How does Medicare work?
How do I pay my doctor?
Bulk billing
Bulk billing is when your doctor bills Medicare directly, accepting the Medicare benefits as full payment for a service. This means if your doctor bulk bills, you cannot be charged a booking fee, administration fee, a charge for bandages, record keeping or a charge by your doctor’s company.
Many doctors bulk bill some of their patients such as pensioners or health care cardholders. If your doctor bulk bills you will be asked to sign a completed form after the service and will be given a copy.
There are circumstances where more than one service can be provided at the same visit and your doctor is not required to bulk bill each service.
Accounts
If your doctor charges you a fee, you can:
- pay the account and then claim the benefit from Medicare
- claim your unpaid account from Medicare and receive a cheque made out in the doctor’s name which you give to your doctor along with any outstanding balance
Medicare usually pays:
- the full Schedule fee for GP services
- 85 per cent of the Schedule fee for other out-of-hospital services
- 75 per cent of the Schedule fee for in-hospital services
The Schedule fee is a fee for service set by the Australian Government and not what your doctor charges you.
Can I use Medicare while I’m overseas?
Medicare benefits are not available for treatment received overseas, however the Australian Government has signed Reciprocal Health Care Agreements with New Zealand, the United Kingdom, the Republic of Ireland, Sweden, the Netherlands, Finland, Italy, Malta and Norway.
Australia ’s Reciprocal Health Care Agreements with these countries cover any immediately necessary treatment you require. Visit Going Overseas for more details.
Last updated: 28 May, 2008