Find out how bulk-billing for medical services works in Australia.
Bulk-billing is when a medical service provider doesn’t bill you, the patient, for the medical service they have provided. Instead, they bill Medicare directly and the provider accepts the relevant Medicare benefit as full payment.
This means that you pass your right to a Medicare benefit on to the service provider, allowing Medicare to pay your doctor directly. It also means that your doctor can’t charge any additional fees and the service you receive is free.
What services can be bulk-billed?
A wide range of medical services can be bulk-billed in Australia, including:
- Visits to your doctor. Many medical practices around Australia offer bulk-billing to all patients when they visit their GP. However, some practices that provide bulk-billing will only do so for specific patients, for example, children or the elderly.
- Specialist services. Some specialists, including pathologists and radiologists, will choose to bill Medicare directly rather than bill you.
- Optometry. Eye tests can be bulk-billed so that there are no out-of-pocket expenses for you.
- Dental. Bulk-billing services for preventative dental check-ups and treatments are provided at some dental practices.
- Podiatry. Medicare will pay a rebate for the consultation fee only and any extra services received will be out-of-pocket expenses.
- Psychology. Some practices offer bulk-billing to customers who attend pre-booked appointments with a psychologist.
The popularity of bulk-billing in Australia
Bulk-billing is an increasingly popular option for Australian patients. Government statistics reveal that almost 85% of all GP visits in Australia are bulk-billed and that bulk-billing rates are rising across all health care categories.
Data from Roy Morgan Research revealed that in the year ending March 2016, only 27.6% of Aussie adults paid for a doctor's visit per month. Compare this with figures from the same period in 2007, when 31.8% of Australians paid for a visit to their local GP or specialist, and it becomes clear that Australians are paying less out-of-pocket expenses for medical services than they were almost 10 years ago.
Issues plaguing bulk-billing
There are a number of issues affecting bulk-billing services in Australia, which could lead to bulk-billing becoming a thing of the past. With almost 85% of GP visits bulk-billed, the Federal Government announced in May 2016 that it planned to freeze the Medicare rebate for GP visits at $37 for the next six years, a move that would boost federal coffers by several billion dollars.
In response to the freeze, a survey of 500 doctors from the Royal Australian College of Medical Practitioners found that 29% of doctors planned to phase out bulk-billing at their practices. A further 22% said they would end bulk-billing but also introduce capped fees for low-income earners. Just 9% of doctors surveyed said that they would continue to bulk-bill all patients. As a result, 14.5 million patients may have to pay higher fees when seeing a doctor.
Many doctors and health care providers have warned that this will lead to an increasing number of Australians being unable to afford GP visits and therefore being unable to access the medical attention they need. At the time of writing, the Federal Government had no plans to resume indexing Medicare rebates for GP visits and it remains to be seen what effect this will have on bulk-billing rates across Australia.
The freeze may have contributed to a recent drop in visits to bulk-billed facilities. Broad type of service visits have fallen slightly from 85.9% at the end of the June quarter to 85.4% at the end of the September quarter.
More about Medicare
Medicare is the basis of Australia’s public healthcare system. It entitles Australian residents and some visitors to access an array of subsidised medical services, low-cost prescription medications and free treatment as a public patient in a public hospital. Medicare is administered by the Australian Government’s Department of Human Services.
Medicare benefits include:
- Free or subsidised treatment from GPs, specialists, optometrists, dentists (in some circumstances) and other allied health practitioners.
- Free accommodation and treatment as a public patient in a public hospital.
- 75% of the Medicare Benefits Schedule (MBS) fee covered for services and procedures received as a private patient in a public or private hospital (this excludes hospital accommodation, theatre fees and medicine).
- Lower cost medications under the Pharmaceutical Benefits Scheme (PBS).
Medicare benefits are only payable for treatments and services received within Australia. The MBS provides a full list of all services that are subsidised by the Australian Government under Medicare. Visit the Department of Health MBS Online website for a complete list of what Medicare covers.
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