Saturday, October 23, 2010

How much rebate will the patient in Australia receive from Medicare for the visit to the specialist?

i dont understand about 75% and 85% in medicare. what it is?How much rebate will the patient in Australia receive from Medicare for the visit to the specialist?
This sort of information is so hard to find out. If you phone them and ask them specifically for your case they will tell you, but to find general answers you have to wade through so much bureaucratic rubbish before you find the answers. Plus it all depends on the type of specialist etc.
Anyway, I am pretty sure that you can get a rebate of 75% of the specialist cost up to the amount that Medicare specifies that type of specialist should charge. If the specialist charges over and above this limit (and most seem to), then you have to pay the gap (shortfall).
So 25% plus the gap amount.
If you have health insurance which covers specialists, they pay it, instead of Medicare.
It gets a whole lot more involved that this, for example if you are part of a family you need to register for the safety net. This works on the basis of you only have to pay so much per year per family for medical costs before Medicare step in to help. The crazy thing is its free to register and everyone who is eligble for Medicare and part of a family is eligble for the safety net, and yet you still have to register for it. It's not automatic.
Sorry, I know this sounds confusing. The problem is that the whole Medicare system is confusing.

I hope someone else who knows more about this answers for you - I only did because I noticed nobody had answered. Checkout: medicareaustralia.gov.au for more informaiton and phone numbers to call.
Well if the standard fee(set by the government is $100.00 then you would either get $75.00 or $85.00 dollars back respectively. However, virtually no specialist ever charges the standard fee. So if the set fee is $100.00 and the doctor charges you $150.00 you still only get the $75.00 or $85.00 back

No comments:

Post a Comment