Is this correct in Australia re pensioner paying for health care

[Noshadelamp]

I'm in the UK with an elderly relative in Australia.
She gets the state pension and no other income. She rents from the council/government.

She has cancer and a lot of her medical appointments she has to pay up front for such as scans, tests and consultants.

Sometimes she gets some back through Medicare but not all of it and sometimes she doesn't get anything back.

Sometimes she pays $600 plus upfront, as well as her transport costs.

This is mind boggling to me here in the UK where there's pensioners who can't afford heating let alone fronting hundreds of pounds for a scan and only getting some it back.

So my question is, what do people do if they literally don't have the money up front?

Is there any government scheme or support for people who literally don't have the money or credit card?

Medicare is the government support.

Australia does not have a free healthcare system.

Yea this is correct

What do those without money do? They die.

That's the brutal truth. Reform want to bring this kind of medical insurance to the UK.

they have this kind of "care" in USA too.

if you value the NHS , remember this when you next cast your vote.

Nobody in Australia is dying because they can't afford medical care. There are safety nets which kick in earlier for pensioners. The medical system in Australia isn't free but it's a large part public funded. If she can't afford to pay the upfront cost and wait for the refund then she can use bulk billing providers who don't charge up front at all (so no cost) but will have a longer waiting list (still shorter than the NHS from what I see on here though).

What’s heating got to do with it? What a weird comparison. Particularly when you say pensioners in the UK can’t pay for it and don’t mention that healthcare is free! Getting a UK dig in for no reason about heating…

Medicare is the part-subsided way healthcare works in Australia - actually it’s very well funded by government. You can Google this. She can get layaway payments through providers if she can’t pay upfront.

On heating - in Australia if you are a pensioners you get a health care card that provides discounts for gas, electricity etc. Most cancer patients go directly into the public system where treatments and diagnostics are free of charge so this situation seems strange , especially for a pensioner. I'd suggest she reach out to an organisation like age care Australia and check she is accessing what she should be including patient transport options.

There’s a 2 tier system in Australia, a no pay basic system with long waits and a semi private system paid for by health insurance or Medicare with copays. Ex bil used to brag how good it was but now following health problems he’s whining a lot online and seems to be similar issues to what we experience and my friends in France moan about, infinite need, not enough resources due to the aging populations

Thank you. At the moment she is managing to pay upfront using credit cards. I'll mention your suggestions, I appreciate it.

I mentioned heating because in the UK it's well known that pensioners receiving just the state pension often struggle to pay for heating, having to choose between "eating or heating" so wouldn't have hundreds of pounds spare to pay for a scan upfront if they had to.
It wasn't a dig at the UK.

I did try a search on Google but as it's such a completely different system to the UK I wasn't even sure what to search for.

Not sure why you are so annoyed by my post, I'm trying to help an elderly relative with cancer in another country and thought people who actually live in that country would be the best people to ask 🤷‍♀️

I’m not angry and heating allowance exists here. Not for everyone as it’s on a scale - like most state-funded benefits. It just seemed a bit weird to raise it in a post about healthcare. It’s not a like by like comparison, which was my point. I know elderly people in Australia and I also tried to help, but sure ignore that bit. I said you can Google Medicare which is what she has and their information is actually really good and clear - and I say that as someone who used to work for the NHS where the same is not always also true unfortunately.

What state is she in?

Different state governments have various (largely unadvertised) relief schemes available that help with some expenses.

For example in Victoria I use this.

Victorian Patient Transport Assistance Scheme (VPTAS) | health.vic.gov.au

There are others.

Most appointments in public hospitals are free. Some scans, tests and so on might require payment. $600-odd upfront suggests she's seeing private specialists but I can't be sure.

I have a pension card as a single Mum and my son is treated at the Royal Childrens for free.

It can be tricky to navigate but in all honesty the system here isn't too bad overall. The fact that she lives in public housing and has a pension card means she needs to have a frank conversation with Centrelink about her Medicare entitlements.

I'm sorry for what's she's going through. Best of luck to you both x

Sorry I should've said-

Anyone with a Medicare card can be treated for free in a public hospital. In a sense the pension card is neither here nor there. It may however provide some added benefit.

For example- my son is about to have dental surgery for free that would otherwise have cost around $5k. Although yes there was a long wait. With cancer clearly you can't be hanging around on a wait list.

My husband had all his cancer treatment at Peter Mac hospital in Melbourne at no cost apart from immunotherapy which we paid for. He was a high earner so your relatives situation seems odd. I do think the initial specialist appointment we may have paid for. Another friend who recently was diagnosed and has private health insurance went to a public hospital for her treatment as she was told cancer is covered by the government, was booked in for surgery within two weeks. I hope this helps x

My mother went through cancer treatment a couple of years ago and used the public system. No wait and I think she might have paid for one or two scans.

