Curious as an OzBargainer what do you do to avoid gaps?
Getting hard for me to find one now since my local GP is charging a gap of $20. I found one that still bulk bills but took me a while to switch. Bad reviews on google but so far ok based on my last few appointments.
How about you?
my GP charges me $70 and I get ~43 back on medicare. So I guess the gap is around $37
my GP charges me $70 and I get ~43 back on medicare
Same for my GP but your guess is a bit off
I guess that's why they're MrThing and not MrMaths. FFS.
$90, and $43 back
Wow $53 gap alot. Ive never seen a GP go over a $40 gap.
mine is at least this… I think it may have been more like $90 now last visit so $47 gap
Why are you paying so much, get a cheaper plan?
According to this
https://www.choice.com.au/money/insurance/health/articles/ch…
The cheapest bare-bones plan in Victoria is $1214 per year - my plan is about $600 more expensive than that but I get the extra cost back because the yearly optical and dental extras are worth around $400 and then there's better coverage for everything else, just in case I need it.
Every health insurance policy starts off with a $1200 sunk cost, unfortunately.
I feel like paying a 50% premium on the cheapest possible option negates your statement than you neither 'need nor want' your policy.
Eg Medibank Basic Everyday Starter is $1250 and gives you a pair fo $249 glasses from specsavers and a free dental check up on top of 60% back on a rubdown or back crack.
Also if you get good at gaming their points platform you can get some new airpods or a watch every year
@6079 Smith: The price you've quoted for Medibank Basic includes the rebate, which doesn't apply to everyone. Without the rebate it's $1,700 per year. And is similar to the plan that I've got.
Ive started churning and burning, generally can get 18 weeks free doing this plus gift cards
If you don't want the cover then simply cancel the policy.
Well you can't because you get charged it in tax instead and a 10 year loading can apply if you don't have it
You're still not forced to have private health. You can choose to pay that money to an entity that isn't trying to rort the system.
"I mean nobody is forcing you to pay for health insurance, you've just made a decision to buy it because it might be financially beneficial for you (in which case you do want it). "
Charging a 1.5% taxable income penalty is effectively forcing someone. Unless you really want to be a pedant and say that I could just choose to not have PHI and pay a lot more tax.
I have been looking at PHI this year as this was the first year as a family we went over the income threshold. For us the saving in tax would be about the same cost as getting PHI so not really beneficial for us unless we claim a lot back.
@onetwothreefour: If it's about net even then beneficial as you could avoid additional lifetime health loading.
Something to consider when running the sums
@futureminime: But also lifetime isn't lifetime, it's 10 years. There's practically no circumstance where you're better off taking out health insurance to avoid lifetime loading.
@Bren20: You are correct, mostly. Not many cases when it's a determining factor on its own, but should be added to the Estimated Value of the Buy case when assessing if private health insurance is cost effective for a situation. That's why I said if it's about net even.
Consecutive 10 years when the increase of 2% per year, ignoring increases in premiums above inflation/time value of money by paying the 20% over 10 years, is a 20% extra cost vs 100% saved by not getting it.
Side note is "If you cancel your private patient hospital cover after paying for the LHC loading for 10 continuous years, you may become liable to pay the LHC loading again if you take out another private patient hospital cover later."
Probably unlikely to affect that many people, as long as you're aware.
The cases where it can be worthwhile is when you believe you will be using the hospital cover, or will be wanting to take out a high level of hospital cover in the near future. E.g. the 100% of the low premium may be cheaper than the +20% of the higher premium.
May be useful if you're planning a family, or getting older/have health conditions and want to smash out the LHL while you may have some minor issues but the chance of major issues is lower so you can get higher cover later without the loading.
So yeah, very few cases.
It's not a tax penalty. It's charging those who have the means to contribute more to the system. No one is forced into private health cover.
@Orion au: $90,000 doesnt mean you have the means to contribute more. A $90,000 salary is a struggle to service a loan for a modest apartment.
