Medicare -Health care system in Australia

Modern Medicare IT system welcomed

It is an established fact that Australians have one of the longest life expectancies in the world. Thanks to the Australia’s health system which is unarguably one of the best in the world that ensures and  provide quality, safe and affordable healthcare  to all Australians through Medicare Benefit Schedule (MBS).

Medicare, being the foundation of health care system in Australia, along with the public hospital system provides free or low-cost access for all Australians to most of these health care services.

Usually Medicare covers entire cost of public hospital services including health services provided by GPs, medical specialists, physiotherapists, community nurses and basic dental services. The MBS has a basic safety net i.e. Medicare Safety Net that helps by making sure you pay less for services once you reach a certain amount i.e. threshold of out of pocket costs.

Especially when you are required to visit a doctor or have medical tests regularly, you are likely to have high medical costs. Under such circumstances the Medicare Safety Net can provide additional financial relief and reduce your out-of-pocket costs.

The types of Medicare Safety Nets

Basically, Medicare pays some part of the scheduled fee and the rest of the fee i.e. difference is to be paid by you.

This assumes importance when your doctor’s or specialist’s fee costs  more fee than the total MBS fee as the difference amount in fee, known as the ‘gap’, you will be required to pay. The ‘gaps’ are based on the different types of Medicare Safety Nets and thresholds.

 Based on this ‘gap’ and ‘threshold’, the different types of Safety Nets designed are:

  • Original Medicare Safety Net (OMSN)

In OMSN, your threshold amount is calculated throughout the year on the bass of ‘gap’ between the MBS schedule fee and benefit paid by Medicare and not by the total of the fees you pay.

  • Extended Medicare Safety Net (EMSN)

Under this type extra benefits for families and singles with high out of pocket medical costs is provided that means your payment includes the MBS fee to doctor and your out-of-pocket cost.

Benefits of Private health insurance

Although Medicare pays for the most of the healthcare costs in Australia yet when you take out an additional private health insurance, you may be in better position in having control over cost for your medical treatments that are not covered by Medicare.

When you take a private health insurance, you get the choice to be treated in a private or public hospital, a private room and option for choosing your own doctor.

The benefits offer by private health insurance varies as per the policy accepted by you. However, some of the common benefits of private health insurance include:

  • Hospital of your choice
  • Choice of doctor or specialist
  • Shorter waiting periods for elective surgery
  • Physiotherapy
  • Dental cover
  • Ambulance cover.

Among most prominent Private Health Insurance companies, iSelect is the most reliable and trusted name largely due to our customer caring, professional and transparent policies.

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