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What Are The Main Flaws Of The Australian Healthcare System, Medicare?

Private Health Insurance Explained
Private Health Insurance Explained

The government of Australia goes to great length to ensuring that the country’s citizens are in great health. In fact, Australia has the 11th highest life expectancy at the age of 81 and health checks are performed on visitors entering the country. However, there are several different noticeable flaws in their healthcare system, Medicare. In the next couple of paragraphs, you’ll have a better understanding of how the government’s health care system functions, why it is flawed, and why Australian citizens and permanent residents should consider a private healthcare system plan instead.

The facts about the Australian healthcare system and Medicare

Australia’s healthcare system began in 1953 with the National Health Act and Medicare was later included in the health system scheme in 1984. It makes perfect sense that the only Australian citizens and those with a permanent resident visa (or have applied for it) should be the ones that can apply for Medicare. However, there are a lot of downsides to using Medicare and the government’s public healthcare system including:

• Long waiting list
• Limited physician practitioner choice
• Limited coverage:
o Dental services
o Optical services for glasses and contact lenses
o Physiotherapy services
o Oversea services

Physiotherapy services include occupational, speech, podiatry, physiological, eye, and chiropractic services. These services used to be covered under Medicare with certain circumstances under the Enhanced Primary Care program with Medicare, but it was cut in 2005 for the Chronic Disease Management program for only long term conditions (6 months or long). Therefore, if you need to meet with a physician or assistant who specializes in a certain area, the coverage will be very limited under Medicare assistance and services such as dental and optical can only be provided if a person’s health condition is extremely severe with no short-term treatment solution. If you have a family, large or small, then dental and optical bills could add up if children need specific care such as braces, glasses, or a small surgery. A child’s Medicare insurance can be covered under their parent’s or guardian’s card until they are 15 years of age. After their 15th birthday, they will need their own card.

If you wish to meet with a specialist, then you need a referral from your doctor or physician that has been chosen by the government to work at the public hospital. Even if you want to seek assistance elsewhere, you basically have to ask for permission. These physicians are not that cheap either and Medicare can pay 85% of the scheduled service fees, but physicians may also choose to charge more and you could easily be paying for more for their services in the long end as part of the Access Gap Scheme. Under the Trade Practices Act, physicians are able to charge more in order to make a profit for them even though they are receiving the Medicare benefit of 85-100% of the bulk bill. If a physician chooses to not participate in the Access Gap, you could end up paying the difference yourself for the additional services not covered by Medicare. The Access Gap goes for physicians under Medicare and private health care plans so before you see a physician, ask if they are a part of the gap or not.

Medicare cannot cover the following services either:

• Ambulance services
• Nursing home assistance
• Hearing aids
• Prostheses
• Exams for life insurance
• Private hospital costs

Limited visits to a physician each year

With Medicare in Australia, not only are waiting lists long and you do not have much of a say as to which physician you want to meet with, you can only visit with someone for only a certain amount each year. Each time you visit a physician, your Medicare card is swiped to automatically give the Medicare benefit to the physician and count that visit under your plan.

Citizens and permanent residences of Australia will decide which type of health insurance is best for them based on where they are in life, their finances, and future needs. If someone decides to switch or begin a private healthcare plan rather than Medicare, here are the benefits and how to get started in enrolment for the plan.

Not too late to switch to a private healthcare plan

To encourage people to take out hospital insurance before they reach the age of 30 years, you don’t have to pay the lifetime health cover. This benefit also includes if you’ve had private health insurance since your 31st birthday. However, if you do join after your 31st birthday, then an additional 2% is added to your premium for 10 years. Depending on what stage you are in your life: single, a couple, or a family as well as your health concerns from potential accidents and dental to cardiac health; your plan will differ from other Australian private health insurance holders.

You can receive real benefits with private healthcare insurance and unlike a Medicare plan that only provides limited benefits and healthcare choices, you will have many more options with private insurance. There are no waiting lists and you have access and get to decide who is your physician, optometrist, and dentist. That’s right, you actually get optical and dental coverage as a part of your plan. Also very important, the plan covers any ambulance bills for an emergency call and accident.

As far as the payment process for a private plan, it includes both the health insurance policy and the lifetime health cover loading but reduced with a rebate. This way, instead of counting the number of times you have visited a physician a year and pay by bulk billing, you only need to pay a monthly fee for everything you need.

If you’re done and tired of the limited benefits you receive with a Medicare healthcare insurance plan, it’s probably a good time to switch to a plan that provides you with more flexible options and covers both short-term and long-term healthcare needs. Check out a private insurance plan to learn more about what it can do for yourself, your partner, and/or your family today.

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