- Claiming
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Cover
- Coronavirus FAQ's
- How we're supporting you during coronavirus
- health.com.au with Kieser
- The value of private health insurance in a pandemic
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- Waiting periods explained
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Extras
- Ambulance explained
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- Dental Explained
- Extras limits explained
- Health Appliances
- Health Screening
- HICAPS & HealthPoint explained
- How does extras cover work?
- Natural Therapies
- Non PBS prescriptions
- Optical explained
- Set Benefits FAQ
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Hospital
- Emergency Department Fees
- Going to Hospital
- Hospital Added Costs
- Insulin Pumps
- IVF & assisted reproductive services
- LHC exemptions
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- Public vs. Private
- Restrictions & Exclusions
- Understanding out of pockets
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- What is LHC?
- What is the MBS?
- Where does Medicare fit in?
- Transcranial Magnetic Stimulation (TMS) Pilot
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- Entry Hospital
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Premium Review
- Annual premium review
- Can I lock in my premium?
- I can’t use my cover like I used to...
- What if my cover is currently suspended?
- Where do my premiums go?
- Why does my premium change every year?
- Why does my premium change, if I rarely make claims?
- Why is my price change different to the national average percentage?
- 3 ways to save money on your health insurance.
- OVHC
- Tax
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How to understand the Australian Healthcare system
Medicare
Australian citizens and permanent residents are part of a public health care system called Medicare, which is paid for through tax. This means that, in the event a permanent resident or citizen of Australia has treatment or surgery in a public hospital as a public patient, it doesn't cost them a cent. In addition to this, Medicare also subsidises some non-hospital treatments and health expenses – such as GP visits, specialist consultations and eye tests.
Medicare (the public health system) is only available for Australian citizens, permanent residents and citizens of countries who have a reciprocal Healthcare Agreement with Australia (more on this below). For visitors to Australia who do not have access to Medicare, taking out a health.com.au Overseas Visitors Health Cover will ensure you have access to some of the benefits permanent residents and citizens receive from Medicare, and also coverage for admissions into a private hospital, if needed.
Visits to the GP
Visits to the local doctor (GP) are subsidised by Medicare for permanent residents, citizens and visitors to Australia with a reciprocal healthcare agreement. Doctors can choose to "bulk bill" patients for the service or issue the patient with an account.
Bulk billing is a method used by doctors to directly bill Medicare for the full cost of their service. In this instance, the patient isn't charged any out of pocket cost. If the doctor chooses to use a patient account (directly bills the patient), the doctor charges the patient the cost of the consultation and the patient can claim part of the fee back from Medicare.
If your policy includes benefits for local doctor (GP) consultations, you will need to submit a claim with your invoice attached for benefits to be paid.
Non-hospital treatment and other health expenses
Whilst having hospital cover will help covering many of the fees incurred whilst spending time as a patient in a public/private hospital, extras cover helps subsidise the cost of healthcare-related expenses charged by non-hospital healthcare professionals such as dentists, podiatrists, chiropractors, optometrists, physiotherapists and more.
Medicare usually does not cover non-hospital treatments and services such as these, and Australian citizens who require these services either pay for them in full or purchase extras cover from a private health insurer to help pay for the cost. Working or student visa visitors to Australia now have the same choice.