@worrierwan: Yes, whilst I agree that house prices and the cost of living has gotten out of hand so that the scenario you introduce is true, you still have more to contribute than someone on 60k who doesn't hit the threshold.
Perhaps the real problem now is that the threshold is too low given where we are at.
Correct. The Medicare levy tax surcharge, 90k and above, hasn’t moved so inflation (cpi wage growth) catches more and more tax payers in it. So effectively you’re just transferring the money from government coffers to private shareholders if you get basic level PHI, which gives you nothing anyway.
@Vomo: Call me naive, but when that's your choice, I'd rather give it to the government than shareholders so perhaps it might contribute to a better health system and helping others.
So if you get private health insurance it means you pay less tax? On what income brackets is it worth it?
You are not forced to pay for voluntary private health premiums. They just offer various financial incentives/penalties for not having this if you meet certain scenarios.
I think Australians have no idea how spoiled they are to have a medical system that provides fairly priced GP services and free public hospital services.
Compared to…. America? Africa? South America? China? In that case, I agree.
Even the UK tbh. The NHS is wonderful but their right wing keep stripping it year after year and there's very little private to offload it. We've got a good mix of public and private here with enough standard setting by the public system to keep the private costs to the consumer down. America is the reverse, private monopolies and virtually nonexistent public.
The NHS is nowhere near as good as it is made out to be. Very good for emergency, but that's about it.
Yes. My point is, ours suck and we are not "spoilt", though sucks less than a selected others.
It's not spoiled. Whitlam's Medibank vision, which became reality in his first term of govt, was that all Aust citizens would be entitled to access free medical care. Private insurance was available for those who wished to choose their surgeon or specialist, but all GP consultations were free. This was a right, not a privilege. It is only through the wilful neglect of successive govts of both stripes that this right has been undermined to the point now where it has been pretty well lost. And why the wilful neglect? Because govts didn't want to allot budget to maintaining the standard of medical care we all took for granted. Their priorities have changed without formal acknowledgement or announcement to the electorate. And people like you have not only swallowed the new normal without protest, but consider we are "spoiled."
What's spoiled is the tremendous medical system we had. A curse on both the major parties for their role in destroying what we took as a given.
And people like you have not only swallowed the new normal without protest, but consider we are "spoiled."
Mate I'm saying that we are NOT spoiled… I'm providing a counterargument to the OP.
I'm forced to pay $1800
No one has forced you. It is your choice
If I don't take out the policy I pay a lot more in tax, for nothing in return. Do you consider that a good choice?
That selfish prick attitude is exactly why this country has gotten this bad
@[Deactivated]: So it's selfish for me to choose to take out a $1800 a year private health policy instead of paying $5,500 a year in penalty tax
Meanwhile people who happily get Medicare for free and pay nothing into the system are presumably not selfish in your book.
What a shit take.
@justworld: $1800 is including extras i believe?
So really the amount that you are "forced" to pay is less than $1800
i was forced to be born. i did not have a choice
Exactly, we pay about $3500/year for family private health insurance but it's completely useless. Especially when you read through it and find out that they always go through medicare first, they only cover what medicare won't and even then it's extremely limited, what a scam. I never pay for a gap but I only see the doctor about once a year just to get a refill on a basic prescription. 99% of my visit (as well as my parents) to all doctors (specialists included) have been completely useless in my experience, they have yet to come up with a solution that webMD couldn't have.
My GP stopped bulk billing a while back. I switched to another GP in the same clinic who still bulk bills and she is just as good. It's a bit strange to have some GPs bulk bill and some don't in the same clinic.
I have been having private health insurance for the last 30+ years. I had my RARP (Robot Assisted Radical Prostatectomy) 3 years ago for $9500, with $414.50 rebate from private health. A friend from overseas did the same RARP this year and it cost him $6000 for the surgery. Both surgeries were done at Epworth but with different surgeons, it puzzles me why someone with private health insurance had to pay so much more out of pocket than a foreigner.
