MEDICARE

Hi there,

As you might read last week, I was sick over Easter. I had a really bad headache that made me sick after 2 days too.
At the pharmacy I was told it was a migraine and I am pretty sure it was, still I wanted to see a doctor, just to double check and to see if I could prevent it from happening again.

MEDICARE

Doctor

I made an appointment to see a doctor. She helped me out, gave me medicine in case it would happen again and told me to take a bloodtest, just to exclude any other things that might have caused the headache.

The next morning I came back to get the bloodtest done and I bummed into something – my health insurance didn’t cover the bloodtest and the result would be a bill of AUD 326 (EUR 230).

How does it work?

For me, as a non-Australian resident on a temporary visa, there is an option to get health insurance in Australia. I need 2 things for that, one is my Dutch passport and the other is evidence of a valid insurance with the Netherlands Health Insurance Scheme or a valid European Health Insurance Card (EHIC) with the initials NL. – see more information here, also for other European countries or travelling from Australia to Europe.

So I still have my health insurance in The Netherlands and with my passport I can enrol into Medicare Australia.
I will be covered by Medicare from the day I arrive in Australia until one of the following expires,
– Dutch Health Insurance
– European Health Insurance Card (EHIC) or
– Visa

What does Medicare give me?

I was quite confident Medicare would cover me for what I am used to in The Netherlands, but after the fact my bloodtest would cost me AUD 326, I thought I should have a closer look into what Medicare does and more importantly doesn’t cover.

Facts

The care that applies for Australians visiting certain countries and when visitors from certain countries come to Australia (ME) is called Reciprocal Health Care Agreements (RHCA). This means the following.

Medicare for me covers:
– Medically necessary out of hospital treatments
– Medically necessary treatments as a public patient in a public hospital
– Prescription medicine available under the PBS at the general rate

Great, so what does this mean exactly?

It covers any medical essential treatment – explained as any illness or injury which occurs while I’m in Australia and which requires treatment before I would go home. (This still applies, since I am here on a temporary visa, meaning I have a date I need to go home and leave Australia – unless I get another visa).

And it covers all the medicine on the PBS list – the Pharmaceutical Benefits Scheme.You can find this list here.

Honestly, for me it is still quite vague what is covered and all the names of the medicine don’t mean anything to me.

At least we have a list with things that aren’t covered, so we can exclude those from our list. These consist of:

Not covered

– medicine not subsidised under the PBS (okay, we do need to do something with that complicated list)
– treatment arranged before my visit to Australia
– accommodation and medical treatment in a private hospital
– accommodation and medical treatment as a private patient in a public hospital (in other words, avoid anything that’s private!)
– ambulance services (DON’T CALL 000, just leave me)
– dental examinations and treatment – except specified items introduced for allied health services as part of the Chronic Disease Management (CDM) program (and it that, just as for me, means nothing to you, you have to pay for the dentist)
– physiotherapy, occupational therapy, speech therapy, eye therapy, chiropractic services, podiatry or psychology except once again, introduced for allied health services as a part of the CDM program (still don’t know what this is, so avoid any sort of therapy)
– acupuncture, unless part of a doctor’s consulation
– glasses and contact lenses
– hearing aids and other appliances
– the cost of protheses
– medical costs for which someone else is responsible, for example an employer
– medical services which are not clinically necessary
– surgery solely for cosmetic reasons
– examinations for life insurance, superannuation or membership of a friendly society
– home nursing

And the list ends saying you can take private health insurance to cover the above.
The list is from the humanservices website of Australia, link.

 

Conclusion in my case and my point of view is that:

– Health insurance in the Netherlands is needed for me to be able to get health insurance in Australia
– I pay for this insurance in the Netherlands
– But I don’t get the same health care as in The Netherlands

So I pay for care that I don’t get, all because I am not from here.
Medicare is for free for an Australian resident – which is their right.
I am lucky I can get into Medicare, not being an Australian resident.
And this is not only about me, but also about the Australian people, who have Medicare and are not covered for everything they need.

My view

This week, just before my bloodtest, I had to make a decision what was more important my health or my money?
But some people don’t have the option to make that decision, because they don’t even have the money to consider it.
For me, this was something that really got me thinking about how the systems work. And me being an ‘outsider’ in Australia will probably not give me the same right for health as an Australian resident, but still – don’t we all deserve the best doctors and the best care that’s out there? Don’t we all want the very best for all the people around us? And aren’t we all equal and have the same rights to medical care?

It’s a difficult discussion and there are a million things to take into consideration. It is just a reminder to be aware of your insurance, your health and your options before you go somewhere or before something happens – know what you have and what you don’t have and don’t let yourself be surprised by somebody telling that they can’t deliver that service for you.

If you want to read more about this, all the information provided above is from this website.  And this link gives you more insight information about Medicare for Australian residents.

Lots of love,

Michelle

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