list is look into health insurance and medicare. EDIT - will are on a 189 visa if that makes any difference.

 

I am trying to get my head around the Australian system so I just wanted to ask a few questions as its a wee bit confusing...

 

1. From my understanding Medicare is free - but not for some stuff.. A&E visits (not the trip to A&E in the ambulance), other hospital visits and operations are free - what are the things that you do pay for hospital wise?

 

2. A lot of people at least when they initially come over get 'Extras' cover which can include ambulance, dental, chiro, optical cover (not sure of anything else) - I imagine it would be wise to get prior to landing but not sure this is possible without a bank account as its a weekly payment -is this correct? And if you get extras cover you don't get all the extras free, just a rebate on certain items?

 

3. The Medicare levey is 2% of wages proving you are on a certain income - amount deducted at source and covers hospital visits - does it also cover GP appts?

 

4. What is a 'gap payment'??? :confused:

 

As a family with two young (4 & 1) kids I want to come over and not have any huge bills should something bad happen - if Medicare is free for most big things I imagine all I want is extras cover for the mean time until I get work/house etc sorted - Then down the line I can think about what else I may need/want such as private medical insurance.

 

Well im hoping I have got the basics but if anyone can shed any more light then it would be grealty appreciated!

 

Thanks,

 

Mark.

Edited by budeman
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1. Medicare will cover most things, but it is too complex to give a list of what it does and doesn't. The issue can be that wait times for "elective treatment" can be incredible. Some people have private health and some don't. I no longer do, as I no longer earn enough to be penalised for not having it.

 

2. Extras wont usually cover all costs. With one big exception. It covers all ambulance costs. We have extras and it covers dental check ups entirely. However, some plans cover only 90% of dental check up. Then you have general dental and major dental. General is things like a filling. Most plans will cover about 70% of general. Major dental like crowns most plans cover a fixed amount and it can be a fixed amount for life - so you can claim $2k once and then no more. A crown is about $2k

 

3. GP visits are a mix of Medicare and private. So, your medicare covers GP visits, but if the GP doesn't bulk bill it means you will also have a bill to pay. On average about $30 a visit.

 

4. A gap payment is the difference between what Medicare pays and what something costs - similar to the GP situation above. It also refers to the difference between what private insurance pays and the bill. With private hospital cover you need to be very careful of the gap. It can be thousands. Surgeons will tell you the cost before an operation and you can chose a surgeon to minimise the gap. But still need to be careful

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Dont forget once you arrive the clock starts ticking on getting your private hospital cover, think you have maybe 3 or 6 months from the date you arrive, after which you get stung for "lifetime loading" which is something like an extra 10% of the advertised premium for every year you are over 30 or 35 cant remember which, either way it is a killer when it comes to the premium, I missed the boat when I arrived, couldnt afford the premium so had to let it go, now the premium is huge for me as I am in my late 40's, thats like 10 years worth of lifetime loading, loaded onto the advertised premium

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Guest Guest6235

Not sure if it's a year from arriving if on a PR visa but not entirely sure.

Stormy - if you ever decided to go back on full private would you then get hit with the extra premium as you came off it so it's like you're starting fresh again? We've thought of doing the extras only but then at a later date we decided to go full cover is that when we'd get hit with the extra premium. Also just having the extras cover doesn't stop you getting hit with the medicare levy does it. We're still not sure how that works. For example if you're on 100k do you get a % taken off you at the tax year end for not having private.

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Many thanks for the replies - jeez it does seem like a minefield.....

 

Think for starters I will just have to look at all the extras packages out there and weigh up the costs/benefits.

 

Regarding Private Medical do many work packages include it? From looking on the Seek website I dont remember seeing any including it.

 

I've tried to have a look at the restriction period for PR visa holders in regards to Private Medical but can't see anything - could you recommend anywhere to look?

 

Thanks again for the responses!

 

Mark.

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Not sure if it's a year from arriving if on a PR visa but not entirely sure.

Stormy - if you ever decided to go back on full private would you then get hit with the extra premium as you came off it so it's like you're starting fresh again? We've thought of doing the extras only but then at a later date we decided to go full cover is that when we'd get hit with the extra premium. Also just having the extras cover doesn't stop you getting hit with the medicare levy does it. We're still not sure how that works. For example if you're on 100k do you get a % taken off you at the tax year end for not having private.

 

At 100k, you are probably not in the high enough bracket to be hit with the levy - I think it is about 170k. But, pop into any of the insurance companies and they will be able to confirm the exact figure, but I know it is a lot higher than 100k.

 

If you have had hospital cover since arriving and then drop it, you get a grace period of nearly 3 years without the loading starting.

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Many thanks for the replies - jeez it does seem like a minefield.....

 

Think for starters I will just have to look at all the extras packages out there and weigh up the costs/benefits.

 

Regarding Private Medical do many work packages include it? From looking on the Seek website I dont remember seeing any including it.

 

I've tried to have a look at the restriction period for PR visa holders in regards to Private Medical but can't see anything - could you recommend anywhere to look?

 

Thanks again for the responses!

 

Mark.

 

Some work packaged include it - mainly professional roles. I have had it with some employers (big mining companies).

Give any of the insurance companies a ring - Medibank are pretty helpful - and they should be able to tell you the timescales for getting it as a PR holder.

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Guest Guest6235
At 100k, you are probably not in the high enough bracket to be hit with the levy - I think it is about 170k. But, pop into any of the insurance companies and they will be able to confirm the exact figure, but I know it is a lot higher than 100k.

 

If you have had hospital cover since arriving and then drop it, you get a grace period of nearly 3 years without the loading starting.

I was on about an individual, do you get hit with it if as a couple if you earn more than the figure you mention.

Are you still on that no term contract.

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Some work packaged include it - mainly professional roles. I have had it with some employers (big mining companies).

Give any of the insurance companies a ring - Medibank are pretty helpful - and they should be able to tell you the timescales for getting it as a PR holder.

 

Excellent thanks will do

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Not sure if it is as a couple or individual as my wife has not worked in oz.

 

yeah, still on the zero contract. Thanks for the heads up on the job. But might have something! Have an interview tomorrow as a trainee teacher in a new scheme that recruits managers in science industry to become teachers. So fingers crossed.

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