Following routine surgery on 9 Dec last yr, I lodged a claim at Medicare for my anaesthetist’s fees. Two weeks later, I checked my online account and noticed that the claim had been processed. It’s now nearly the end of Jan and I STILL haven’t received the chq for the anaesthetist.
Contrast that with the situation of the surgeon, where I paid his fees myself UPFRONT prior to the surgery. I then lodged a claim with Medicare and in less than one week, the refund (a LAUGHABLE 20% of the total) was in my bank account.
So why does Medicare takes forever to issue a chq to the anaesthetist, but refunds PAID DIRECTLY to the patient/claimant are credited in under a week?
And how CONVOLUTED is this system? If you DON’T pay your med professional upfront but rather, wait for Medicare and your pvt health insurer to stump up first; this is the logistical nightmare you’re faced with:
- Submit your bill to Medicare together with the form
- Wait weeks and weeks for Medicare to send you the cheque for your med professional
- Send that chq to your med professional
- Wait for the revised bill from your med professional
- Submit the new bill PLUS Medicare statement plus another form, to your pvt health insurer
- Wait a few more weeks for your pvt health insurer to send you the chq for the med professional
- Forward that chq together with the balance to the med professional.
How much time and money is this costing everyone?
To be honest, I detest this scam of a health system of ours!
We pay “Medicare Levy” of 2% PLUS we pay huge pvt health insurance premiums (which are skyrocketing in leaps and bounds way above the rate of inflation) but (excluding hospitals) we STILL end up paying about 75% of our own med bills. And on top of that you now have to wait weeks for chqs to arrive, all the while being HARASSED by the doctors to pay their bills, which you can’t do anyway because you don’t know what your share is going to be!
Why can’t people like me just opt out of Medicare and negotiate a deal with a private health insurer to adequately cover all med bills?
No-one ever told me about a 2-way form, so for me it's always an unbelievably long, complicated and convoluted process to go thru to get a simple chq to the surgeon
and yes agreed, the health system in this country is a giant scam. The middle classes pay through the nose for their health care (and for everything else) while those who live on welfare get absolutely everything for free including all med treatments
I know someone who, through a lifetime of smoking, lost both his legs to gangrene. Had many diff ops to try and save his legs, But since he's lived on welfare for the past 6 or 7 yrs, he has never pd a cent for his med care and has spent prob 6 months in hospital
how we can ever get this country back on its feet financially when this is happening all the time?
the govt should get out of the health care system, except for providing v basic care for the destitute and those who simply cannot afford even basic pvt health. Whatever the govt touches, turns into a disaster
I agree with the poster who said that private health insurance is a misnomer and should really be called "hospital insurance" because that's all its good for,
but EVEN THEN, they scam you
for my recent surgery, I paid an "excess" of $150. Last time I had surgery in 2010, the "excess" was only $100, so they managed to wangle a 50% increase in the "excess" before I even realised it
Hallelujah!!
Just thought I'd let you all know that the chq from Medicare finally arrived today - for the laughable amount of $225 out of a total fee of $1,185 i.e. 18.9% of the tot anaesthetist fee.
OK so, I now have to:
1. Fwd the chq to my anaesthetist
2. Wait for a revised bill from my anaesthetist
3. Fwd the revised bill PLUS another form to my private "health" i.e. hospital insurer
4. Wait for that chq to arrive
5. Fwd that chq to my anaesthetist and wait for revised bill no 2
6. Pay the balance myself
My expectation is that the private health rebate will be about ONE THIRD of the Medicare rebate or $75, meaning that of my tot anaesthetist bill of 1185, I myself will pay 885 or 74.7% of the total!!
So for this I must pay close to $4K p.a. for private health insurance PLUS 2% of my taxable income to the govt for a "Medicare Levy"
Imagine if you had a car insurance pol that paid you 25% of yr claim, so if you had an accident and the damage bill was $6K, you would get back the princely sum of $1,500, leaving you out of pocket 4.5K AND to top it all you had to pay for TWO insurance pols
Now to the surgeon's fee, which you'll recall as I mentioned in my opening post, I PAID UPFRONT.
I received my refund pretty quickly from Medicare (again about 20% of the tot) but can't proceed to claim my refund from my private health insurer until I get a RECEIPT or REMITTANCE from Medicare. BUT there's no sign of that! So that claim is now in limbo while I wait a few more weeks for Medicare to send me the paperwork, because of course, my pvt health insurer will NOT pay out until Medicare have done so first, and they have the paperwork to prove it
And again, its the same rigmarole. Forms to Medicare, refund from Medicare, more forms to pvt health insurer until eventually I get a refund from them and then of course a claim on yr tax return for a med expense rebate
It's becoming a FULL-TIME job dealing with these med claims and I've had plenty of them the last 6 months
Is there any more convoluted, complicated and downright UNFAIR health system anywhere??
