7.2 medicare

Question 1

what is medicare and what does it do

Answer 1

Medicare is Australia’s universal health insurance scheme.
Medicare gives all Australians, permanent residents and people from countries with a reciprocal agreement access to subsidised health care.

Question 2

services covered by medicare

Answer 2

• doctor and specialist consultations
• most surgical and other therapeutic procedures performed by general practitioners
• xrays
• eye tests performed by optometrists
• pathology such as blood and urine tests
• fee-free treatment and accomodation in public hospitals
• dental services for some children under the child dental benefits scheme
• 75% of the schedule fee for treatment in a private hospital

Question 3

medicare safety net

Answer 3

Provides extra financial assistance for those that incur significant out-of-pocket costs for Medicare services. Once an individual or family has contributed a certain amount out of their own pocket to Medicare services in a calendar year, further financial support is provided by the government, making Medicare services cheaper for the remainder of that year.

Question 4

what is not covered by medicare?

Answer 4

Medicare covers most ‘clinically necessary’ hospital and doctors’ services. Any cosmetic or unnecessary procedures are generally not covered.
Other services not covered by Medicare include:

• most costs associated with private hospital care.
• most dental examinations and treatment.
• in-home nursing care or treatment
• ambulance services
• most allied health services (unless referred by a GP or carried out in a public hospital).

Question 5

advantages of medicare

Answer 5

• Choice of doctor for out-of-hospital services
• Available to all Australian citizens
• Reciprocal agreement between Australia and other countries allows Australian citizens to access free health care in selected countries
• Covers tests and examinations, doctors’ and specialists’ fees (schedule fee only), and some procedures such as X-rays and eye tests
• The Medicare Safety Net provides extra financial contributions for medical services once an individual’s or family’s co-payments reach a certain level

Question 6

disadvantages of medicare

Answer 6

• No choice of doctor for in-hospital treatments
• Waiting lists for many treatments
• Does not cover alternative therapies
• Often does not cover the full amount of a doctor’s visit

Question 7

how is medicare funded?

Answer 7

• the Medicare levy
• the Medicare levy surcharge
• general taxation

Question 8

medicare levy

Answer 8

The Medicare levy is an additional 2 per cent tax placed on the taxable income of most taxpayers. Those with low incomes or with specific circumstances may be exempt from paying the levy.

Question 9

medicare levy surcharge

Answer 9

People without private health insurance earning more than a certain amount have to pay an extra tax called the Medicare levy surcharge. The Medicare levy surcharge increases as income increases