[karim elkady]

Hi all

I have a tricky situation and I would love if someone could help me out

im supposed to be applying for the PR(sub class 186) by Dec 2013 and been advised that I will receive a blue medicare card (Interim) my main problem now is that my wife is currently pregnant and the PR will be pending until she is due because she will need to have an Xray which is not going to happen while she is pregnant.
So my question is will that blue medicare card cover the pregnancy/labour costs in a public hospital in Australia?. Please bear in mind that she is pregnant before we get that card. And our private health insurance doesn't cover her pregnancy cost as she has been in Australia for less than 12 months.

Any help would be appreciated -- Thank you

 

[stbaugh13]

Hi, since its highly improbable that your wife will be able to do an XRAY whilst pregnant it is also clear that you will not receive your 186 visa. Therefore your wife will not be covered by Medicare for her pregnancy costs. How far along is she? If she is not yet 6 months along I would suggest accompanying her back to Egypt and have the baby there as the bills in Australia will be quite enormous.

 

[mohkam]

Karim... please check with Medicare..... I almost sure that she will be covered for the pregnancy and delivery.. I will make some search and be back to you with the exact solution..

 

[ozbound12]

Hi all

I have a tricky situation and I would love if someone could help me out

im supposed to be applying for the PR(sub class 186) by Dec 2013 and been advised that I will receive a blue medicare card (Interim) my main problem now is that my wife is currently pregnant and the PR will be pending until she is due because she will need to have an Xray which is not going to happen while she is pregnant.
So my question is will that blue medicare card cover the pregnancy/labour costs in a public hospital in Australia?. Please bear in mind that she is pregnant before we get that card. And our private health insurance doesn't cover her pregnancy cost as she has been in Australia for less than 12 months.

Any help would be appreciated -- Thank you

The interim (blue) Medicare card entitles you to all the same benefits as a permanent (green) card. The only difference is that you will only be covered up until the date shown on the card.

As such you'll be covered for pregnancy-related care/birth at public hospitals only. You may still have some out of pocket costs, such as the gap when you visit your GP (unless they bulk bill) and I think there is a gap for ultrasounds as well. The care you get at a public hospital will be good but the only difference as far as I can tell is that you don't get to choose your doctor (so you may have multiple doctors over the course of the pregnancy) and you will probably not get a private room.

 

[drshk]

Hi Karim,

I agree with what ozbound has said, the interim card gives you all the same benefits so your wife's GP costs (make sure you go to a GP that bulk bills, I think most do) and labour costs in a public hospital as a public patient would be covered. I have heard many people prefer going as public patient even though they have private cover as the care is really good.

All the best, and congrats on the upcoming new addition to your family

The interim (blue) Medicare card entitles you to all the same benefits as a permanent (green) card. The only difference is that you will only be covered up until the date shown on the card.

As such you'll be covered for pregnancy-related care/birth at public hospitals only. You may still have some out of pocket costs, such as the gap when you visit your GP (unless they bulk bill) and I think there is a gap for ultrasounds as well. The care you get at a public hospital will be good but the only difference as far as I can tell is that you don't get to choose your doctor (so you may have multiple doctors over the course of the pregnancy) and you will probably not get a private room.

 

[ozbound12]

Hi Karim,

I agree with what ozbound has said, the interim card gives you all the same benefits so your wife's GP costs (make sure you go to a GP that bulk bills, I think most do) and labour costs in a public hospital as a public patient would be covered. I have heard many people prefer going as public patient even though they have private cover as the care is really good.

All the best, and congrats on the upcoming new addition to your family

My experience has been that most doctors DON'T bulk bill unless you have a concession card or are unemployed. At least at my clinic I pay around $70 per visit and I get $36 back from Medicare. The one time I went to a bulk bill doctor was one of the worst experiences I've ever had with a medical practitioner - she was rude, barely looked at me and was rushing me out the door so she could see her next patient. I do NOT recommend you go to a bulk bill doctor!

 

[Naveed539]

Hi oz bound 12'

Just need a lil bit if clarification...what do we should understand by bulk billing Abid what benefits are associated with it for PR holder...secondly you mentioned in your last post that you were reimbursed with 36$ out of 70$...how can we know and calculate that how much percentage if expences are supposed to be reimbursed in different medical conditions....I went to Medicare website but was unable to develop general understanding...

Please comment....

 

[ozbound12]

Bulk billing means the doctor bills the Medicare rate for their services (for a standard consult, that's about $36), which means there is no out-of-pocket cost. However, most doctors charge more than the Medicare rate for their services so there is usually what's called a gap - the difference between what Medicare will pay for and what the doctor charges - which is what you're responsible for paying.

Doctors at private clinics can charge basically whatever they want but the going rate seems to be about $70-90 for a standard consult.

 

[Naveed539]

Thanks oz bound for a clarification'

Proceeding further...is the expense made at private clinics like consult charges etc are also subjected to reimbursement by medicare or only the expences made at public hospitals...?

Secondly does gp adds different health tests costs also in consult charge bill or not...?

Lastly how are the medicines charges being reimbursed by medicare...I mean is person supposed to pay the gap between the standard rate if any and the actual rate...?

Kind regards'

 

[drshk]

Oh, my experience has been very different. I have only gone few times to a GP, the clinic bulk bills so I didn't have to pay anything and the GP was very nice as well. I haven't gone to any specialist so no experience there.

Guess it depends on the clinic/GP you go to.

My experience has been that most doctors DON'T bulk bill unless you have a concession card or are unemployed. At least at my clinic I pay around $70 per visit and I get $36 back from Medicare. The one time I went to a bulk bill doctor was one of the worst experiences I've ever had with a medical practitioner - she was rude, barely looked at me and was rushing me out the door so she could see her next patient. I do NOT recommend you go to a bulk bill doctor!

 

[ozbound12]

Thanks oz bound for a clarification'

Proceeding further...is the expense made at private clinics like consult charges etc are also subjected to reimbursement by medicare or only the expences made at public hospitals...?

Secondly does gp adds different health tests costs also in consult charge bill or not...?

Lastly how are the medicines charges being reimbursed by medicare...I mean is person supposed to pay the gap between the standard rate if any and the actual rate...?

Kind regards'

Medicare covers you fully at public hospitals and for doctor's fees as described above. If there are any tests that need to be done and they're done at a private hospital you will be responsible for the full cost.

Medicare subsidises part of the cost of most medications through the PBS. More here: Pharmaceutical Benefits Scheme (PBS) - Medicare Australia