Medicare Flashcards
(18 cards)
definition
Medicare is Australia’s universal public healthcare system, providing access to essential
medical services and subsidising treatment costs for all Australians
services covered by Medicare
-Doctors and specialist consultations
-Eye test performed by optometrists
-X-rays
- Pathology such as blood and urine tests
services not covered by medicare
-Treatment in private hospitals
-Dental services
-Ambulances
-Home nursing and treatment
how can there be no out of pocket expenses
medicare is funded by the federal government, there are no direct costs to Australians
medicare levy
Australian taxpayers are charged 2% of their taxable income to help federal government fund Medicare
Medicare levy surcharge
additional charger for people who earn higher incomes, if they do NOT take out private health insurance. Additional 1-1.5% surcharge
general taxation
if revenue collected from ML and MLS are not enough to cover full costs, government can use general taxation.
schedule fee
the governments set amount for a medicare-covered service
GAP
The difference between the amount your doctor charges and the amount that is paid by Medicare
out of pocket expenses
extra money a patient has to pay for a service, including both the GAP and any extras the doctor may wish to charge
bulk billing
Doctor has chosen to only charge 85% of the schedule fee, meaning there is no GAP the patient has to pay
medicare safety net
extra financial support for those with incur significant gap costs. Once an individual or family reaches a certain threshold in one calendar year, their Medicare benefit is increased to 100%, meaning their schedule fee is fully covered for the remainder of that year.
Medicare advantages
patients have a choice of doctors for out of hospital services
available to all AU citizens
medicare safety net
disadvantages
no choice of doctor for in hospital services
waiting lists exist for elective surgeries
sustainability
- Medicare only covers health services that are deemed to be medically, necessary and clinically essential, thereby allowing these services to be in place for future generations.
- It does not cover the full schedule fee- only 75% for in hospital services and 85% for out of hospital services
access
allows for ALL austrlaina citizens, to ave access to subsidised medicare listed services regardless of the SES, income or location
equity
the Medicare Safety Net aids those who experienced higher costs of basic healthcare services and provides support for those who need additional support.
low income earners can be expect from medicare levy
funding
medicare is funded through taxes (medicare levy/ medicare levy surcharge/ general taxation)
