Medicare Australia

The division of the Australian government that handles the universal healthcare system in the country is called Medicare Australia. Some people also refer to the Medicare plan itself as Medicare Australia. The Australian Medicare program helps Australian citizens afford medications, as well as many medical procedures.

How Medicare is Handled

Although Medicare Australia is the larger organization that runs Medicare in the country, Medicare services are actually handled by the Department of Human Services (DHS). It is the responsibility of the DHS to give out Medicare benefits and enforce medicare policies, which are created by the Department of Health and Ageing (DoHA).

What do I qualify for under Medicare Australia Benefits

The Australian Medicare system generally pays for 755 of the Medicare Schedule fee, which is a payment limit set for various medical services. The Medicare program can also provide Australian residents with free or deeply discounted optometry and specialty treatment, as well as general medical care.

Another big part of Medicare Australia is the savings that it offers on medications. Many Australian residents would not be able to afford their medications without it.

Reciprocal Health Care

Some healthcare services outside the country of Australia may also be covered for those who are part of Medicare Australia. This is called reciprocal health care. Australia currently has such agreements with New Zealand, Italy, and Belgium, as well as several other countries.

The Medicare Safety Net

The Medicare Safety Net is a program that provides extra benefits for those who are already on Medicare, if necessary. It is mainly designed to cover some or all of the costs for those people that have to undergo regular medical testing. Once the regular Medicare benefits threshold has been met, the Medicare Safety Net benefits will begin.

Individual people do not have to register for the Medicare Safety Net. Medical spending information will automatically be collected by the Department of Human Services and, once you spend a certain amount, your extra benefits will automatically start. However, if you want your entire family to be protected by the Medicare Safety Net, you do need to fill out a family registration form. You can find that form at http://www.humanservices.gov.au/customer/forms/sn1, get a copy at any service centre, or call 132 011 for more information.

How do I go about claiming benefits

After you are enrolled in Medicare Australia, it is possible that your doctor will do all of the claiming work for you. He or she may do what is called bulk billing, which means that the full service bill will be sent to the Medicare division of the DHS to be paid. If that is the case, you shouldn’t be charged any extra fees or have to take any further actions. However, you should receive documentation in the mail that your medical visit or procedure was paid for under Medicare. If you notice any discrepancies, you should call and report them.

It is also possible that your doctor may not do bulk billing. He or she may actually bill you directly for any doctor’s visits or medical procedures. If that happens, you will need to pay the costs up front, but you can file a Medicare Australia claim to be reimbursed. Your doctor’s office may file the claim paperwork for you automatically. If not, you can download a claim form at http://www.humanservices.gov.au/customer/forms/pc1 and mail it in.

Medicare Online

You may also be able to claim directly online. For more information about making an online Medicare claim, visit http://www.humanservices.gov.au/customer/services/medicare/medicare-online-services. From that page you can also access services that will allow you to:

  • View Your Medicare Claims History
  • Update Your Account Details
  • View Medicare History for Family Members Whose Names Are on the Same Account

Using Your Medicare Australia Card

If you qualify for Medicare Australia, you will receive a Medicare card in the mail. You should keep that card in a safe place. You will need to take it with you to any medical appointments that you may have. You will also need to present it whenever you are picking up medications. If you don’t have it with you, you may not be able to receive discounted medications.

You should also be aware that Medicare cards do expire. However, a new card should automatically be sent to you shortly before the old card expires. When that happens, you should dispose of your old card. If you somehow lose your card, or if a new one doesn’t arrive in time, you should contact the Medicare division of the DHS and request a new card.

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