If you're not covered by a health fund, or if you have a large bill to pay, some doctors may offer a payment plan.
The average cost of an appointment with a GP (general practitioner) in Australia is around $50, while the average cost of a specialist appointment is around $130.
Estimate of fee
Doctor consultation fee
Medicare schedule fee
Medicare rebate to a patient (100 per cent of schedule fee)
Out-of-pocket expense to patient
Medicare is a public health system run by the Australian Government. It covers general medical treatments sought in a public hospital. Medicare rebates are also extended for in hospital services to minimise the gap of out of pocket expenses payable.
About 80% of GP practices bulk bill, and 20% or less charge a fee for each visit. Medical services provided in a bulk billing arrangement imply that the public or private patient does not foot any medical costs. Medicare pays for all general practice medical costs. Many doctors also accept the medicare schedule fee without asking the patient to meet the out of pocket costs. Bulk billing does not cover all allied health services and specialist appointments. Out of hospital services can only be bulk billed if your GP recommends and refers you to specialist service providers. These specialist allied health professionals must register with Medicare to be eligible.
Check if your health fund offers cover for doctors' standard consultation costs.
Visit a local community health centre or free clinic.
Speak to your local GP about a payment plan.
If you're seriously ill and need to see a specialist, you may be able to get help from Medicare under the Chronic Disease Management (CDM) program. To be eligible for this program, you must have at least one of the following conditions: diabetes, heart disease, asthma, chronic obstructive pulmonary disease (COPD), arthritis, or mental health issues. The Health Care Card also gives you access to a range of health services at a reduced cost or for free. To be eligible for a Health Care Card, your income must be below a certain level. If you're not eligible for Medicare, there are a number of community organisations that may be able to help. Try contacting your local council or searching online for 'community health services' in your area.
Bulk billing is a term used to describe the process of charging a health fund for a patient's visit rather than the patient. Bulk billing is common in Australia and is offered by around 80% of GP practices. It's a great way to save money on doctors' visits, as you don't have to pay any fees upfront. However, not all services are bulk billed. If you choose to see a doctor privately, they may charge you what is known as an 'out-of-pocket fee.' Out of pocket costs is a co payment plan where the patient pays fees not catered for by the medicare cover. If you're not covered by a health fund, or if you have a large bill to pay, some doctors may offer a payment plan. This allows you to break the bill up into smaller payments. Speak to your doctor or local council about this option if it's available. Medicare also offers the Health Care Card, which gives you access to a range of health services at a reduced cost or free.
Medicare is Australia's national health insurance system covering people living in Australia but not those with "no legal residency" status. It provides free hospital treatment as a public patient in a public hospital but lower costs for treatment as a private patient in either a public or private hospital. In addition to Medicare benefit, there are also concession cards that can provide further savings on medical costs. These concession cards include the health care card, pensioner concession card, and veteran's affairs card. Medicare rebates and gap payments by private health insurers enable patients to seek specialised medical services in a private hospital facility. The Medicare benefit system works in collaboration with the Pharmaceutical Benefits Scheme. This scheme exists to offer subsidised drugs and prescribed to patients during GP appointments.
There are different rules about what you can claim through Medicare depending on which level of cover you have: general or private. This includes different costs for seeing a doctor or having X-rays and scans. You can find a list of what you're covered for on the Medicare website. Generally, if you see general practitioners and they bulk bill, you will not pay anything. Medicare foots the full fee. However, most doctors occasionally require patients to see a specialist for pathology tests, surgical procedures, specialised diagnostic tests, theatre fees, physiotherapy, or related medical treatment procedures. In such situations, you may have to pay an out-of-pocket fee. This is usually around $30, but it can be more or less depending on the doctor. You can claim some of these specialist charges back through Medicare, but you will need to show your receipt as proof of payment. Refunds are typically paid back into the claimer's bank account. The Medicare Safety Net mechanism is a provision to protect patients who have recurrent doctor visits from paying excessive gap fees. The safety net threshold is met if annual gap fees reach a certain amount.
Average waiting times vary from one location to another across major cities as well as day vs night GP services appointments. However, you should be able to see a doctor the day you call or within 1-2 days after making an appointment, depending on the severity of your health.
An out-of-pocket fee is an amount charged by a medical practitioner (a GP or specialist) for seeing them privately, rather than under Medicare arrangements where the Government makes a full payment or pays a greater portion of the total costs of your consultation.
Medicare is Australia's national health insurance system covering people living in Australia. Health funds are private companies that offer cover for the medical expenses of private patients.If you're not covered by a health fund, or if you have a large bill to pay, some doctors may offer a payment plan. This allows you to break the doctor's charge up into smaller, more manageable payments for you. Speak to your doctor or local council about this option if it's available. For more information on general practitioners and the work they do, take a look at the Victorian Government's Better Health channel.
No, you do not need to be in a private health fund in Australia to access medical care. However, if you are not covered by a health fund and need to see a specialist, you may have to incur out-of-pocket costs.
Private health funds in Australia vary in price, but on average, they cost around $70 - $200 per week per person. This price may change depending on the level of cover you have. The more medical benefits you get, the more money you pay as a medical insurance premium.
Private health insurance covers you for the cost of your medical expenses. If you have an accident or illness, private health insurance will cover some of your costs. Types of private health funds in Australia include the below.
Hospital Only Cover. This covers some or all of the costs for hospital stays.
Extras Cover pays some or all the cost for extras like dental and optical fees.
Combined Cover provides both types of cover above combined into one policy with premiums that vary depending on how much coverage you want to receive.