I think Australians have no idea how spoiled they are to have a medical system that provides fairly priced GP services and free public hospital services.
That utterly disappointing attitude of "we are receiving sooo much" brings high medical charges, brings co$tly everything.
Virtually all countries with high paying taxes will offer medical and other social services (including education) without charges.
Tax collection should be to pay for services to the community and NOT politicians perks.
My GP charges $40, no matter how long the appointment is, and nothing for follow up visits (test results, scheduled check in etc)
That is a good approach. When do you consider a visit a follow up or an entirely new case? Appointments can get rushed too as medicare sets the duration on std and long appointment. GPs tend to be quick to not get questioned.
Maybe you could create a poll so you have a good idea of the spread. In all honesty I don’t know what gap I’m paying however I have a brilliant GP and I can afford the money. When it comes to my health I’m willing to pay that bit extra.
Standard consultation, Pay $96.42, Rebate $42.85, Out of pocket $53.57. I’m in a regional area, no bulk billing available.
This.
We had bulk billing, but now pay a gap (around $35). We now usually get in within minutes of the appointed time and the waiting room is not crowded. I don't mind a gap if it prevents an over-crowded waiting room, but the system needs fixing.
In Vic and I haven't found anywhere that bulk bills and is good.
If you're in a bulk billing place feels like you're in a big factory. They want you in and out in 5-10 minutes. Will prescribe you stuff pretty easily (even if they shouldn't), but it's not a very good experience for the places I've seen like that.
Otherwise atm I pay $55 gap and thought that was on the lower end.
Sometimes I appreciate the 5-10minute sessions though. Like a routine check for instance. You pay a gap to request for blood work, then return for the result. That is already 2 payments, before thats fully covered. I don't see any cost in that apart from professional advise.
Get a telehealth appointment for the results, they have to be bulk billed
no they don't
No doctors are required to bulk-bill anything they do, unless they specifically decide to publicly advertise they will, or work for a bulk-billing organisation.
The vast majority of medical professionals and GP's don't bulk-bill at all.
As someone whose doctor definitely does not bulk bill telehealth, no they don't have to be bulk billed.
7 Minutes is a standard length for a single-issue GP consult.
A "double consult" is a consult 15-20min in length regarding more than one medical issue, but will be charged a rate usually proportional to a doc's time, based on that baseline level of a 7 minute consult.
What's a double??
Standard consult
https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=2…
https://medicalcostsfinder.health.gov.au/services/G23/oh?ter…
"lasting at least 6 minutes and less than 20 minutes"
Long consult
https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=3…
https://medicalcostsfinder.health.gov.au/services/G36/oh?ter…
"lasting at least 20 minutes"
Extended consult
https://www9.health.gov.au/mbs/search.cfm?q=44&sopt=I
https://medicalcostsfinder.health.gov.au/services/G44/oh?ter…
"lasting at least 40 minutes "
What's a double??
It's literally what I said it was.
You linked to nothing but the bulk-billing codes and what doc's can bill the government for in terms of specific medicare-related incentives.
My comment explained how a non bulk-billing or mix-billing GP charges (which is how the vast majority of doctors do business in Australia).
Inside a GP practice, staff don't refer to consults based on government billing titles, as that forms only one part of a total bill for a consult.
Bulk billed
Care to share more details? Situation, area, history with GP?
Staff discount basically.
Another aspect you should consider about why there's less bulk billing practices is the cost. Doctors are on all sorts of different agreements where many take home 70% of the billings. With the rest left to pay the wages for the practice manager, administration staff, nurses, the supplies for the doctors/nurses, administration related costs, infrastructure like power, IT, rates, water, rent, insurance, accreditation and every other cost associated with the business.