Close friend is going through the same treatment and is using her private health insurance and it is costing her thousands.

It really does depend on which pathway you choose. We saw my son's colorectal surgeon privately and he offered to put us on the public list. Cost us nothing.

The safety net kicks in at $861 and then you get 85% back. Not all scans are covered but doctors are if you have a referral.

I think if Reform did get in at the next election, any big changes to NHS care by them would make sure that they would only last for one term.

People in Australia do not die if they haven't got money. Stop spouting rubbish.

Once she's paid a certain amount in out of pocket expenses (safety net) she will get approx 85% of her costs back - this resets on a calendar basis and it sounds as if she'll hit that fairly quickly unfortunately.

As a pp said above, it sounds as if she's not being bulk billed (medicare pays everything with no co-pay/out of pocket) and she needs to look into that.

This is ridiculous. Australia has a very good healthcare system with very good supports for low income people. After reading so much about the NHS on here and elsewhere there is now way I'd exchange the Australian system for the NHS.

When you receive a govt age pension you get a concession card, which includes healthcare discounts, including very cheap prescriptions. I've clients we skim in under the pension threshold just to get this.

Those without money use the free public system, and there are some providers who bulk bill (don't charge a gap payment). It takes longer, but from my time on MN it's not as bad as the UK. Those with money can choose. Private has a lot of gap costs but is quicker & more control over who you see.

As a pensioner your relative shouldn't be paying out of pocket in the public system. If they are going private, the gap can be substantial. The difficulty is knowing HOW to get things free. I've been referred to expensive providers because of practice preferences & one specialist refused to use anything from the bulk billed provider because of personal preference. Putting me $400 out of pocket instead of $0.

Don't compare us to the US, it's a completely different system.

This is incorrect. I am an age pensioner. I am being treated for my fourth cancer. Through the public system it is all free. And cancer is a category 1 condition. Surgery within 30 days followed by chemo and radiation. Only cost was take home medication just over $7 per script. Treatment has included Pet and mri scans.

I'm Australian and yes we do have free healthcare. I had open heart surgery as well as vascular surgery on my leg last year and spent a few months in hospital and didn't pay a cent.

Which state is she in? The cancer council would be a good place to ring and she will get loads of information from them. She should not be putting things on credit cards. The doctor can write bulk bill on all her referrals.

Australia’s medical system is heavily funded by the Government - Medicare.

For example, Medicare will pay a GP $X amount for a standard appointment. However, some places charge more than the Medical Schedule Fee, so if you want to attend that Dr or practice, you have to pay the ‘gap’. Again, it is usually on the spot, after your appointment, you pay full price (Fee + gap), and then they immediately run your Medicare card and you are refunded the Fee straight into your bank account.

If you do not want to pay the ‘gap’ (ie pay at all), then you just need to chose a GP that doesn’t charge more.

I go to a GP that does charge, but I can get an appointment on the day I call, and the gap is less than a takeaway lunch so I’m fine with it. I’m sure it’s probably takes a little longer to get an appointment at a GP that doesn’t charge.

The same is true of tests - ultrasounds, CTs, physios etc. It can be difficult if you live in a country town, as there might only be 3 GPs or one place that does radiology, so you might be at the mercy of their billing. But if you are prepared to travel, or live in an urban area there is usually lots of choice for ‘bulk billing’.

Your health Fund may also cover things that Medicare doesn’t. Does she have a Health fund?

If your relative is elderly, does she have everything set up to get payments back immediately? Most medical providers have things set up for quick/immediate repayment of the Medical Schedule Fee. I’m not sure if this is true for more specialist treatments, but I’d be surprised if it wasn’t.

My husband had cancer . His first consultation was with the surgeon who has a private practice so he had to pay a consultation fee . Got some back on Medicare . The surgeon then booked him into a public hospital in Victoria and all his surgery and scans and any other tests after that was all free . I think if she is still a patient under the public hospital system it would be free .

It sounds like she has somehow got herself into the private system where yes, you pay upfront and get some money back through Medicare/health insurance. She will have a public option which she needs to get into, as others have said cancer treatment in Australia is excellent and not dependent on ability to pay. I find it hard to believe that she hasn’t been made aware of her options but she should contact one of the cancer charities who would be able to help advise.

Having said that I know from experience that if you find a treatment team you trust you may want to continue with them, that’s what happened to me and I did end up significantly out of pocket despite having top level private health insurance but I had a particularly rare and aggressive cancer so my options were were more limited than most.