MEDICARE SAC CHECKLIST Flashcards
(41 cards)
medicare
aus’s universal health insurance scheme that provides access to health care that’s subsided by the federal government
why was medicare created
provide access to affordable basic healthcare in public health sector
medicare safety net
patients co-payments for out of hospital medical expenses reach a certain level services get cheaper for the rest of the year
postives of medicare (what it provides) … listed
- clinically necessary medical fees
- consulation fees for doctors and specialists
- tests and examinations
negatives of medicare (what it doesnt provide) … listed
- costs associated with private hospitals
- most dental examinations and treatments
- ambulance services
how is medicare funded … listed
- general taxation
- the medicare levy
- the medicare levy surcharge
medicare levi
2% tax for all aus tax payers to fund medicare (low incomes and certain circumsatnces are exempt)
medicare levi surcharge
additional 1-1.5% tax on high income earners who dont have private health insurance (income based)
bulkbilling.. listed
- doctor or specialist charges only the schedule fee
- payment is claimed directly from medicare
- no out of pocket expenses
out of pocket expenses
if medical practices charge more than the ‘schedule fee’ you’ll have to pay a certain amount in out of pocket expenses (gap fee)
schedule fee
the amount that medicare contributes towards certain consultations and treatments.
the government decides what each item is worth and thats what medicare pays
PBS… listed
- up to $38.80 for most PBS medicines
- $6.30 for concession
- government pays remaining cost of the medicines
why was PBS created
provide essential medicines to people who need them, regardless of their ability to pay
private health insurance
insurance policy that helps pay for services not covered by medicare
why was private health insurance created
to give individuals more choice with their health care that they wish to access,
aswell ax reducing the burden on the public health system
postitives of private health insurance… listed
- enables access to private hospital healthcare
- choice of doctor while in public or private hospital
- shorter waiting times for some medical procedures
negatives of private health insurance
- costly in terms of the premiums that have to be paid
- gap costs for the patient
- qualifying periods apply for some conditions before they make a claim on private health insurance
private health incentives… listed
- private health insurance rebate
- lifetime health cover
- medicare levy surcharge
why was private health incentives created
to encourage people back into private health insurance
private health insurance rebate
government contributes a certain amount of money towards your private health insurance (income based)
lifetime health cover
after the age of 31 pay an extra 2% on their premiums per year that they age which prevents on paying huge amounts on medical fees in future if needed.
patients rights … listed
- privacy of and access to their own medical records
- treatment with respect and dignity
- seek other medical opinions about their condition
medical confidentitality
set of rules that means anything discussed between doctor and patient must be kept private.
known as doctor-patient confidentiality
exemptions to privacy laws … listed
- if patient or someone elses h&w or safety are seriously threatened.eg(if patient is unconscious and a paramedic, doctor or nurse needs to know whether the patient is allergic to any drugs)
- When the info will reduce or prevent a serious threat to public health or safety. (eg, warning the public if theres an outbreak of a serious contagiuos illness covid. )
