Bulk Billing GPs

August 15, 2017

Medicare bulk billing is when your GP directly bills Medicare for the service that you receive. To be eligible to be bulk billed

  • Need to be enrolled with Medicare
  • Have a green Medicare care

 

N.B., If you don’t currently have a Medicare card, you’ll need to complete a Medicare Enrolment Application Form that can be downloaded from the Department of Human Services Website.

 

Generally speaking most general practices in Australia will bulk bill all students and pension card holders. For other types of patients, practices in lower socio-economic areas have higher rates of bulk billing than practices in more affluent neighborhoods. If they bulk bill you for services you must

  • Sign a form
  • Press ok on the practice electronic processing terminal post appointment

 

Please note that if you are having more than one appointment with the GP this will mean that they won’t be able to bulk bill you. Generally speaking you are only entitled to one appointment per day in order to receive the Medicare Benefit. Also note that the practice is not able to charge you additional costs for booking or administration fees. Or for consumables such as bandages or treatment rooms costs.

 

Medicare Safety Net

The Medicare safety net is calculated based on a calendar year (1st January – 31st of December). It is designed to help individuals and families with high health costs to manage their treatment by doctors and hospitals. If you know you will have high health costs as a family it is worth while registering to be a Medicare Safety Net family.

There are two types of Medicare Safety Nets

  • Original Medicare
  • Extended Medicare

 

There are 3 Medicare Safety Thresholds

  • Original Threshold ($430.90)
  • Extended Medicare Safety Net General Threshold ($624.10)
  • Concessional and Family Tax Benefit A Threshold ($1248.70)

 

Different Medicare rebates apply to individuals and families for out of pocket hospital and doctor’s visits for the different types of thresholds.

 

For example, one you have reached the original threshold you will get a higher Medicare benefit for fees charged by private billing doctors. Each time you or your family goes to the doctor, Medicare Australia will tally the cost to determine when you have reached the thresholds. It is indexed yearly to keep up with inflation. To reach this threshold you will need to pay $430.90 in out of pocket fees for medical appointments. Once you have reached the threshold you will receive 80% rebate on private billing services.

 

The second safety net is for concessional card holders and families that are eligible for the family tax benefit (Part A). The third safety net is for all Medicare card holders and comes into play once out of pocket expenses have exceeded $1248.70

 

Medicare

The Medicare system has been around in Australia since 1984, partly based on the American Medicare system. To help pay for Medicare an income tax surcharge of between 1.5-2.5% per annum depending on the tax payers income. Along with doctor’’s consultation fees Medicare also pays for:

  • Tests and examinations you doctor may order for you
  • Eye tests
  • Surgical procedures

 

Healthcare Cards For Veterans

There are a number of healthcare cards that are available for people who have been members of the Australian Defense Force. This system is completely funded by the Department of Veterans Affairs

 

Gold Health Care Card. Provides full range of healthcare benefits.
White Health Care Card. Covers card holders for specific conditions
Orange Pharmaceutical Benefits Card. Provides certain medicines at reduced rates for people over 70 years of age.

 

In summary, Australia has one of the best healthcare systems in the world. Medical treatment is often free or very cheap to the end user in most scenarios.