Depending on your individual situation and the frequency with which you require care, your medical expenses can accumulate as sure as the sun rises. Understanding Medicare and Pharmaceutical Benefits Scheme (PBS) thresholds is key to keeping these costs in check.
- Visit doctors who bulk bill so you are never out of pocket. If your doctor does not offer this service, retain your receipt for presentation at your local Medicare office. If applicable, you may receive cash back on a percentage of the costs.
- The Medicare Safety Net is the difference between the doctor’s charge and the Medicare rebate. The difference counts towards the eligibility threshold. For concession cardholders and Family Tax Benefit recipients, the threshold is $562.90. For all others the threshold is $1,126. Once the thresholds are reached the safety net covers 80% of the difference between the doctor’s charge (for non-inpatient services) and the Medicare rebate. Eligibility for the threshold lapses on 31 December each year and must be re-established from January 1 each year.
- If you need a lot of medicine in a calendar year, the PBS Safety Net helps you with the cost. Once you reach a safety net threshold you can apply for a PBS Safety Net card, which will mean your PBS medicine will be less expensive, or even free, for the rest of the calendar year.
- If you choose a more expensive brand of medicine, or if your doctor prescribes one, the extra amount you pay won’t count towards your Pharmaceutical Benefits Scheme (PBS) Safety Net. Ask your doctor for a generic medicine if available.
The current threshold for Concession cardholders is $336 and for all others is $1,317.20.
Other Medical Assistance
- Some ambulance services are provided free of charge to eligible pensioners holding a Health Care card. St John Ambulance provides a 50% concession for anyone holding a current Pensioner Concession Card from Centrelink.
- Life Support Rebates are available if you require medical equipment in your home that is necessary to sustain your life, such as: home dialysis, respirator, oxygen concentrator, and external heart pump machine. The Life Support Rebate is additional to any pensioner rebate to which you may be entitled.
- BGF will assist eligible clients with payment of HIV medications.
- The Medicare Chronic Disease Dental scheme allows chronically ill people who are being managed by their GP, under an Enhanced Primary Care (EPC) plan, to access Medicare rebates for dental services. It is available for most services provided by a dentist, dental specialist or for dental prosthesis in private dental surgeries. Dental services covered include dental assessments, preventive services, extractions, fillings, restorative work and dentures.
- Eligible patients may access Medicare benefits of up to $4,250 in total over two consecutive calendar years for dental services. The primary purpose of the dental treatment must be to improve oral health or function. Medicare rebates will not be paid for dental services that are purely cosmetic in nature. The Federal Government are planning to remove this $4250 subsidy on December 31st 2011.
- Free dental assistance is available to eligible people through public dental clinics.