Australia probably has one of the best publicly-funded healthcare programs in the world. Commonly referred to as Medicare, this public service covers a great deal of medical services and expenses for Australian citizens and to an extent, non-citizens as well. Because of its numerous benefits, it should be a must for any eligible Pinoy living in Australia to register for it.
But what sort of advantages does Medicare Australia actually provide its beneficiaries with? Can non-Aussie visitors also benefit from it?
Let’s start with discussing the advantages that come with being a citizen that’s registered with Medicare. As such, you are entitled to the following:
1. Free public healthcare.
If you seek treatment from doctors or specialists working in public hospitals, Medicare usually covers 100% of the cost. This also includes the consultation fees, laboratory or diagnostic tests, hospital accommodations, operating room fees, and other incidental expenses such as gauze bandages or oral medications.
Also, while your general physician should recommend a visit to specialist doctors for it to be covered by Medicare, optometrists are an exception to this rule. Even without a note from your general physician, eye tests at the optometrist’s are automatically covered by your Medicare membership.
2. Subsidized private healthcare.
For example, if you wish to be treated by a doctor who isn’t practicing at a public hospital but you still want to avail of Medicare benefits, then you can do so as a private patient. In this case, about ¾ of the total bill for your medical services and procedures will be covered.
Do note, however, that you will still need to pay for other expenses like hospital accommodations (if you didn’t avail of an outpatient procedure), medicines, and theatre fees (if you underwent an operation that required the use of the hospital’s operating theatre).
If you see a specialist often and/or undergo regular medical tests (e.g., blood tests, PAP smears, tissue biopsies, ultrasounds, etc.), you can also benefit from Medicare’s Safety Net feature. This kicks in once you reach a certain threshold, after which you end up receiving higher Medicare benefits to help offset the cost of these visits and/or tests.
3. Reduced costs for medicines.
Thanks to the Pharmaceutical Benefits Scheme (PBS), Medicare members can purchase their prescribed medications at much lower prices, provided that they can be found on the official list of PBS-covered medicines. All you need to do to avail of this is to present your Medicare card.
4. Rebates on private health insurance premiums.
Sometimes, an Australian citizen might pay for private health insurance as this helps to offset certain expenses that Medicare doesn’t cover, such as incidental charges that you might incur as a private patient in a public hospital. The good news is that, yes, Medicare also helps defray the costs of private health insurance if you meet the following criteria:
a.) You availed of insurance from a registered Australian health insurer;
b.) Your policy covers either hospital procedures and extra incidental expenses or both.
If you qualify, Medicare will provide you with rebates that will help reduce the cost of your private health insurance premiums. If your family avails of private health insurance, the rebate is computed based on the age of the oldest person on the insurance plan along with annual earnings.
5. Limited assistance when it comes to seeking medical treatment abroad.
Medicare benefits usually don’t apply to Australian citizens who opt for medical services abroad. However, it’s a different story if you visit a country that Australia has Reciprocal Health Care Agreements with.
So, if you are an Aussie citizen registered with Medicare and you visit any of the following countries, then you are eligible for free treatment at a public hospital as well as for subsidized medicines: United Kingdom, the Republic of Ireland, Sweden, New Zealand, Finland, Belgium, the Netherlands, Slovenia, Malta, Norway, and Italy.
Still, the Reciprocal Health Care Agreements weren’t designed to replace private travel healthcare insurance, so you should still avail of that for emergency purposes whenever you travel abroad.
Reciprocal Health Care Agreements: Medicare Benefits for Non-Aussie Visitors
As its name suggests, reciprocal health care agreements also provide for non-Aussies visiting Australia. If you are visiting Australia from any of the countries mentioned in the previous section, you are covered by Medicare for essential medical treatments (i.e., treatment for injuries or illnesses that manifest in Australia and need to be treated prior to your journey back). The period within which you are covered will depend on the country of your origin:
For visitors coming from the Netherlands, Belgium, or Slovenia, you are covered up until the expiry date on your European Health Insurance card (a prerequisite for availing of Medicare benefits) or until the end of your visit, whichever comes sooner.
Those visiting from the United Kingdom, New Zealand, the Republic of Ireland, Sweden, Norway, or Finland, you are covered for the length of your stay.
Citizens of countries like Malta and Italy are covered for a maximum of six (6) months dating from their date of arrival.
Apart from subsidized essential medical services, non-Aussie visitors who are eligible for Medicare benefits under the Reciprocal Health Care Agreements also have the following advantages:
Subsidized essential medications, as per the Pharmaceutical Benefits Scheme;
Coverage for essential treatments carried out by a doctor outside of a hospital