Health Care in Australia

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Out-of-pocket Payment Examples

Below are some real examples of medical procedures, benefits and out-of-pocket payments reported to us in 2011/2012:

Doctor (GP)

Standard consultation
Cost: $67.00
Medicare paid: $34.90
Out-of-pocket payment: $32.10

Doctor (Specialist)

Consultation
Cost: $155.00
Medicare paid: $69.00
Out-of-pocket payment: $86.00

Dentist

6-monthly examination and clean
Cost: $135.00
Health fund paid: $135.00
Out-of-pocket payment: nil

Quick examination and one restoration (filling)
Cost: $175.00
Health fund paid: $97.80
Out-of-pocket payment: $81.20

Chiropractor

Initial consultation (about 30 minutes)
Cost: $75.00
Health fund paid: $35.00
Out-of-pocket payment: $40.00

Standard consultation/manipulation (about 10 minutes)
Cost: $50.00
Health fund paid: $19.20
Out-of-pocket payment: $30.80

Physio

Initial consultation (about 30 minutes)
Cost: $63.00
Health fund paid: $32.90
Out-of-pocket payment: $30.10

Standard consultation (about 15 minutes)
Cost: $56.00
Health fund paid: $35.60
Out-of-pocket payment: $20.40

Specialist Physio

Initial consultation (about 60 minutes)
Cost: $200.00
Health fund paid: $32.90
Out-of-pocket payment: $167.10

Standard consultation (about 30 minutes)
Cost: $100.00
Health fund paid: $21.70
Out-of-pocket payment: $78.30