Though health care is generally an important fundamental right, the truth is it is costly to most of Australian citizens. The ability of not paying for health care expenses from ones pocket is the main benefit of taking a health insurance cover. Just like other facilities, you can either take a private or a public health insurance cover.
The public health insurance option; Medicare
Established in 1984, Medicare ensures that Australian citizens have free access to treatment in all public hospitals. Medicare also includes treatments from general practitioners, optometrists, dentists and specialists who participate in this scheme at a subsidized fee or even for free.
The participating optometrists and dentists can render only some of the services described by MBS (Medical Benefits Schedule) while the patient bares the cost of other auxiliary or general treatment. The Pharmaceutical Benefits Scheme under the Medicare scheme also subsidizes the cost of the prescribed medications.
Generally, the Medicare scheme means:
· Free admission to all public hospitals and medical care, treatments and after care services from the health providers.
· The chance of not paying form your pocket for all hospital fees, accommodation, surgical operations and medications.
Medicare provides the services for all Australian citizens for free based on tax contributions extra levy that is imposed on citizens with a high income. For single persons the threshold is $73,000 while couples with a combined income above $143,000 are also subject to the Medicare levy. Low income earning citizens do not contribute to the Medicare scheme.
Eligibility for Medicare scheme
All Australian residents are eligible for this Medicare scheme as long as they are New Zealand holding permanent Australian visas or they have applied for one though terms and conditions apply. All Australian citizens are eligible for this public health insurance scheme.
If ones citizenship is not clear, he or she should submit required documents to support their residency in Australia.
Private health insurance
Australians also have the option of taking up a private health insurance cover that is offered by private health insurance funds or providers. The largest private health insurance in Australia is Medibank Private, a fund that is owned by the government but follows all the regulations outlined for private insurance funds in the country.
In contrast to private health insurance in America, The premiums of private health insurance in Australia is not determined by health, medical history, age or address. The following are the major categories of private health funds:
Non-profit Health funds
They include GMHBA or HCF health insurance
· For Profit
They include Australia Health Insurance Fund or the MBF health Fund.
· Regional
They include the Territory insurance office that caters to the Northern Territory or the HBF that provides for citizens living in Western Australia.
A person has the option of determining the private health fund to choose by comparing the available policies online. Individuals who choose private health insurance have a wide range of health care options compared to those who choose Medicare.
Based on the premiums paid, you can have all the medical expenses covered by the fund or end up taking care of some of the expenses when the cover is depleted.
Importance of being rated in the community
No private fund in Australia should refuse a person a subscription or policy based on any other following factors:
· Job
· Gender
· Religion
· Race
· Hobbies
· Sexual orientation
The community rated fund ensures that the potential subscribers purchase the policies at the same premiums and rates as well as enjoy all the benefits like other citizens that subscribe to the same plan. Difference in premiums in different states exist but the law forbids intra state differences.
The waiting game
The private health can extend the comprehensive health coverage to the subscribers and they can also impose a waiting period of up to a year at their own discretion especially when the person seeking insurance cover has a PEA (preexisting ailments).
This waiting period minimizes the risk of the fund attracting profit seeking subscribers. This waiting period also applies to existing subscribers who would want to upgrade their cover as well as new members looking for an insurance cover.
This waiting period prolongs the time a person should wait to receive the claim benefits. Waiting period on individuals with an obstetric condition or PEA means that the fund will not pay the claims until 12 months or until the set period elapses after taking the cover.
