Medicare card (Australia)

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An example Medicare card.
An example Medicare card.

A Medicare Card is a green coloured plastic card which identifies the persons listed on it as eligible for rebates under the Australian Medicare system when they are treated privately by a doctor with a provider number. Doctors who do not have provider numbers do not attract the medicare rebate, and so the medicare card cannot be used with such doctors. All permanent residents of Australia and their families are eligible for a "Medicare Card", except for those resident on Norfolk Island[1] where the Medicare system does not apply; eligibility is not connected to Australian citizenship. The card lists an individual as well as any members of his or her family he or she chooses to add who are also permanent residents and meet the Medicare definition of dependent. The card must be produced or the Medicare number provided if the Medicare rebate is paid directly to the doctor under the bulk billing system. It is also necessary to provide a Medicare number (although not necessarily show the card) to gain access to the public hospital system to be treated at no cost as a public patient. For non-elective treatment, public hospitals will admit patients without a number/card and resolve Medicare eligibility issues after treatment.

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[edit] Use of the card

Medicare is administered by Medicare Australia (until late 2005 known as the Health Insurance Commission (HIC)) which also has responsibility for supplying Medicare cards and numbers. Almost every eligible person has a card: in June 2002 there were 20.4 million Medicare card-holders, and the Australian population was less than 20 million at the time (card-holders includes overseas Australians who still have a card).

However the use of the card is limited to consultations with medical practioners who are eligible for medicare provider numbers. Such access has been made subject to increasing requirements since the mid 1990s [1].

The widespread use of the Medicare card means a distinction needs to be drawn between the card and failed proposals for an Australia Card. The Medicare card is used for health purposes only and cannot be used to track in a database a number of activities. It contains a name and number, and no photograph. Individuals are not legally required to have a Medicare card, to carry it with them, or to produce it on request.

The primary purpose of the Medicare card is to prove Medicare eligibility when seeking Medicare-subsidised care from a medical practitioner or hospital. Legally, the card need not be produced and a Medicare number is sufficient. In practice, most Medicare providers will have policies requiring the card be presented to prevent fraud.

From 2002, a Medicare card must now be shown at a pharmacy when collecting Pharmaceutical Benefits Scheme (PBS) medication.

The Medicare card is used as a recognised form of ID in opening bank accounts or obtaining a driver's license. On the ‘100 point scale’, on which 100 points of ID are required for proof of identity, a Medicare card is generally 25 points.

The medicare card linked rebate can only be used with consulting medical practitioners who have been issued with a provider number. Practitioners who are in breach of a contract with the commonwealth face typically 12 years prohabition on access to a provider. This means that a Medicare Card holder cannot get a rebate from these medicare practioners regardless of registration at any (state) board or specialty for that (12) year period.

[edit] Issue of Medicare Cards

Medicare cards can be issued to individuals or to families, with a maximum of five names per card. Children are listed on their parent's card – a family may be all on one card, or a child may be listed on one parent's card, or both parents' cards. Children who are wards of the state will be listed on a card with the Department of Children’s Services as cardholder.[2] Medicare cards may be used to show a relationship when parents have different surnames to their children.

Individual Medicare cards are generally only issued to people over 15. This is a Medicare Australia policy (not legislation) and there are exceptions for people at boarding schools or away from home. Significantly, this policy may detract from the right of a mature minor to gain confidential medical care. Using their family's Medicare card (and presenting the card) could notify their parents of the consultation.[3]

[edit] See also

[edit] References

  1. ^ http://www.medicareaustralia.gov.au/yourhealth/our_services/medicare/about_medicare/enrol_eligibility.htm
  2. ^ http://www.acwa.asn.au/acwa/news/medicare.html
  3. ^ NSW Law Reform Commission, Issues Paper 24 (2004)