Medical costs

We can help you and your family with medical costs. There are also things you can do to keep your costs down.

Seeing a doctor

If the doctor bulk bills, we’ll cover the cost and you won’t need to pay at all.

If they don’t bulk bill, you’ll need to pay.

If your doctor doesn’t bulk bill, you’ll need to pay either:

  • the full cost
  • the difference between what they charge and what we cover.

If you pay the full cost, you can make a claim for the amount we cover. Your doctor can also make a claim on your behalf.

When you make your appointment, ask if they bulk bill. If they don’t, you can ask what they charge. You can also ask them what you may get back from us.

Read more about seeing a doctor.

Medicare Safety Net

If you have a lot of out of hospital costs, the Medicare Safety Net can help keep them under control. If your costs for the year reach a threshold amount, we’ll pay more of your costs. You can check what your threshold is.

If you’re single with no children, you don’t need to register for the safety net. If you’re a couple or have children, you need to register as a family.

You need to enrol in Medicare before you can use the safety net.

Getting medicines

Some medicines can cost a lot of money. The Pharmaceutical Benefits Scheme (PBS) subsidises the cost of medicine for most medical conditions.

We have concession cards that can help you get health care and medicines at a lower cost. If you have a concession or health care card, you can get further discounts on PBS medicines.

If you need a lot of medicines, the PBS safety net can help keep your costs down. Once you meet the yearly threshold, you’ll pay less for the medicines you need. You can check what your threshold is. It’s best to discuss the PBS Safety Net with your pharmacist so they can keep track of your spending.

Going to hospital

You can choose to be a public or private patient when you go to hospital. As a public patient at a public hospital, you won’t have to pay.

You’ll need to take your valid Medicare card or number with you when you go to hospital.

Read more about going to hospital.

Emergency visits

If you’re visiting emergency as a public patient in a public hospital, your costs are covered.

We don’t cover ambulance costs. Ambulance costs are different in each state and territory. Some states and territories offer discounts for some people or may cover the costs for all people. It’s best to check. You can check what the ambulance costs are for where you live on the PrivateHealth.gov.au website.

If your ambulance costs aren’t covered where you live, private health insurance may cover these costs. Read more about ambulance cover on the PrivateHealth.gov.au website.

Surgery

If you’re a public patient in a public hospital, it won’t cost you anything.

You may have costs if you’re a private patient in either a public or a private hospital. You need to pay the difference between what we cover and what your surgery costs.

Ask for a quote from your specialist before surgery. Your private health insurance may cover the costs. Talk to your insurer before surgery to make sure you know what they cover.

Read more about private health insurance and Medicare to see what insurance may cover.

If there's an amount your insurer doesn’t cover, talk to your specialist about payment options.

After care

Any after care needs are part of your surgical costs. When you have surgery, your specialist will talk to you about your after care needs.

Accessing income support

If you have an illness, injury or disability and can only work limited hours, Centrelink may be able to help. Use our payment and service finder to see if you can get Centrelink assistance.

Page last updated: 3 July 2019

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