Minor illnesses, such as a coughs, colds or sore throats, can be treated with over-the-counter medicine from a pharmacy, but there are times when you may need medical attention.
If you or someone you’re with is seriously injured or in need of urgent medical help, call Triple Zero (000). If you’re sick, but it’s not a life-threatening emergency and you do not require immediate medical attention, your first stop should be to see a GP.
What’s a GP?
In Australia, the local doctor is called a GP, or a General Practitioner. GPs treat minor medical issues such as stomach aches, fevers, diarrhoea and provide prescriptions for medicine.
GPs can also refer you for x-rays, blood tests or, if your illness needs further treatment, can refer you to a specialist doctor.
Where can I find a GP?
GPs can have their own independent practice, or be part of a larger group of medical practitioners in a medical centre.
You can search for a GP near you at www.healthdirect.gov.au/australian-health-services
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, the MBS fee is $37.05. If your GP charges $50, you’ll get the MBS Fee of $37.05 back from Medibank, meaning your out-of-pocket cost will be $12.95.
It’s a good idea to ask your GP what your visit will cost beforehand, and to give Medibank a call to find out how much you’ll get back.
Can I get anything back for the cost of medicine?
Overseas Student Health Cover and Top 85 Working Visa Health Insurance include benefits for pharmaceuticals. This means if you have either of these covers, you can get help with some of the cost of prescription-only medication prescribed by a GP or specialist outside of hospital. Some medicines (like most oral contraceptives) are excluded, and you may have annual limits on how much you can claim, so it’s worth reading your cover summary and member guide to know exactly what’s included in your cover.
What about hospitals?
Hospitals are generally used for medical emergencies and for operations. In Australia, there are public hospitals (owned and run by state governments) and private hospitals. If it’s not an emergency, sometimes it can take a long time to be treated in the public hospital system, and you don’t always get to choose your doctor.
Medibank has partnerships with 475* private hospitals and day surgeries in Australia – called our Members’ Choice network – so you have greater choice in where to have your medical treatment. When you visit a Members’ Choice hospital you’ll generally get better value for money compared to a non-Members’ Choice private hospital, as long as the service you receive is covered by our agreement with the hospital and is included in your cover.
Medicare also sets an MBS Fee for hospital treatments by a doctor, surgeon or anaesthetist. Like with GP visits, you can claim back at least the equivalent of the MBS Fee from Medibank, if the service you’re getting is included in your policy.
If you need to go to hospital it’s best to call Medibank first. Contact us and we can help you though the whole process.
Find our more about Medibank’s range of overseas health cover options.
* As at October 2017