UNDERSTANDING HEALTHCARE AFTER TRANSITION
Discover the ins and outs of the Australian healthcare system as you transition from the Australian Defence Force. Learn about public and private healthcare services, from seeing a doctor and getting medication, to specialists and hospital care. We’ll unpack the complexities of the healthcare system.
UNDERSTANDING HEALTHCARE AFTER TRANSITION
Discover the ins and outs of the Australian healthcare system as you transition from the Australian Defence Force. Learn about public and private healthcare services, from seeing a doctor and getting medication, to specialists and hospital care. We’ll unpack the complexities of the healthcare system.
Healthcare after serving
During your time in service, Joint Health Command is your go-to-partner for managing your health. In life after service, DVA will be your primary partner for managing your liability accepted conditions. But beyond any DVA accepted conditions, who will look after the rest of your health needs?
The Australian healthcare system is a combination of both public (government-funded) and private healthcare services. This guide explains how they fit together, to help you understand how to navigate the civilian healthcare system after you leave the ADF.
Healthcare after serving
During your time in service, Joint Health Command is your go-to-partner for managing your health. In life after service, DVA will be your primary partner for managing your liability accepted conditions. But beyond any DVA accepted conditions, who will look after the rest of your health needs?
The Australian healthcare system is a combination of both public (government-funded) and private healthcare services. This guide explains how they fit together, to help you understand how to navigate the civilian healthcare system after you leave the ADF.
The Australian Healthcare System
The Australian healthcare system consists of many moving parts, but the four key services you are most likely to use are seeing a doctor, getting medication at a pharmacy, visiting healthcare specialists, and being treated in a hospital.
Doctor or 'GP'
Commonly called a General Practitioner or ‘GP,’ your local doctor is the most common starting place for using the Australian healthcare system.
Pharmacists
A pharmacist is also a healthcare provider and medication expert. Their role is to ensure your medications are safe and appropriate for your needs.
Specialists and Professionals
There are many healthcare specialists and professionals, including dentists, optometrists, dermatologists, psychiatrists, and more.
Public and Private Hospitals
Hospitals are an important part of the health system, providing a range of public and private healthcare services from emergency care to elective surgery.
Australians use these health services as needed, dependent on their health needs, conditions, and personal circumstances. Some may visit a pharmacy or doctor infrequently; some may have regular appointments with a doctor, specialists, or other health practitioners; others may go to hospital for tests, treatments, or surgeries.
The government pays for the cost of some of these services under the Medicare system (known as public healthcare services). The government also encourages Australians to hold private health insurance, which assists with the costs of using private healthcare services, in order to ease the burden on the public health system.
Seeing a Doctor
Your doctor (general practitioner, or GP) is usually the first person you go to if you have a health issue. They will decide whether you need to see another health professional and can refer you to a medical specialist if you need specialised care. They can also prescribe medication you need, which you get from the pharmacist.
GP’s coordinate your healthcare and can provide ongoing care throughout your life. Because your GP gets to know you and your health needs, they can provide care that is most suitable for you.
Who pays for the doctor?
If you have a Medicare card, the Government pays some or all the costs of seeing a doctor. By law, private health insurance does not offer cover for GP visits.
If your doctor offers ‘bulk billing’ this means Medicare will cover the full cost of your appointment and you won’t need to pay at all. If your doctor doesn’t bulk bill, and charges more than what Medicare covers, you’ll need to pay the out of pocket cost.
Sometimes doctors charge over and above the standard amount Medicare covers. The difference between what the doctor charges and what Medicare covers is an out-of-pocket gap that you’ll need to pay.
In this instance, your doctor can still make a claim with Medicare on your behalf for the standard consultation cost that Medicare covers, leaving you to pay only the gap. By law, this gap expense can’t be claimed back through either Medicare or Private Health Insurance.
So, when you make your appointment to see a doctor, ask if they bulk bill. If they don’t, you can ask what they charge. You can also ask them what you may get back from Medicare and what the gap is.
To see a GP, you need to be registered with Medicare and have a Medicare card. If you don’t already have one here’s how to register for a Medicare card.
