Medicare card (Australia)
Encyclopedia
An Australian Medicare Card is a green coloured plastic card (or light blue for interim cards) 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 are eligible for an Australian "Medicare Card", except for those resident on Norfolk Island
or those who are not deemed to be residing in Australia, 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 (e.g. Emergency), public hospitals will admit patients without a number/card and resolve Medicare eligibility issues after treatment.
However the use of the card is limited to consultations with medical practitioners who are eligible for Medicare provider numbers. Such access has been made subject to increasing requirements since the mid 1990s http://www.adf.com.au/contents.php?subdir=library/1997/prov_number/&filename=PHP_index.
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 care
purposes only and cannot be used to track in a database a number of activities. It contains a name and number, and no visible photograph (however, the Tasmanian "Smartcard" version has an electronic image of the cardholder on an embedded chip). 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 Australian Medicare card is to prove Australian Medicare eligibility when seeking Australian Medicare-subsidised care from a medical practitioner or hospital. Legally, the card need not be produced and an Australian Medicare number is sufficient. In practice, most Australian 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 Australian 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 prohibition on access to a provider. This means that a Medicare Card holder cannot get a rebate from these Medicare practitioners regardless of registration at any (state) board or specialty for that (12) year period.
Individual Australian 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 potentially notify their parents of the consultation, but only if the parents request information about their child's medical claims.
In Tasmania, an enhanced version of the Australian Medicare card, called a "Smartcard", was introduced in 2004 and differs only in that it contains a chip that stores the same data found on the standard Medicare card, and also an optional digital photograph of the cardholder.
Medicare (Australia)
Medicare is Australia's publicly funded universal health care system, operated by the government authority Medicare Australia. Medicare is intended to provide affordable treatment by doctors and in public hospitals for all resident citizens and permanent residents except for those on Norfolk Island...
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 are eligible for an Australian "Medicare Card", except for those resident on Norfolk Island
Norfolk Island
Norfolk Island is a small island in the Pacific Ocean located between Australia, New Zealand and New Caledonia. The island is part of the Commonwealth of Australia, but it enjoys a large degree of self-governance...
or those who are not deemed to be residing in Australia, where the Medicare system does not apply; eligibility is not connected to Australian citizenship
Citizenship
Citizenship is the state of being a citizen of a particular social, political, national, or human resource community. Citizenship status, under social contract theory, carries with it both rights and responsibilities...
. 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
Bulk billing
Bulk billing is a payment option under the Medicare system of universal health insurance in Australia. The health service provider, usually a Doctor is paid 85% of the scheduled fee directly by the government by billing the patient via their Medicare card. The service provider receives only 75% of...
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 (e.g. Emergency), public hospitals will admit patients without a number/card and resolve Medicare eligibility issues after treatment.
Use of the card
Australian 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 practitioners who are eligible for Medicare provider numbers. Such access has been made subject to increasing requirements since the mid 1990s http://www.adf.com.au/contents.php?subdir=library/1997/prov_number/&filename=PHP_index.
The widespread use of the Medicare card means a distinction needs to be drawn between the card and failed proposals for an Australia Card
Australia Card
The Australia Card was a controversial proposal for a national identification card for Australian citizens and resident foreigners. The proposal was made in 1985, and abandoned in 1987....
. The Medicare card is used for health care
Health care in Australia
Health care in Australia is provided by both private and government institutions. The Minister for Health and Ageing, currently Nicola Roxon, administers national health policy...
purposes only and cannot be used to track in a database a number of activities. It contains a name and number, and no visible photograph (however, the Tasmanian "Smartcard" version has an electronic image of the cardholder on an embedded chip). 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 Australian Medicare card is to prove Australian Medicare eligibility when seeking Australian Medicare-subsidised care from a medical practitioner or hospital. Legally, the card need not be produced and an Australian Medicare number is sufficient. In practice, most Australian 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
Pharmaceutical Benefits Scheme
The Pharmaceutical Benefits Scheme or PBS is a program of the Australian Government that provides subsidised prescription drugs to residents of Australia. The PBS ensures that all Australians have affordable and reliable access to a wide range of necessary medicines.-History:The PBS was established...
(PBS) medication.
The Medicare card is used as a recognised form of ID in opening bank accounts or obtaining a driver's license
Driver's license
A driver's license/licence , or driving licence is an official document which states that a person may operate a motorized vehicle, such as a motorcycle, car, truck or a bus, on a public roadway. Most U.S...
. 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 Australian 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 prohibition on access to a provider. This means that a Medicare Card holder cannot get a rebate from these Medicare practitioners regardless of registration at any (state) board or specialty for that (12) year period.
Issue of Medicare Cards
Australian Medicare cards can be issued to individuals or to families, with a maximum of five names per card. Families with more than five members will have additional names listed on additional cards, while retaining the same card number. 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, or even in some cases, alone on their own card if their name exceeds a specific number of letters. Children who are wards of the state will be listed on a card with the Department of Children's Services as cardholder. Medicare cards may be used to show a relationship when parents have different surnames to their children.Individual Australian 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
Gillick competence
Gillick competence is a term originating in England and is used in medical law to decide whether a child is able to consent to his or her own medical treatment, without the need for parental permission or knowledge....
to gain confidential medical care. Using their family's Medicare card (and presenting the card) could potentially notify their parents of the consultation, but only if the parents request information about their child's medical claims.
In Tasmania, an enhanced version of the Australian Medicare card, called a "Smartcard", was introduced in 2004 and differs only in that it contains a chip that stores the same data found on the standard Medicare card, and also an optional digital photograph of the cardholder.