MEDICAL EXPENSES - TIPS
I wish someone had told me beforehand, but I found out the hard way! As far as tests go (not surgeries), if you need any tests whatsoever, xRays, ultrasounds, bloodwork, bone scans, brain scans or MRI's, book them for when you are an IN-PATIENT as they are 100% covered. So ask your GP/Oncologist if there are any tests/scans that can be done whilst you're an in-patient because you will save yourself megabucks. Ideal time to get your cholesterol checked for free! Kath
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So if I am a private patient and go for these tests not as an inpatient in hospital , I have to pay?. I go to my oncologist on Wednesday.Well maybe if I have to have tests I will ask her to book me into hospital,.Wonder what she will say?. Realy stinks when you pay top cover. Glad we have you to give us advice, as I do not know anything. Debbie
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Hi Jen, it must be a state thing, I'm in Victoria. My Oncologist makes it a point of scheduling tests for when I am an in-patient so I'm not out of pocket. Surgery out of pocket - that's another story and yes, it's a disgrace! Kath.
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I've learned to be assertive and simply ask the question. When you go to your Oncologist on Wednesday, mention your medical expenses are becoming an issue and can he/she bulk bill you? If you need to have any tests, ask to have them done at a facility that could bulk bill you. I always ask now and have never been denied. Kath x
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Thanks I live in N.S.W. I will make sure I ask. Debbie.
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My experience so far - I'm in Victoria is that there can still be a Gap while an inpatient in a Private Hospital - for me this has been for Pharmacy and Pathology though I had reached a limit on my pathology that meant my gap was capped. with my pathology - the health fund and medicare co-contributed and I paid a Gap.
My understanding though was that inpatient Gap expenses did not contribute to the Medicare Safety Net while Outpatient gaps did. Once you reach the safety net - I think you are guaranteed to get 80% of the out of pockets back but only for out of hospital expenses.
http://www.medicareaustralia.gov.au/public/services/msn/index.jsp
I have not had any of my imaging tests as an inpatient so I am not sure about that. It does help though to use the one provider because within a certain timeframe (not sure what) it may be classed as the same "episode" and the costs start to reduce.
I have a literal box with about 8 separate folders to manage the billing and paying - awaiting medicare cheques, MBF cheques, paying Gaps etc... I am still waiting on a Medicare cheque for my pathology from my surgery.
My tip - Copy all of your invoices. If you submit to Medicare and do a dual claim they take the invoice and you have no record of your charges and out of pockets - also they get lost!
Amanda xx
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Definitely get them done in hospital if you can! I had to have an MRI on my liver as a shadow was found when I had my initial CT scan. Medicare didn't cover any of it as it was done as an outpatient and for some weird reason they don't pay for these types of scans if you have already had a BC diagnosis!! It cost me $440. If I had had it done as an inpatient I may have been able to claim some or all of it through my health fund.
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By the way, make sure that you keep track of your out-of-pocket expenses for each financial year (I'm a chartered accountant!). If you spend more than $2,000 you can claim a rebate of 20% of the excess on your tax return at the end of the year. Unfortunately the threshold increased to $2,000 this year - it used to be $1,500! You can include all of your out-of-pocket hospital, specialists, pathology, radiology, prescriptions (not over the counter chemist items though), and doctors bills. Also optical and dental. It doesn't include any cosmetic procedures or natural therapies though. Reconstructions are not considered to be cosmetic for the purposes of the rebate.
Hope this helps
Louise x
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By the way, make sure that you keep track of your out-of-pocket expenses for each financial year (I'm a chartered accountant!). If you spend more than $2,000 you can claim a rebate of 20% of the excess on your tax return at the end of the year. Unfortunately the threshold increased to $2,000 this year - it used to be $1,500! You can include all of your out-of-pocket hospital, specialists, pathology, radiology, prescriptions (not over the counter chemist items though), and doctors bills. Also optical and dental. It doesn't include any cosmetic procedures or natural therapies though. Reconstructions are not considered to be cosmetic for the purposes of the rebate.
Hope this helps
Louise x
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HI
have read the blogs here and can't believe that you have had to pay for scans tests etc. I had every thing from the biopsy to the Nuclear med injection, bone scan, bone density scan and CT scan done without parting with a cent! The hospital I was seen at has an arrangement I presume to have the various places to bulk bill the hospital (my treatment was all done in public system) all as an outpatient. I did have to pay the threshold of $33.30 for the chemo drugs and anti-nausea meds but was not thousands out of pocket. I am also seen privately by my surgeon but he bulk bills so again don't have to pay. Why is it all so different? It seems unfair for people to have to pay when others are not.
Sarah
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I am guessing that there is also a Public v Private issue here too? Can anyone shed any light?
I had my Mammo, US, Biopsy, CT, Bone Scan done as an outpatient at MIA (Medical Imaging Australia) - by the time my bone scan was invoiced it was Gap- free as I had reached a threshold set by MIA (I spent 30mins at Medicare this morning trying to work out all of the invoices)
I am interested if this is just imaging or pathology as well. My Gap for my inpatient pathology was nearly $300 none of which contributes to my Gap benefit for Medicare as I was an inpatient - this had already been reduced by the pathology company as I had reached their out of pocket limit.
It is all very confusing. :-)
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Do you live in N.S.W.?. Thanks for the info. Go to my Oncologist Wednesday , hope she can give me some answes on it. Debbie
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Hi all,
I am through the private system in NSW and have been lucky to have had my tests / scans etc bulk billed. When your specialist suggest these tests ask if they can send you to places that bulk bill. Also some private imaging places bulk bill if you are an oncology patient and if you are on a health care card from centrelink they will usually bulk bill as well (worth looking into getting this card as comes in handy for medications etc).
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Hi all,
I am through the private system in NSW and have been lucky to have had my tests / scans etc bulk billed. When your specialist suggest these tests ask if they can send you to places that bulk bill. Also some private imaging places bulk bill if you are an oncology patient and if you are on a health care card from centrelink they will usually bulk bill as well (worth looking into getting this card as comes in handy for medications etc).
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Hi Louise, exact same for me. Couldn't believe I had a $440 scan that saw me out of pocket 100%. I was so furious I wrote to my local Member of Parliament and disappointingly never got a reply. I now know had this scan been done whilst an inpatient (in Victoria), it wouldn't have cost me a cent. You live and learn.
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Hi Louse, me again. I knew you could claim your out of pocket medical expenses as my Accountant claimed mine last year (in excess of $21K out of pocket). I just assumed reconstruction would be considered cosmetic, now that I know otherwise, I'll get all my reconstruction bills out for this years tax return. Great tip, thanks.
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