medicare Flashcards
(15 cards)
medicare
medicare is australia’s universal health insurance scheme that provides access to health care that is subsidised by the federal government.
* priority is given according to clinical need
who gets it?
- australian citizens
- permanent residents
- people from countries with a reciprocal argeement (NZ, UK, or name a few more)
what is covered by medicare
- x-rays
- doctors and specialist consultations
- eye tests performed by optometrists
whta is not covered
- comestic surgery
- dental
- ambulance services
what is schedule fee
schedule fee is the amount that medicare contributes towards certain consolation and treatments, determined by the goverment
what is bulk billing
bulk billing is when the doctor or specialist charges only the schedule fee, therefore there is no out of pocket expenses for the patient.
what is patient co-payment
patient co-payment is the payment made by the patient for the service, that is in addition to the cost covered by medicare.
advantages of medicare
- choices of doctors for out of hospital services
- avaiable for all australian citizens
- covers tests and examition, doctors and specialist fee (schedule fee only), and some procedures such as x-rays and eye tests
- reciprocal agreement between australia and other countries allows australian citizens to access free health care in selected countries
disadvantages of medicare
- no choice of doctor for in-hospital treatment
- waiting lists many treatment
- does not cover alternative theparies
- often does not cover the full amount of a doctor’s visit
how is medicare funded
medicare is funded through 3 ways
* the medicare levy (it is an additional 2% tax placed on taxable incoe of most taxpayers
* the medicaer elevy surcharge (MLS) 1-15%. this is payable by higher icome earners who don’t have private health insurance
* general taxation
what is the medicare safety net
the medicare safety net provides extra financial assistance for those that incur significant out of pocket costs for medicare services in 12 month periods.
sustainability in medicare
determining which services will be subsided through medicare can preserve funds for the most necessary services, making it sustainable for now and future generations
access in medicare
medicare reduces the cost of medically necessary services providing access to these services.
funding in medicare
medicare is funded by the medicare levy, medicare levy surcharge and general taxation
equity in medicare
the medicare levy is equitable as it is based on a percentage of a person’s income. This means that higher earners generally pay more than lower income earners.