Now if the practice has trouble employing doctors they'll need a locum doctor and it's near impossible to make profit when you have one of those. A locum can easily make $250 an hour and depending on the circumstances (rural practices especially) that price can be even higher. You'll find that a lot of regional hospitals employ locum doctors and that's a whole different can of worms.
It certainly doesn't help when Medicare are always changing the rules about what item numbers can be used with what. It's not uncommon for a practice to be using different item numbers together (particularly in chronic disease management), getting it approved and paid out by Medicare only to discover later it was an "administration error" and now they need to pay it back. Do they chase payment up with the patients or accept the loss?
Obviously pay rates vary between practice and location before someone tries to tell me I'm wrong (I'm generalising), but it does help explain why there's less bulk billing practices and why a lot of GPs would like to see the Medicare rebates increased.
yeah I've seen some fuzzy goings on with item numbers so wonder how many 'higher earning' item numbers get used when the more exact item number may not have paid so much …
@Hangryuman: It's so easy to make mistakes when one person at Medicare says "what you're doing is fine" and then when you send off the batching it gets rejected. I know there is one person in Medicare who is notorious for rejecting a lot of payments. They know the ins and outs of every item number.
I'm paying a $27 gap, for around the last 18 months now. On one level I resent paying a gap as I believe medicare represents one of the best uses of the tax I pay. However I understand why GPs are doing this, after years of years of having medicare rebates frozen.
I'm lucky in that I can afford to pay; judging by the thinning waiting room crowds at the little local medical centre, the move towards 'user-pays' medical has stopped folks visiting for things they may have before. And I have the feeling the medical centre might be 'drumming up' some business while demand recovers. One one hand that translates to a more attentive approach to health (can't complain there), but at a cost of some additional visits I didn't think were needed (or wouldn't have questioned if it was fully bulk-billed)… feels a bit like a slide to US-style pay-for-use medical.
I'm on that boat now. I feel the medicare system should fix it and not people finding ways to fix it themselves, so I try to find a place where bulk billing is still available.
There's more to it though, I think. I feel the clinics are too easy in using disposable materials. All related to other industries in service.
I pay a gap of maybe $35-45 or so.
I'm happy to do so for similar reasons mentioned by others.
I'm also a big believer in some kind of co-pay for everything as people don't value free things well (i.e. people tend to overuse free things) - but that might just be my economist hat coming out.
Agree, people definitely think twice if there is a co-payment.
My GP co-payment is about 37 for a 10min and I think 60 for 20min.
The bigger issue is that it now takes 3+ weeks to get an appointment, almost 4 weeks, 2 years ago it was 2 weeks, and before COVID it was about a week.
I've pretty much told her to marry me because that's the only way to keep up to date on my health 🤨
I feel better solution will be first 5 attendances in a year should be gap and next 5 with $30 gap payment and next $5 with $60 gap payment and so on. This way people who seldom falls sick still can get treatment and people who rot the system can wisely think about how often they want to visit for simple ailments.
Bad reviews on google
Because they wouldn't do what they asked when shopping for prescriptions?
Medicine is even worse than cars. Everyone is an expert.
Mostly complaints on how they do appointments on the app. Being bumped out of the queue because they went somewhere else while waiting, grumpy receptionist. Nothing really related to what service they came for.
I'm still bulk billed. The doctor we saw for the kids in the same medical centre started charging a gap fee.
A relatives doctor had a $75 gap fee an a long consult. While looking for doctors more local to them, many had a gap fee of between $30 and $50. In some cases, there was a note that existing patient remained bulk billed.
my doctor depends how he feels.. If he's in a nice mood, he'll bulk bill but if he's in a bad mood, it's $35 out of pocket
Ikr. This triggers me. The receptionist at my GP even told me how some are not willing to pay the gap when they are earning a lot. I stopped myself from lecturing her. I can go on with the details but its irrelevant.
What's wrong with a GP requesting you to pay a gap? A GP clinic bulk billing on Medicare only earns $43 per 15 minutes which is less than what a plumber would charge you for his services.
