Health Guide

Should you go to the doctor, or the hospital emergency department?

There's a lot of confusion about when you should visit a doctor (GP), or call an ambulance to take you to the hospital emergency department.

Written by Editor Medibank

When you should see a GP

In Australia, the local doctor is called a General Practitioner (GP).  A GP should be your first point of contact for any non-emergency and general health problems.

A GP can help you by diagnosing and treating pain, diseases and other health issues. They can also help with mental health support, vaccines, referrals for tests or scans, managing and treating wounds, prescribe medication if required, as well as referring you to specialist doctors. Some GPs also specialise in women’s health.

How does Medibank help with your GP visit?

If you have Medibank overseas health cover, we’ll contribute to the cost of GP visits if out-of-hospital medical is included in your cover. Check your cover summary to see if your cover includes GP visits.

Medicare, the Australian public health system, sets a fee (known as the Medicare Benefits Schedule Fee, or MBS Fee) for GP visits. As long as it’s included in your cover, Medibank will pay at least 100% of the MBS Fee for GP visits. Most of the time you’ll have to pay the GP’s fee first, then claim the benefit for the MBS Fee back from us afterwards. If your GP charges more than the MBS Fee, you'll have to pay the difference, which means the amount you get back from us may be less than the amount you paid. This difference is called an out-of-pocket cost because it literally comes out of your own pocket.

For example, if you see a GP and are billed with item 23 (standard attendance lasting less than 20 minutes), the MBS fee is currently $38.75^. If your GP charges $50, you’ll get the MBS Fee of $38.75 back from Medibank, meaning your out-of-pocket cost will be $11.25.

If you hold Medibank’s OSHC (Overseas Student Health Cover), you can visit one of our Direct Billing Clinics or have one of our out of hours partners visit your home. These clinics have an agreement with Medibank to send the bill directly to us. Depending on the Doctor you see, you may on occasion experience an 'out-of-pocket' expense which is not covered by Medibank. Please ensure you confirm any 'out-of-pocket' expenses you may have to pay prior to your appointment by contacting the direct billing clinic. Remember to take your Medibank OSHC membership card and photo identification, such as your student ID card with you to your next appointment.

For Medibank OSHC you can find an OSHC Direct Billing clinic here.

For ahm OSHC you can find an OSHC Direct Billing clinic here.

^MBS fees are set by the Australian Government Department of Health, and are subject to change at any time without prior notice.

When you should call 000 for an ambulance

You should call 000 and ask for an ambulance if you, or someone nearby, are seriously injured or in need of urgent medical attention. If you’re not sure whether you or someone nearby is experiencing something that could be life-threatening, it is always best to call triple zero (000). You will be asked which service you require and you can tell the operator that you need an ambulance.

If you’re not confident speaking in English you can ask the operator for an interpreter. Just be aware this might add extra time.

Some examples of needing an ambulance can include:

  • Severe asthma attack or trouble breathing
  • Heart attack
  • Severe burn
  • Uncontrolled bleeding
  • Sudden collapse
  • A fall from a great height
  • Sudden onset of weakness or paralysis in the face, arm or leg.

When you should visit a hospital's emergency department (ED)

If you are seriously injured or in need of urgent medical attention, go to a hospital Emergency Department.

Some examples of needing to attend a hospital Emergency Department can include:

  • A major injury
  • An accident such as a broken bone
  • A heart attack / chest pain
  • Problems with breathing or bleeding not stopping
  • Severe pain
  • Loss of consciousness
  • Drug overdoses or poisoning 

It is important to note that turning up in an ambulance does not always mean you get treated sooner. The urgency and severity of your symptoms as assessed by the nursing and medical staff at the hospital will determine how quickly you will be seen. Sometimes you may have to wait a while if they do not consider you to require urgent medical attention. 

Ambulance - what is covered by Medibank?

Medibank OSHC products pay benefits towards unlimited emergency ambulance attendances and transportation to a hospital where immediate professional attention is required, and your medical condition is such that you couldn’t be transported any other way.

For more information on ambulance services call us on 134 148.

How you can use your cover to support you

If you hold Medibank’s OSHC (Overseas Student Health Cover), you have access to a 24/7 Student Health and Support Line for:

  • Medical assistance from a registered nurse
  • Counselling services
  • Emergency legal advice
  • Travel document assistance
  • Health system guide
  • Family and friends message service
  • Living in Australia support
  • Interpreter service

For Medibank OSHC call 1800 887 283.

For ahm OSHC call 1800 006 745.

Written by Editor Medibank

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