急问，临居没有MEDICARE，怎样买保险啊？

larakk

我和老公不是PR，没有MEDICARE卡。加上最近自己生病，感觉看病真是个问题，原来一直以为自己身体好，就没有在意，现在看来应该考虑要买份保险，而且因为小孩子过来了。有几个问题很困惑，请大家指教：

1。我们不是PR是不是就不可以申请MEDICARE CARD？

2。如果要买保险，是不是要买VISITOR INSURANCE，不是一般的PRIVATE HEALTH INSURANCE？
  因为我看了好多的帖子PRIVATE HEALTH INSURANCE是建立在MEDICARE的基础上的，也就是说MEDICARE可以COVER的部分，PRIVATE    HEALTH INSURANCE是不COVER的？（不知道我这样理解对不对？
如果是这样的话，那就意味着我们要买的是有MEDICARE性质的保险对么？

3。大家可以帮我看下这个保险好么？http://www.austhealth.com/
   TABLE 120里100% of Australian Health System Fees for Out-Patient Medical *的解释
* Out-Patient medical expenses - 100% Australian Health System Fees, also known as Medicare Benefits Schedule (MBS) Fees. Doctors generally charge more than the MBS Fees and will leave you with a "gap" or co-payment

是什么意思啊？
这个保险的性价比可以么？或者有没有和我类似情况的，有什么更好的推荐？

问题多多，先谢谢拉！

[ 本帖最后由 larakk 于 2008-2-25 13:24 编辑 ]

astina

不知道你们什么签证。 你关于private health insurance的理解是对的，是建立在medicare的基础上的。

如果是一般访客，要买visitors insurance

大饼

如果lz是临居并且已经申请了PR，根据新条款应该是可以有medicare 的。

larakk

原帖由 astina 于 2008-2-25 13:24 发表
不知道你们什么签证。 你关于private health insurance的理解是对的，是建立在medicare的基础上的。

如果是一般访客，要买visitors insurance

AS姐姐，我们拿的是163签证，我查了移民局网站，上面对我们的签证有这样的解释
With this visa you are unable to access Medicare, the Australian Government medical expenses and hospital care scheme.
See: www.medicare.gov.au

Private Health Insurance is available to you, but it is not a requirement for the grant of this visa

这样是不是就意味着我们不可以申请MEDICARE呀？

larakk

原帖由 大饼 于 2008-2-25 13:29 发表
如果lz是临居并且已经申请了PR，根据新条款应该是可以有medicare 的。

还没有开始申请，要今年年底才可以申请，那看来是不是只能买VISITOR INSURANCE咯？

qqyang

原帖由 larakk 于 2008-2-25 13:22 发表
3。大家可以帮我看下这个保险好么？http://www.austhealth.com/
   TABLE 120里100% of Australian Health System Fees for Out-Patient Medical *的解释
* Out-Patient medical expenses - 100% Australian Health System Fees, also known as Medicare Benefits Schedule (MBS) Fees. Doctors generally charge more than the MBS Fees and will leave you with a "gap" or co-payment

这是我研究过的最便宜的visitor cover了，但是only apply to working visa。如果LZ符合资格，我觉得这个保险不错的。

larakk

对呀，我就是看了你的帖子才找到的，还真要谢谢你呢。但是这段解释我不明白，可以帮忙看下么？什么意思啊？就是它和MEDICARE CARD的作用一样？所谓的GAP是不COVER的？GAP是什么意思啊？

qqyang

原帖由 larakk 于 2008-2-25 14:31 发表
对呀，我就是看了你的帖子才找到的，还真要谢谢你呢。但是这段解释我不明白，可以帮忙看下么？什么意思啊？就是它和MEDICARE CARD的作用一样？所谓的GAP是不COVER的？GAP是什么意思啊？

GAP就是实际费用和Medicare涵盖的费用上限之间的差额，比如说，X光Medicare能报销80元，但诊所实收100元，那100-80=20元就是GAP，也就是你自己要掏腰包的部分。

使用这个保险和Medicare卡的区别是，使用Medicare卡你可以直接刷卡，然后付差额，而用保险，你必须先支付全额，然后再从保险公司那里报销Medicare卡涵盖的部分。

larakk

哦，是这样，那如果小孩子看看病或者大人看常见病是不是买个这样的保险就差不多拉？一个季度460刀，如果要COVER GAP的话要930刀，好象太贵了点哦。MEDICARE是不是不能看中医的啊？

qqyang

原帖由 larakk 于 2008-2-25 15:22 发表
哦，是这样，那如果小孩子看看病或者大人看常见病是不是买个这样的保险就差不多拉？一个季度460刀，如果要COVER GAP的话要930刀，好象太贵了点哦。MEDICARE是不是不能看中医的啊？

