From ambulance bills to hearing aids and dental treatment, older Australians may be entitled to help with health costs they are currently paying themselves. Here’s what to check.
Not every way of reducing your health costs involves changing your insurance.
Sometimes it is simply a matter of knowing what you are already entitled to. And with different rules across states, concession cards and government programs, it is easy to overlook help that could make a difference to the household budget.
Here is a practical checklist.
Start with a cost that can catch people by surprise.
Medicare does not cover ambulance services in Australia. Not the call-out, not the journey and not the treatment provided by paramedics.
Instead, the arrangements depend on where you live, your concession status and, sometimes, where you need an ambulance.
For people who move interstate in retirement, this is particularly important. Cover that applied in one state may not work the same way in another.
Here is a general guide to ambulance arrangements around Australia.
These are broad arrangements rather than a guarantee of cover. Eligibility, emergency versus non-emergency transport, medical necessity and interstate travel can all affect what you pay.
One point is particularly important: if you have ambulance cover through your private health insurer, check exactly where it sits in your policy.
Some insurers include ambulance benefits with hospital cover, others with extras or combined policies, and some offer standalone ambulance cover.
Dropping extras or changing your policy without checking could mean losing ambulance protection.
An ambulance bill can amount to hundreds or thousands of dollars, depending on the service and distance travelled. Air retrievals can be considerably more expensive.
If you are uncertain about your arrangements, contact your state ambulance service or health fund before you need them.
There are three important federal concession cards that older Australians often confuse.
The Pensioner Concession Card is generally issued to Age Pension recipients and certain other eligible payment recipients. It provides access to cheaper medicines under the Pharmaceutical Benefits Scheme (PBS), a lower PBS Safety Net threshold and various state, territory and local concessions.
Depending on where you live, those additional concessions may include help with utilities, transport, council rates or health-related services.
The Commonwealth Seniors Health Card is particularly worth checking if you are a self-funded retiree. It is available to eligible people who have reached Age Pension age but do not receive certain government income-support payments. And here is the important distinction: the Commonwealth Seniors Health Card is income-tested, but it is not assets-tested.
That means owning your home or having substantial assets does not automatically disqualify you.
However, income from certain investments and deemed income from account-based income streams can count towards the income test.
The card provides access to cheaper PBS medicines and the lower PBS Safety Net threshold, along with some other concessions depending on where you live.
The third is the Low Income Health Care Card. This is available to eligible Australians on low incomes, including people who have not yet reached Age Pension age and those who are older. Services Australia generally assesses gross income received during the eight weeks before an application.
It can provide cheaper PBS medicines and access to other concessions. The practical point is that eligibility can change as your circumstances change.
A card you did not qualify for several years ago may now be available if your income has fallen or your financial arrangements have changed.
It is worth checking with Services Australia rather than assuming you are ineligible.
Hearing aids can be expensive, particularly when purchased privately.
But the Australian Government’s Hearing Services Program offers subsidised hearing assessments, devices and ongoing support to eligible Australians. People who hold a Pensioner Concession Card, certain Department of Veterans’ Affairs cards and some other eligible groups may qualify.
Importantly, the program includes fully subsidised hearing aids, meaning eligible participants can obtain suitable approved devices without paying for the devices themselves. Partially subsidised devices are also available, but these can involve an additional payment for features beyond those provided by fully subsidised options.
Your provider must offer an appropriate fully subsidised option when a hearing device is recommended under the program.
An optional maintenance agreement may involve an annual contribution of approximately $50, depending on the arrangements and any exemptions.
If you are currently paying privately for hearing aids or relying on extras benefits, check your eligibility before making another purchase. You may already have access to government assistance that reduces what you need to spend.
Public dental services are another area worth investigating. Every Australian state and territory provides some form of public dental care for eligible residents, although the rules differ.
Pensioner Concession Card and Health Care Card holders may qualify for subsidised treatment, depending on their state, age and other eligibility requirements. Services can include examinations, fillings, extractions and emergency dental treatment.
There is a catch, however.
Waiting times for non-urgent public dental care can be lengthy, and access varies considerably between locations. Emergency treatment is generally prioritised according to clinical need.
So while public dental care may reduce costs, it will not necessarily be the quickest option.
Glasses are another expense worth checking. Several states operate spectacles assistance schemes for eligible concession holders or people on low incomes.
These may provide subsidised basic frames and lenses, although eligibility, contributions and replacement periods vary.
Before paying for your next pair of glasses, ask your optometrist whether a government spectacles scheme operates in your state and whether you qualify.
Once a year, perhaps around your birthday or the start of a new financial year, run through these questions.
That last question ties this article back to the broader issue of private health insurance.
For some households, extras cover provides useful benefits that justify the premium. For others, checking what is available through government programs may reveal opportunities to reduce spending.
It is important to compare what you would actually receive, including waiting times and annual benefit limits, before changing or cancelling cover.
You can compare your health insurance with Starts at 60, or talk it through with an Australian adviser on 1800 31 23 60. There is no obligation and no pressure to switch – plenty of people call simply to find out whether their current cover still stacks up.
IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.
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