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Healthcare in Australia
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OverviewAustralia has a fairly complex healthcare system, comprising both public and private hospitals and medical practitioners and literally dozens of insurance schemes set up to fund them.The state-run healthcare scheme is called Medicare. This is an Australia-wide health insurance scheme, funded through income tax. Healthcare under Medicare is available to all citizens and permanent residents of Australia. In addition to Medicare, many Australians choose to take out some form of private health insurance. The levels of cover range from ancillary (eg. for dental and optical treatment) to full hospital cover. In recent years the Australian Government has made changes to the tax structure in order to encourage people to take out private health insurance. ----- MedicareUnder the Medicare scheme, Australian residents get:
Some General Practices "bulk bill" Medicare, in which case you don't pay anything. Other GPs may charge more than the Medicare schedule fee and you will have to pay the difference (known as the "Medicare Gap"). Low-income families can also reclaim some of the gap payments. Note that Medicare does NOT cover the full cost of medicines that your GP prescribes. When you collect your medicine from the pharmacy, you will have to pay a script charge. Low-income families can apply for a concession card, thus reducing the amount they pay for medicines. Links www.medicareaustralia.gov.au/public/migrants/language/index.shtml ----- Private Health InsuranceMany Australians choose to take out some form of private health insurance. There are many healthcare funds in the marketplace and each offers a variety of schemes and levels of cover.Probably the biggest choice is whether to opt for hospital cover or ancillary cover only. Ancillary CoverAncillary cover, also known as "essentials" or "extras", covers treatments that Medicare does not, such as dental, optical, podiatry, physiotherapy etc. Most funds offer various levels of cover to suit an individual's requirements.Points to consider: maximum levels of cover for individual treatments, maximum annual claim limits and qualifying periods before you can make claims on certain treatments. Hospital CoverPrivate Hospital cover allows you to choose when to have your treatment, which hospital to go into and even which doctor or consultant to have. But do not assume ALL costs will automatically be covered by every fund. For private hospital costs, Medicare covers 75% of the Schedule Fee, with your health fund covering the remaining 25%.If your hospital or consultant charges more than the schedule fee, you may have to pay "the hospital gap", unless your fund also provides gap cover. There are also a number of options on the level of hospital cover you get - eg. Whether you get a private hospital room, or whether theatre costs and pharmaceutical charges are covered. As the whole issue of health cover has become more complex, so a number of healthcare advisors have come into being. If you do not want to spend too much time comparing individual funds, you may want to contact one of these companies. ----- Qualifying PeriodsAll health funds operate qualifying periods, whereby new customers have to wait a specified period before being eligible to claim benefits. When comparing health funds, you should pay particular attention to these waiting periods, as they can vary considerably.A typical example is a six-month qualifying period before you can claim for spectacles or contact lenses. Occasionally a health fund may waive certain qualifying periods as part of a marketing initiative, or under special circumstances. ----- Switching Health FundsHistorically, anyone switching between health funds may have had to wait for the qualifying period (again) before claiming benefits from their new fund.The Australian Government has introduced legislation to ensure that customers can switch between funds and will immediately be entitled to the same level of cover in the new fund as they were entitled to in the old. ----- Incentives for Health InsuranceIn recent years, the Australian Government has introduced tax and other legislation in order to encourage the take-up of private health cover. A number of incentives exist:The Medicare Levy SurchargeMedicare is funded by income tax - currently 1.5% of everyone's taxable income goes to Medicare. The Medicare Levy Surcharge is an extra 1% on income tax, which must be paid by higher earners who do not take out private hospital cover. For this test, higher earners means single people earning $50,000 per annum or couples earning a combined $100,000. For families, the threshold increases by $1500 for every child.The ATO have a Medicare Levy Calculator which will estimate your levy and surcharge based on your taxable income and number of dependents. Lifetime Health CoverThis is a Government initiative intended to encourage Australians to take out hospital cover earlier in life rather than waiting until they are older and more likely to use the benefits. Those who take out cover before their 31st birthday will pay reduced premiums throughout their lives. For every year over the age of 30, a 2% loading is added to the premiums.30% tax rebate on premiumsA 30% tax rebate is allowable on premiums paid to health funds. The rebate is not means tested and is allowable on both hospital and ancillary cover.----- Considerations for MigrantsApart from the general issues of comparing several funds to find the one that best suits your circumstances, there are two specific issues that migrants need to consider:Lifetime Health Cover (see Incentive for Health insurance), sets higher premiums for those joining a fund over the age of 30. New migrants are entitled to a grace period of one year after arrival during which they can still qualify for the standard premium. Follow this link to the Dept of Health and Ageing for more information on this. Qualifying Periods are generally only waived when someone transfers from one Australian fund to another, so a migrant's prior record of private healthcare in their home country is of no benefit. We are not aware of any funds which make special exceptions for migrants, but as the healthcare marketplace is getting increasingly competitive, this may be something to ask about. Because of these issues, reviewing private health insurance is not something you should put off for months after you arrive in Australia. With the availability of information over the internet, it's quite easy to do all your research before you leave your home country, therefore having one less thing to organise when you arrive. Remember to apply for your Medicare card soon after you arrive in Australia. Check the HIC website for the location of your nearest Medicare office. ----- Healthcare AdvisorsHealth Insurance Consultants Australia is an independent consulting service, who can provide you with a free, impartial assessment of the health cover options available and help you find a cover that is appropriate to your needs and budget. Health Insurance Advisors Australia is an independent business, established to provide friendly, professional advice concerning all aspects of Australian Private Health Insurance. ----- Healthcare Linkswww.medicareaustralia.gov.au/public/migrants/language/index.shtml The Health Insurance Commission (HIC) has lots of info on Medicare and private health insurance in general. They also have a Welcome Kit for new migrants available in many languages. The Department of Health and Ageing. www.healthinsite.gov.au - a government initiative, funded by the Department of Health and Ageing, aims to provide easy access to quality information about health. The Australian Medical Association (AMA) has, among other things, a checklist for comparing health insurance funds. ----- DisclaimerInformation on this website is intended to give the reader an overview of many aspects of life in Australia, such as healthcare, real estate, tax, superannuation etc. While we at Aussiemove.com have performed a large amount of research on each subject area, we do not claim to be experts in those fields and we recommend that migrants discuss their requirements with companies specialising in those fields before making purchases, investments or other decisions concerning their move. The content of this website is general in nature - no specific advice is intended. We provide links to other companies as a service to our readers. We have taken reasonable care to ensure that each linked website does not contain offensive or inappropriate material. However, we are not responsible for the accuracy of any of the material in any linked website, or the advice that may be contained therein. ----- |