你看看保不保Emergency？很多小孩发起烧来都是半夜去Emergency的。如果不保，那就贵了。

如果有条件，应该买含牙科的保险，每人每年最好能上牙医那里检查2次，及早预防牙病。如果没有条件，每年回国一定要去看牙医，否则，积重难返生活质量大大下降，治疗费用也会很高。还有小孩，一口健康的牙齿可以让他/她以后不被同龄人歧视。

larakk

cover Hospital Emergency Room
有这样一条，这个是不是你说的Emergency？

COVER的内容有以下
    *  100% In-Hospital (In-Patient) expenses covered (eg. medical, accommodation, specialists, medicines and drugs etc)
    * Hospital Emergency Room
    * Rehabilitation programmes following hospitalisation, including continuing out-patient treatment
    * 100% ambulance cover
    * Medical repatriation to your home country
    * Funeral Expenses
    * * Out-Patient medical expenses - 100% Australian Health System Fees, also known as Medicare Benefits Schedule (MBS) Fees. Doctors generally charge more than the MBS Fees and will leave you with a "gap" or co-payment

astina

这个内容应该够用了

larakk

那算包括小孩子半夜去医院挂急诊么？还有就是那个GAP会不会很离谱啊？

[ 本帖最后由 larakk 于 2008-2-25 17:55 编辑 ]

astina

包括了

larakk

既然这样那我们就买这个吧，460一个QUARTER还算挺合算的吧？如果要包括DENTAL就要1250刀一个季度了，我觉得小贵了点。反正年底就有望申请PR，到那时候有了MEDICARE再去买个有DENTAL的PRIVATE HEALTH INSURANCE也可以的吧？

[ 本帖最后由 larakk 于 2008-2-25 19:01 编辑 ]

astina

当然，有medicare了以后，你再看下我关于private insurance的帖子，光买extra看牙和眼睛，还是非常便宜的

larakk

section 3  Elective surgery expense

In-hospital expense and same day surgery expense for elective surgery up to a maximum of A$2000 per person per annum in total for non-critical surgery determined as elective by a Medcial Practitioner appointed by the health fund.


请问这个是什么意思啊？就是说如果手术的话，最多就报销2000块？
还有这里HOSPITAL的概念都是指的公立医院么？

larakk

因为网上是这样描述的-100% In-Hospital Private Cover
这里PRIVATE COVER的概念是可以看私立医院么？

astina

原帖由 larakk 于 2008-2-25 18:29 发表
section 3  Elective surgery expense

In-hospital expense and same day surgery expense for elective surgery up to a maximum of A$2000 per person per annum in total for non-critical surgery determine ...

住院费（包括门诊手术费），每人每年上限2000.对致命疾病的手术除外，由保险公司的医学专家来判断是否致命。

astina

原帖由 larakk 于 2008-2-25 19:13 发表
因为网上是这样描述的-100% In-Hospital Private Cover
这里PRIVATE COVER的概念是可以看私立医院么？

有上下文吗？从字面理解，这里的private未必是私立医院，而是你本人掏钱买的保险（而不是medicare)称为private cover -- 个人意见。

larakk

原帖由 astina 于 2008-2-25 19:16 发表



住院费（包括门诊手术费），每人每年上限2000.对致命疾病的手术除外，由保险公司的医学专家来判断是否致命。

100% In-Hospital (In-Patient) expenses covered (eg. medical, accommodation, specialists, medicines and drugs etc)

不是说100% In-Hospital (In-Patient) expenses covered的么？怎么又说上限是2000呢？那么这个100%COVER的概念应该是指项目，不是指所有的诊金咯？CONFUSING

