Find out more about after-hours GP care and what is covered by your private health insurance.
Illnesses, injuries and other health concerns don’t always occur during office hours. From late nights to weekends and even public holidays, you can fall ill at any time and may require after-hours care from a GP. But if you do require after-hours care, will any of the costs you incur be covered by private health insurance?
The good news is that some Australian health funds provide benefits to help you get the medical attention you need, when you need it. Read on to find out exactly what is and isn’t covered by private health insurance for after-hours GP care.
If your GP is closed and you need after-hours medical care, some Australian health funds will provide benefits to help cover the cost of any treatment you receive. The exact type and level of cover provided differs between health funds, but you can generally receive cover for annual membership to an after-hours GP service, such as the National Home Doctor Service.
This membership is included as part of your health insurance premiums, allowing you to access bulk-billed treatment from a GP who comes to your home outside office hours. As the treatment is bulk-billed you will not have any out-of-pocket expenses, and you can also be supplied antibiotics and other common medications on the spot at no cost.
If required, the National Home Doctor Service then makes a follow-up appointment for you with your regular GP the following business day.
By including after-hours care in their policy benefits, the funds that offer this type of cover are providing extra peace of mind to their members.
After-hours primary healthcare refers to the care a patient receives when their condition can’t wait for treatment until regular primary healthcare services are available on the next business day. This should never be considered an adequate substitute for “in-hours” healthcare, but it should be accessible for all Australians so that essential care and treatment is always available when needed.
In 2014, a government review into the delivery of after-hours primary healthcare in Australia saw the development of new funding arrangements for these services nationally. This led to the creation of a PIP After Hours Funding incentive to provide ongoing support to after-hours services tailored to meet the needs of local patients around the country.
It also led to the establishment of a new after-hours GP Advice and Support Line, which allows Australians to access tailored healthcare advice when they can’t receive face-to-face GP services outside of office hours.
Are you sick or injured and unsure how to find a GP outside office hours? These resources can help you find a GP and get the healthcare you need:
- National Home Doctor Service. The National Home Doctor Service service allows you to receive a home visit from a bulk-billing GP after hours by calling 13 SICK.
- HealthEngine. HealthEngine is a handy site that allows you to find and book appointments with doctors, physios and a range of other healthcare professionals Australia-wide. The service is available 24 hours a day, 7 days a week.
- DoctorDoctor. DoctorDoctor can help residents of Brisbane, Melbourne, Perth and Sydney access an after-hours GP through its on-call home doctor and phone triage service.
- Doctor Home Visits. If you live in WA, Doctor Home Visits can help you find and book an after-hours GP.
- After Hours GP Helpline. Need to find a doctor or pharmacy that is open now? After Hours GP Helpline can help you find a pharmacy close to you, or phone the helpline on 1800 022 222.
Although after-hours GP care offers many benefits, there are still some issues that have occurred with after-hours services that all patients should be aware of. For example, concerns have been raised about the continuity of care provided to patients who access out-of-hours healthcare but then don’t receive any follow-up care from their regular GP. This is a particular problem for older patients with complex chronic conditions that rely on careful medication management for effective treatment.
The after-hours healthcare system also works very differently in metropolitan areas to how it functions in remote and rural areas. Rural GPs are called upon to provide a wide range of services and increasingly treat patients with more and more complex conditions, all of which leads to high workloads and significant pressures for GPs, as well as impacting on the financial viability of offering after-hours services.
Finally, some GPs have voiced concerns that the rise of after-hours services is compromising the level of care delivered to patients through the use of experienced junior GPs, and that the generous rebates on offer to after-hours practitioners could lead to a Medicare cost blowout. These issues are likely to continue to be debated as the popularity of after-hours GP services continues to rise.