Medication and Pharmacies
Often your GP will write you a prescription for medication that you’ll need to fill at the pharmacy. It is the role of the pharmacist to ensure civilians use and access medicines correctly and safely.
Pharmacists are responsible for the supply of medicines, ensuring that the medicines prescribed to patients are suitable by advising people about medicines, including how to take them, what reactions may occur and answering any questions.
You don’t always need a referral from your GP – a lot of medicines, tablets, ointments, creams, etc. are available from your pharmacist ‘over the counter.’
Who pays for medication?
The medicines available over the counter at your pharmacy, or even at a supermarket, generally treat minor conditions like headaches, hay fever, and rashes. You will have to pay the full cost for over-the-counter medicines, and they can’t be claimed back through either Medicare or Private Health Insurance.
Your doctor may recommend stronger medicines, such as antibiotics or strong painkillers, and will write you a prescription for these to take to the pharmacist. Some prescription medicines can cost a lot of money, so to make these medicines more affordable, the Government provides the Pharmaceutical Benefits Scheme (PBS).
The PBS offers reduced cost for PBS prescription medicines, making them cheaper to buy, but you’ll also need your Medicare card to access them. The PBS does not subsidise all medicines, so any medications that are not part of the scheme can’t be claimed back through Medicare, but may be claimable through Private Health Insurance. It’s best to call and speak to us about what medication is claimable under Navy Health private health insurance.
Specialists and Allied Health Professionals
A specialist is a medical doctor who is an expert in a specific area of health or medicine. To see a specialist, you will need to get a letter of referral from your GP first. Specialists work in clinics, and in both private and public hospitals. The most common specialist roles are dermatologists, cardiologists, gynaecologists, obstetricians, oncologists, paediatricians, and psychiatrists.
An allied health professional is a trained professional in a specific area of healthcare who works as part of your healthcare team, such as a dentist, physiotherapist, optometrist, dietitian, osteopath, speech pathologist, chiropractor, or podiatrist. It’s also common for your GP to recommend you see an allied health professional, although you don’t need a referral.
Who pays for these services?
The fee to see a specialist or allied health professional can vary from hundreds to thousands of dollars and depends on whether you receive these services in a public hospital, or if you access them at a private clinic or private hospital.
All civilians with a Medicare card are entitled to free treatment in a public hospital. You can choose to visit a private hospital as a private patient when being treated by a specialist. In this case you will need to pay their fees. These fees are split between Medicare, who pays a portion of the total fee, and you. however, if you choose to hold private health insurance you can be reimbursed for some or all of the remainder of these fees depending on your cover.
If you have a chronic health condition or require mental health support, you may be eligible for some allied health services as part of a treatment plan, that are partly or fully paid by Medicare. Speak to your doctor to see if this applies to you.
Private and Public Hospitals
Everyone with a Medicare card is entitled to free treatment in a public hospital. A public hospital is also where you are more than likely to be taken in the event of an emergency.
Aside from emergency, there are many reasons why you may end up in either a private or public hospital including, to have surgery, for childbirth, to receive special medication, or for other treatments prescribed by your doctor. People with serious illnesses or injuries, or chronic disease conditions may have to stay in hospital for weeks, months, or even longer.
While treatment in a public hospital may be free, Australia’s public hospitals are dealing with a number of pressing challenges. As the population grows, and as rates of chronic diseases (such as heart disease and diabetes) rise, demand for hospital services has increased. As a result, the public hospital system is under a lot of pressure, with waiting times for elective surgeries having blown out to years in some cases.
To avoid this, the alternative is to seek care through a private hospital, and there are roughly the same number of private hospitals available in Australia as there are public hospitals. In a private hospital you can choose your own doctors and specialists, you will have shorter wait time for planned surgery, and subject to availability you may get to enjoy having your own room.
Who pays for hospital services?
If you have a Medicare card, you are entitled to free treatment in a public hospital. In a private hospital, you will need to pay the fees, which is why people take out private health insurance.
Different private health insurance policies cover different services for a private hospital stay. So, it’s important to find out what your policy covers and whether you need to pay anything if you choose to go to a private hospital.
It’s best to call and speak to us about what is and isn’t covered, or you can look here at what’s covered under Navy Health’s Hospital Covers.