astina

住院的话医疗费，住院费，专科医生，药等费用，都cover,但是上限是2000刀。我觉得说了满清楚呀

larakk

原帖由 astina 于 2008-2-25 19:18 发表

有上下文吗？从字面理解，这里的private未必是私立医院，而是你本人掏钱买的保险（而不是medicare)称为private cover -- 个人意见。

1
SCHEDULE OF COVER
AHI Insurance 100% In-Hospital Cover plus 100% of Australian Health
System Fees for Out-Patient Medical
SECTION 1 IN-HOSPITAL (IN-PATIENT) EXPENSES for INJURY and
SICKNESS, including REHABILITATION PROGRAMMES
following hospitalisation
100% Cover without excess or co-payment
In-Hospital (In-Patient) Expenses incurred as a result of sustaining Injury or Sickness and
paid by You or on Your behalf to a Medical Practitioner, registered nurse or registered
physiotherapist or hospital or rehabilitation facility for medical, surgical, x-ray, hospital, nursing
or other medical treatment as listed below, including prescribed medicines, drugs and medical
supplies within Australia.
Private Accommodation
Shared Private Ward
General Ward
Theatre Fees
Intensive Care
Procedure Room
Anaesthetic Services
Same Day Surgery
Specialist Medical Care in Hospital
Rehabilitation programmes following hospitalisation
Dental Reconstruction (following trauma)
Prostheses (Surgically implanted)
Special Surgical Dressings, Supplies and Procedures
Physiotherapy in Hospital
Drugs and Medicines in Hospital
Specialist Nursing
X-rays
Pathology
Medical and Surgical Supplies
Blood Transfusions
All Medical, Surgical and Ancillary services and other In-Hospital services approved by
IMAN/AHI
Parent Hospital Accommodation Charges
2
SECTION 2 OUT-PATIENT MEDICAL EXPENSES for INJURY and
SICKNESS
100% of Australian Health System Fees, also known as
Medicare Benefits Schedule (MBS) Fees.
Out-Patient Medical Expenses incurred as a result of sustaining Injury or Sickness and paid
by You or on Your behalf to a Medical Practitioner for medical, surgical, x-ray, pathology,
nursing or other medical treatment as shown below, including the cost of drugs and supplies
administered by a medical practitioner, as part of the treatment.
Primary and Specialist Medical Practitioner Outpatient Medical Care for Injury and
Sickness
Medical Practitioner visits to office, hotel or residence
Visits to Medical Practitioners - General Practitioners and Specialist Medical
Practitioners
Sports Medicine
Pathology for Injury and Sickness
Diagnostic Testing
Tests and Procedures
Pathology Tests
Laboratory Tests
Blood Tests
Medical Practitioner-ordered Outpatient Medical Services for Injury and Sickness
Plastic Surgery (reconstruction after accident)
Chemotherapy
Radiation Therapy
X-rays
Other Medical Tests, operations, treatments and specialist procedures as approved by
IMAN
SECTION 3 ELECTIVE SURGERY EXPENSES
In-Hospital (In-Patient) Expenses and Same Day Surgery Expenses for Elective Surgery
up to a maximum of $A2000 per person per annum in total for non-critical surgery
determined as elective by a Medical Practitioner appointed by the Health Fund.
SECTION 7 AMBULANCE EXPENSES
100% Cover without excess or co-payment
Road and Air Ambulance services within Australia.
SECTION 8 INSURANCE AND LIABILITY SURCHARGE
Insurance and Liability Expenses levied by Medical Practitioners and Hospitals in
Australia, up to a maximum of $A20,000 per Policy per annum in total.


具体是这样的，麻烦阿丝姐姐帮我看看好么？算不算可以去私立医院啊？

larakk

You must disclose if you, or any accompanying family member:
1. Have undergone pre-employment health screening
a) examination by a doctor
b) x-rays
c) blood and urine tests
2. Have signed a health undertaking with the Department of Immigration and
Citizenship (DIAC)
3. Are aware of any existing signs or symptoms of an ailment, illness, condition or
disability
4. Have had an ailment, illness, condition, or disability, for which medical treatment
was received in the last 6 months
5. Have received hospital treatment in the last 3 years
6. Have an implant of any kind
7. Are currently taking prescribed drugs
8. Have received any other treatment (including physiotherapy or chiropractic)
within the last 6 months
9. Are pregnant
You have a duty to disclose to us whether you are aware of any Existing Ailment affecting
yourself or accompanying family member, as this is relevant to our decision to offer you health
insurance. If you do not disclose all relevant information at the time of applying to join the
Health Fund, we may refuse to pay your claim, or may cancel the policy immediately. Should
any decision need to be made about a claim for what may be an Existing Ailment, the Health
Fund will appoint a Medical Arbiter to make a decision based on the information available.


这一段也不是很明白，这9个问题中前3个问题我该怎样回答？
针对第一个问题，什么叫pre-employment health screening？
我们在出国拿签证前倒是做过类似体检，算么？
2。DIAC是什么啊？好象没有签过这样的东西
3，应该答 否 对吧？我们现在都挺好的

问题多多，麻烦阿丝姐姐拉，因为我怕答的不好may refuse to pay your claim，or may cancel the policy immediately.