Learning Your Cover Options for Health Insurance in Australia

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The healthcare system in Australia is one of the most successful systems in the world. Australia also claims one of the world’s highest life expectancies – another proof of the system’s claim to fame. The governing principle of health insurance in Australia is one where both the private and public sector are involved.

Therefore, health insurance in Australia is a cover of care that is a combination of private and public health care plans where both the private and public sectors are involved.

Therefore, residents who are interested in health insurance in Australia must consider a number of factors when they review private health insurance plans. Not only must people consider who is covered under a plan, but they also must look at what is covered under health insurance in Australia.

Two types of health insurance exist – general treatment and hospital treatments (extras or ancillary). You can buy these covers separately or choose a fund that features combined policies. There are limitations on when or what you are able to claim with a purchased policy.


The Medicare System


Residents also must consider what specific government incentives or surcharges affect health insurance in Australia. The Private Health rebate represents a federal subsidy covering the cost of insurance while Lifetime Health Cover guidelines have been written to encourage insurance policyholders to buy private health cover earlier and to make sure they maintain the cover. The Medicare Levy Surcharge represents a tax that impacts anyone who earns above a specific income who does not carry private hospital cover.

Anyone who is living in Australia on a temporary visa or who is applying for a visa subclass 457 must take out private health cover. Anyone who is visiting Australia on another type of visa should also consider taking out cover for the length of his or her stay.

Therefore, expats who plan to move to Australia and reside and work on a 457 visa, which is the most popular of visa categories, have to prove to Australian officials that they are sufficiently covered by a minimum amount of private health insurance in order to receive a visa. These individuals should refer to the country’s Department of Immigration and Citizenships (DIAC) site.



The Medicare System

To understand why you need to use health insurance in Australia as a supplement, you need to understand something about the government-supported healthcare system, which is known as Medicare. This public healthcare system is offered to all citizens of the country as well as permanent residents.

The healthcare offered through the programme is paid by taxes that have been levied on individual salaries. This Medicare scheme entirely covers the treatment offered in public hospitals and offers both partial and complete cover of the expenses associated with doctors’ consultations – an expense that generally entails about 85% of the costs.



How to Sign Up for Medicare if You Are a Temporary Resident

For anyone who is an expat who needs to sign up for Medicare, they will need to use a passport, permanent visa and travel documents in order to obtain the a Medicare card. The process generally takes almost two months and, therefore, should be facilitated soon after arrival in the country.

Medicare is available for just about anyone who is coming into the country as the information kits are provided in not only Braille but also in 18 other languages. The information explains the healthcare system in full detail, including the payment structure and benefits.


Private Health Cover



Issuing Rebates

Doctors will either directly bill Medicare or, if the patient chooses to pay, then he can claim a rebate from the agency by way of a drop box for claims. Currently, 239 claims drop boxes are set up in the country. The rebate may also be obtained by the mail or telephone. After a claim is made, the rebate is instantly submitted into a claimant’s account.



Tracking Charges

The Health Insurance Commission in Australia tracks charges by doctors and provides a schedule of government-set fees. The cost of prescription medicines are covered by a PBS (Pharmaceutical Benefit Scheme), which offers subsidies to patients for their medications. Not anyone who is eligible in the country for Medicare, however, will have the cost of emergency transport covered. That is why it is important to look at private health insurance in Australia as well.



Private Health Cover

Over half of the populace in the country carries some type of private health cover, which is encouraged for both expats and locals. While the government subsidizes private health cover, higher-rate taxpayers, who do not have private health insurance, are, in turn, penalized with a Medicare Levy Surcharge if they do not opt to take, at the minimum, a Basic Hospital cover for any elective surgery.

For anyone temporarily residing in Australia, private health cover is compulsory and can also be expensive. In some cases, the cover can cost as much as AUD 500 per month for a comprehensive cover plan.

While Australia does feature private healthcare facilities, none of them provides emergency healthcare services. Therefore, whether you live in Australia or are living in the country for the time being, you still have to rely on public healthcare for emergency help.


The major portion of private healthcare package options specialises in surgery, especially non-emergency type surgeries – like orthopedic procedures. Because the use of private healthcare facilities reduces the demand on public healthcare facilities, Medicare will not offer rebates to as many as 30% of the people who choose care at a private facility. That is another reason you need to look into health insurance in Australia.

When you look into covers for health insurance in Australia then, you have to make your choices based on what is already covered and what type of care you expect to receive at a private facility. Look at what specific costs are covered by Medicare, then look at the expenses you need to cover with a health insurance policy.

How many people in your household will be covered by health insurance? Do you want to add everyone in your family to a policy? Maybe you are single. In that case, what specific covers do you need to review for an individual?

Take time to review the plans that are offered on the Internet. You can make the most of your health insurance funds by comparing the various policies. If you have a family, see if you can obtain a discount on the premium or see if discounts are offered for practising good health habits, such as not drinking or smoking.