Medicare – The surprising benefits you might be missing

There are plenty of upsides to living in this sunburnt country, including (but not limited to) beachside mornings, superior coffee culture, gorgeous wildlife, and naturally, warehouse sausage sizzles. We’ve also got a not-so-little thing called Medicare.

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Australians have been benefiting from Medicare since 1984. Even amidst the release of Ghostbusters, Girls Just Want to Have Fun, and Purple Rain, the launch of Medicare was a big deal, establishing basic health care for all Australians. 

Nowadays, the Medicare Benefits Schedule has expanded far beyond its initial 2,300 items in the 80s. 

However, the stressors and distractions of modern parenthood can make many of its benefits fly over your head. 

So, if you’ve been too busy searching for missing socks, negotiating snacks, and fiddling with parental controls – here’s what you missed on Medicare.

 

The rundown on bulk billing

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Bulk billing is likely a familiar phrase to you. When your doctor bulk bills, with your permission, they send the claim directly to Medicare. This means you don’t need to pay anything at the time of your visit, and there are no out-of-pocket costs.

Bulk billing can cover visits to GPs and specialists, tests and scans like x-rays and pathology tests, and eye tests performed by optometrists.

This service is offered at your GP or specialist’s discretion and not all practices do it. 

However, there are incentives for GPs to bulk bill concession card holders and children under 16, so practitioners are more encouraged to bulk bill these groups.

You can also find bulk billing only GPs by visiting the Healthdirect website.

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Affordable mental health services

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Mental health is intrinsic to family life. Whether it be the emotional highs and lows of postpartum, teaching your toddler emotional intelligence, or wondering if there’s more going on with your tween besides simple ‘hormonal changes.’

It can be a tricky cycle because to care for your child’s mental health, you need to care for your own too. What is it they say about pouring from an empty cup?

Whilst mental health services often come with a sharp price tag, there are ways to make them more affordable with Medicare. 

There’s a growing network of Medicare Mental Health Centres that offer free, walk-in mental health support. You don’t need a referral or a Medicare card to access services. 

The centres are staffed with highly qualified mental health professionals and people with lived experience of mental ill health. The support they offer is immediate and short to medium-term but they can also help connect you with other services to support you into the future. 

Separately, you can also chat to your GP about receiving a Mental Health Treatment Plan. Medicare helps cover the cost of up to ten individual and ten group therapy sessions of mental health support each year.

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Meet Medicare Urgent Care Clinics

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The life of a parent means ending up in the emergency department far more often than you’d like.

And the truth is, most times your kid doesn’t need emergency care, like if they need stitches or have a cut. 

Medicare Urgent Care Clinics address urgent, but not life-threatening, illnesses and injuries. That includes minor infections, minor fractures or sprains, insect bites, rashes, gastro, and mild burns. These clinics are bulk billed, take walk-ins, and open early and late.

Chances are, you’ve got one nearby. Approximately 70% of Australians will live within a 20-minute drive of a Medicare Urgent Care Clinic.  To find your nearest Medicare Urgent Care Clinic, visit health.gov.au/MedicareUCC.

So next time your child’s soccer game gets a little too rough, you won’t have to spend half your day in the emergency department.

The Child Dental Benefits Schedule

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As if dentist appointments weren’t already a dramatic affair, requiring fruit-scented stickers and “You’ve got this, buddy”, there’s also financial considerations. 

The Medicare Child Dental Benefits Schedule (CDBS) helps cover basic dental care for eligible children aged 0-17. It provides up to $1,095* over two years for services like check-ups, cleaning, fillings, and extractions.

Before booking your appointment confirm that your dentist participates in the CDBS and will bulk bill the appointment.

To be eligible, your child must: 

• be eligible for Medicare
• be aged between 0 and 17 years
• receive, or have a parent or guardian who receives, a relevant Australian government payment, such as Family Tax Benefit Part A, at any point in the calendar year. 

*This is the 2024 indexed amount. The amount is adjusted on 1 January each year.

You can visit public dental clinics or private dentists who accept CDBS. Just ask your dentist if they provide services under the Child Dental Benefits Schedule and check if there are any extra costs before your appointment.

The CDBS doesn’t cover orthodontics, cosmetic treatments, or dental work done in hospitals, but it’s a great way to keep up with your child’s regular dental care without worrying about big bills.

Who can access Medicare?

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Most of these services require you and your kids to be registered with Medicare. So, before you can make the most of these benefits, check that you’ve ticked that box. 

You’re eligible for Medicare if you live in Australia and you are: 

• an Australian or New Zealand citizen 
• an Australian permanent resident 
• applying for permanent residency (conditions apply) 
• a temporary resident covered by a ministerial order
• a citizen or permanent resident of Norfolk Island, Cocos (Keeling) Islands, Christmas Island, or Lord Howe Island. 

You’re also eligible for Medicare if you’re visiting Australia from a country with a Reciprocal Health Care Agreement (conditions apply). 

Enrolling is easy and can be done:

• through your myGov account
• by completing a Medicare enrolment form and submitting your form and supporting documents by mail or email
• by visiting a Services Australia service centre. 

Importantly, make sure your bank details are up to date so you can receive your Medicare benefit. (Almost one million Australians have unpaid Medicare benefits waiting to be paid).

For more information about getting Medicare benefits, visit the Services Australia website.

Wrapping it up

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Having kids around (as wonderful as they are) means there’s always something.

One daycare sickness knocks the entire family down for a week, a fun day trampolining ends up in a twisted ankle and a bump on the head, and your four-year-old’s ear infection just keeps coming back. 

But the benefit of being in Australia is that there’s support for those moments. Sometimes it’s just about knowing how to make the most of that help. 

Sources

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Services Australia, Bulk Billing, June 2024

Services Australia, Child Dental Benefits Schedule, September 2024

Services Australia, Enrolling in Medicare, November 2024

Department of Health and Aged Care, About Medicare Urgent Care Clinics, March 2024

Department of Health and Aged Care, The History of Medicare, February 2024