How to beat out of pocket health costs

If you think that your health care costs are rising faster than ever, sadly, you’re right. There’s a lot of complexity attached to health care costs so it can be difficult to understand exactly what is causing your medical bills to rise so sharply.

Last week the Grattan Institute released a report, Not so universal, which offered both context and measurement of how increasing medical costs are causing many to simply go without the attention they need. The major points made in the report are:

• in 2020-21, nearly half a million Australians did not access needed specialist medical care because they could not afford it. Even more did not fill a prescription for the same reason.
• Out-of-pocket expenditure for medical services and medications on the Pharmaceutical Benefits Scheme (PBS) amounted to $7 billion over this time
• Private specialist fees are unregulated – basically these specialists can charge what they like. For example, 50 per cent of initial appointments with a dermatologist, urologist, or ophthalmologist, are charged at more than double the $90 Medicare scheduled fee.
• Fees charged (above the gap) by specialists including dermatologists and cardiologists have risen by 50 per cent over the past 10 years.
• The result of such costly medical care is that the people who need the most healthcare – the poor and the chronically ill – are missing out more than other socio-economic cohorts.

The Grattan Institute has many policy suggestions to improve this situation, including making diagnostic tests free, so that those on low incomes do not delay diagnosis. This would increase the likelihood of successful treatment and recovery, because at the moment such people simply can’t afford to have tests when they are needed.

There is some good news, however, and that is that those who hold either a Pension Concession Card (PCC) or a Commonwealth Seniors Health Card (CSHC) are often bulk billed on items that are out-of-pocket for those who don’t hold these concession cards. This can add up to a significant amount. For example, according to the Grattan Institute, cancer sufferers paid more than $5000 per year on out-of-pocket medical expenses in the past financial year. Given that nearly half the population (43%) will be diagnosed with some form of cancer by age 85, this is a massive annual financial burden. Concession cards really can make a critical difference to your physical and financial wellbeing,

If you have already been granted an Age Pension, regardless of whether full or part, you will have automatic access to a PCC to help ameliorate your out-of-pocket medical bills.

If you are unsure as to your pension status, why not check our Age Pension entitlements calculator to see if you are close to qualifying?

And, as we’ve reported previously, the uptake of the CSHC by those who (based upon their income) would be entitled, is very low. Even if you don’t currently qualify for an Age Pension, the same entitlement calculator can quickly do the sums and share if you are able to get this other, valuable, concession card.

The first step to maximising your entitlements is to check you are getting all of yours. You can get started by using our free calculator. 

Check Your Entitlements