Medicare, Veterans’ Affairs, and Private Health Insurance

Medicare Cover And How You Are Affected

As of the start of January 2015 the Commonwealth Government of Australia announced changes to the Medicare system and how that affects Optometry, and you – our valued patients. Due to this, in order to cover the costs of providing quality eye-care services to our patients, our practice is not able to bulk-bill patients for eye-care services.

The exact fees charged depend on the clinical care you require, and this will be discussed with you regarding the type of service to be provided. This means that there is a gap between the fee charged and the rebate received from Medicare.

Pensioners, students, and concession card holders will continue to receive discounted consultation fees, and where rebateable by Medicare, the gap is usually very small in these cases.

Additionally, the majority of consultation services we perform attract a Medicare rebate (subject to Medicare eligibility). We can usually process this rebate for you directly on line here at the practice, eliminating the need to have to go to a Medicare office and the filling out of forms and standing in lines waiting to be served. The rebate is usually deposited back into your bank account by Medicare directly within a couple of working days.

We appreciate your understanding, and for working with us regarding these regulations from Australia’s National Health System.

Veterans’ Affairs Patients

Most Veteran’s and their eligible family members are covered fully by the Department of Veterans’ Affairs for most consultations and optical appliances. This includes Eye Examinations and Spectacles which may need to be provided (subject to Department of Veterans’ Affairs eligibility).

There are some limited exceptions to these rules, and the exact fees charged depend on the clinical care you require. This will be discussed with you regarding the type of service to be provided and any additional out-of-pocket expenses you may be liable for.

Private Health Insurance

Many of the products we supply will be completely or partially covered by your Private Health Insurance. If you have Ancillary cover (often known as “Extras”) with Optical Benefits, you are usually entitled to a rebate from the Health Fund. This cover usually extends to Spectacle Frames, Spectacle Lenses, and Contact Lenses and occasionally some other items depending on the actual Health Fund involved.

We are recognised with almost all registered Health Fund Insurance companies in Australia via our on line “HICAPS” system.

We can usually process your rebate for you directly here at the practice, with our “HICAPS” machine and on line system. This saves you from having to go personally to the office of the Health Fund, or from having to submit the claims online yourself, saving you valuable time.

In most cases the Health Fund will provide a limited amount of benefits for the items claimed for, with an out of pocket expense applying (or a “Gap” as it is often called).

We also have a limited range of products within our “No-Gap” range, where you have no out of pocket expense. Please note that this is a limited range and that conditions apply.

Please note that if you have Hospital cover only (i.e. without Extras or Ancillary Cover) you will not be covered for Optical benefits.