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

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

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.

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

Thanks I live in N.S.W. I will make sure I ask. Debbie.

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

MEDICAL EXPENSES - TIPS | BCNA Online Network

24 Replies

Em
Member
15 years ago
Thanks for the tip Leonie, I have not used dental as I have extras cover, but I do remember someone telling me there is a list of what can and can't be done etc. I have had an EPC for physio and that was straight forward, so comes in handy if you have maxed your extras out or don't have cover x
Em
Member
15 years ago
Hey Debbie, you go and see your GP and ask for an EPC plan for dental. They write one out not to sure about the rest but your GP should know a bit more. Sorry I don't know anymore but I hope some of this info helps x
Debbie_J
Member
15 years ago
How does it work with the dental side, what do you have to do?. Debbie
Em
Member
15 years ago
Ladies I forgot to mention about the Enhanced Primary Care program through medicare. It is for people with chronic illnesses and cancer comes under the program. What it is, is you go to your GP and ask for an EPC for instance for physio. The GP writes it out and you take it to your physio and are able to claim like 6 visits at Medicare (physio is not covered by Medicare but under this program it is). You can also get dental covered you get like $4,000 over 2 yrs to spend on dental work.

Hope this info helps!
Em
Member
15 years ago
It is means tested in a way, it is based on how much you and your partner have earn't in the past 8 weeks (including bank interest etc) it is very much worth looking in to!
Dot42
Member
15 years ago
Hi I live in WA. When I was told by my private health fund, that I face huge out of pocket expenses. I decided to go public when my diagnosing doctor told me that everything is completely covered by public hospital. (Plus the public hospital is also where my mother was diagnosed with breast cancer).

I am so glad I went public, I asked to be treated as a public patient. I have not had to pay for any MRI, Brain Cat scans, ultrasounds, and other tests, chemotherapy, operations and reconstructions. Plus in my hospital, breast cancer patients having masectomy had a private room. I had tissue expanders put in straight away. Now waiting for my next operation to have the silicone implants put in. No doubt I have to wait for this next operation. I only just been put on the list because of other complications of mine but it only a few months wait. I am having the operation in July. Well worth the wait. The money I saved from not going private, I am now going to use on my family's first overseas holiday with my hubby and 4 kids.

So now I am considering cancelling my private health. Whats the point if it can't help me when I need it. Plus maybe then I can afford more holidays. lol. Decided since having breast cancer, I want to take more holidays with my family.

Dot
Dot42
Member
15 years ago
Hi I live in WA. When I was told by my private health fund, that I face huge out of pocket expenses. I decided to go public when my diagnosing doctor told me that everything is completely covered by public hospital. (Plus the public hospital is also where my mother was diagnosed with breast cancer).

I am so glad I went public, I asked to be treated as a public patient. I have not had to pay for any MRI, Brain Cat scans, ultrasounds, and other tests, chemotherapy, operations and reconstructions. Plus in my hospital, breast cancer patients having masectomy had a private room. I had tissue expanders put in straight away. Now waiting for my next operation to have the silicone implants put in. No doubt I have to wait for this next operation. I only just been put on the list because of other complications of mine but it only a few months wait. I am having the operation in July. Well worth the wait. The money I saved from not going private, I am now going to use on my family's first overseas holiday with my hubby and 4 kids.

So now I am considering cancelling my private health. Whats the point if it can't help me when I need it. Plus maybe then I can afford more holidays. lol. Decided since having breast cancer, I want to take more holidays with my family.

Dot
jennywren
Member
15 years ago
Interesting comments girls, especially regarding the healthcare card. Is it means tested? I always believed it was and that I therefore wouldn't qualify, so I would be interested to know.

Hope everyone has a nice Easter x
Kath_Perrin
Member
15 years ago
Hi Em, can't agree with you more. Everywhere I go and everyone I see I now automatically ask to be bulk-billed or be referred to someone who will. Re Health Care Card, unfortuntely I didn't find out about this until after my surgeries and well into my treatment. I simply picked up the phone, called Centrelink and asked if I was entitled to have one and I was! Ask a family member to help you with the paperwork.
Kath_Perrin
Member
15 years ago
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.