medicare Flashcards
(18 cards)
what is medicare
Medicare is Australia’s universal public healthcare system, providing access to essential medical services and subsidising treatment costs for all Australians
medicare levy
a 2% tax on all eligible taxpayers
medicare levy surcharge
an additional 1-1.5% tax on all eligible taxpayers who do NOT have private health insurance
($90,000 for 1%, $140,000 for 1.5%)
what is covered
- public hospital services
- GP appointments
- treatment and accommodation as a public patient in a public hospital
- blood tests
- x-rays
- 75% of the schedule fee for treatment in a private hospital
what isnt covered
- dental examinations
- ambulances
- home nursing
- physiotherapy
- private hospital costs
- cosmetic surgery
out of hospital expenses
Medicare will pay for all or some of the fees relating to many essential healthcare services
most surgical and other therapeutic procedures performed by general practitioners are also covered
how it works
coverage of healthcare services is based on a schedule fee by the federal government
practitioners may wish to charge more than the scheduled fee, leaving the patient to cover the difference as an out of pocket expense
if practitioners only charge the schedule fee, the individual is said to have been bulk billing
in hospital expenses
as a public patient in a public hospital, accommodation and treatment by doctors and specialists is covered by Medicare (including initial treatment and aftercare)
if an individual chooses to not be admitted to a private hospital or as a private patient in a public hospital, Medicare will pay 75% of the schedule fee for treatment by doctors and specialists, but will not contribute to accommodation or other costs such as theatre fees and medication
bulk billing
where the doctor bill sMedicare directly and accepts the Medicare payment as full payment, meaning there is NO out of pocket expense for the patient
schedule fee
the amount Medicare will contribute to a health service
medicare safety net
provides extra financial assistance for those that incur significant out of pocket costs for medicare services
once an individual or family has contributed to a certain amount of their own pocket to Medicare services in a calendar year ($700 for singles, $1000 for couples and families0, further financial support is provided by the government, making Medicare services cheaper for the remainder of that year
advantages
- choice of doctor for out-of-hospital services
- available to all Australian citizens
- reciprocal agreement between Australia and other countries
- Medicare Safety Net
disadvantages
- 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 (out of pocket fees)
access
medicare is available for ALL Australian citizens, allowing all Australians to have access to subsidised Medicare listed services regardless of their SES, income and location
Medicare allows people to choose their own doctors in out-of-hospital services, allowing for individuals from certain religions to feel more comfortable and ensuring they receive the best possible care
funding
Medicare is funded through taxes (Medicare Levy, Medicare Levy Surcharge, General Taxation)
it is funded so that individuals can access Medicare listen healthcare services for a subsidised cost
equity
the Medicare safety net aids those who experience higher costs of basic healthcare services, and provides support for those who need additional support. Some low income earners, based on their taxable income, are exempt from paying the Medicare Levy
sustainability
Medicare only overs specific services. This ensures Medicare can yield the greatest health outcomes whilst preserving funds, allowing Medicare to be maintained into the future.
