Everything you need to know about bulk-billing

Most of us have taken advantage of bulk-billing at some point in our lives. Sunday trip to the radiologist for an x-ray after a footy tackle gone wrong? You might’ve been bulk-billed. Getting an eye test from your local optometrist? It’s likely bulk-billed. Quick trip to the GP after a nasty bout of gastro? If you didn’t have to pay, you’ve probably been bulk-billed.

When you’re bulk-billed for a trip to a medical professional, it means you don’t have to pay for your visit. Instead of charging you, the health professional accepts the rate that’s included in the Medicare Benefits Schedule (MBS) as full payment and bills the Australian Government directly.

If you’re not bulk-billed, you’ll be charged a ‘patient account’. This is when your doctor charges you a fee and you can claim a portion of the MBS back through Medicare. The part of the fee that you can’t claim through Medicare is called an ‘out of pocket’ or a ‘gap payment’.

If you live in Australia and have a valid Medicare card, you’re eligible to be bulk-billed; however, whether a doctor or specialist offers you bulk-billing is completely up to them or the business they work for.

You can sometimes claim the benefits from Medicare at your doctor’s office; other times, you’ll be required to claim through Medicare Online, via the Medicare mobile app or by mail. The benefits will be deposited straight into your bank account, so you don’t have to worry about picking up cash or waiting for a cheque.

Not all health professionals bulk-bill, so before making an appointment, it’s important to do some research. You can call the practice directly, or use the health service tool on the healthdirect website to search for local bulk-billing doctors and specialists.

Some examples of the services that may be covered by bulk-billing include:

• Appointments with GPs or specialists

• Scans, like X-rays

• Tests that may require pathology

• Eye tests performed by optometrists

As an incentive to increase bulk-billing rates across the country, Medicare now provides an extra payment to doctors in eligible areas if they bulk-bill pensioners, health care card holders or those under 16 years of age. You should let your doctor know if you carry a:

• Commonwealth Seniors Health Card

• Ex-Carer Allowance (Child) Health Care Card

• Foster Child Health Care Card

• Health Care Card

• Low Income Health Care Card

• Pensioner Concession Card

At nib, we know how important it is to stay healthy. That’s why we offer a range of Extras covers that pay benefits for your visits to health professionals that aren’t covered by Medicare. From physiotherapy and chiropractic to dental and optical, you can choose a cover that best suits your individual health needs. For more information and to get a quote, visit our dedicated Extras page.