@May4th: Now that drs reckon they can do thier job over the phone, that seems to be the direction we're heading.
A plumber doesn't have customers line up and wait for thier service.
A bulk-billing GP's tax return would show far more income than a plumber's, and is sufficient IMO.
I'm quite happy for drs to charge more, but I won't be using thier services so long as bulkbilling exists.
@SlickMick: depends on how good/business savvy your plumber is, your plumber also may not be paying tax whereas your GP does. at the end of the day it's supply and demand, and not everyone has access to BB GPs, and it looks like it will increasingly be the exception rather than the norm given the chronic underfunding
@SlickMick: your $200 callout fee for a plumber is often covering the hour each way they have to drive to come to your home - sometimes 1.5 hours each way in peak traffic which is why they may prefer to come at 7am
$0 gap and I haven't needed a GP in years. Most things can be sorted out by yourself. Only reason to visit a GP is to occassionally access their gate-keeping service to get through to another doctor who actually does stuff or to get a scan or blood test.
Use Google to find bulk billing GP's in your area
Any GP's deal that I can post :)
Mine has a gap, I think around $30. Bulk billed for follow up. He also does some tests to make it a check up once per year when going in for something else, doing blood tests and a few other general checks, and will bulk bill that, I guess he can bill Medicare a bit more for that. Mental health care plan and some other things are bulk billed, but I haven't gotten around to doing that like I should have.
I tend not to go to the GP until I really need it, at which point I'm usually willing to pay a gap to avoid waiting 3 days or whatever for an appointment.
My local practice used to bulk bill everyone. Then it introduced gap payments for most patients. Not me, I've got a concession card. Now they're not accepting new patients at all. So I'd like to switch GPs to see if I could find someone more competent - she's a nice person but she isn't solving any of my medical problems - and who I didn't have to book 3-4 weeks ahead to see, but I couldn't get in elsewhere if I tried.
I have to say, I warned people years ago this would happen. They said we've got a shortage of doctors, so lets open the immigration doors wide open to any who want to come here. They said immigration will solve the problem. I said that isn't what happens with immigration. What will happen is that Australian kids will see that they have to compete against people from poorer countries who are willing to work for lower wages, and they'll choose another occupation. And that's exactly the situation we've ended up with with GPs. These days only 15% of Australian medical students choose to be GPs. That's why we've got a shortage of GPs.
But, hey, no problem. Recent research compared the performance of GPs, with GPs with AI assistance, with AIs without any supervising GP. Having an AI to help them diagnose helped a bit. But the AI won easily. Bring on AI GPs.
https://www.theguardian.com/commentisfree/2024/nov/30/if-ai-…
These days only 15% of Australian medical students choose to be GPs.
It is hardly a free and open market! Doctors generally have high pay, high job security and high status. So there are at least 20 applicants for every medical school place. Those select few who get through the admissions process tend to be highly competitive and ambitious. Dux of their school. So of course they want to get into the top specialities.
Right now we two streams: Medical/Surgical and Dental. If a third degree type was added, for GP, it too would be inundated with quality applicants. Including those not from recent immigrant families.
AI diagnosis is great, but good luck getting the AMA to cooperate. AI needs lots of data, and the vested interests are very protective of their data. Also, the privacy problem, real or perceived.
I like your train of thought. They are indeed connected and kids these days prefer to exit early at school and do trades.
The AI helps to cut the beaurocracy in the system, just my observation.
My family doctor has always bulk billed though there is a wait each time of around 30-45 mins to see a doctor since the clinic is popular. Sometimes I go to one of the big clinics that charges an $80 gap but it's instant, no wait.
I think Australians have no idea how spoiled they are to have a medical system that provides fairly priced GP services and free public hospital services.
Meanwhile, I'm forced to pay $1800 a year in private health premiums for coverage that I neither need nor want.