Patient contributions for health care
New patient contributions will mean patients pay in part for the services they use — helping to ensure health services are sustainable and used efficiently
Commitment to Medicare
The Government is committed to Medicare and is taking steps to ensure the growing costs of health services are sustainable.
Through the Medicare Benefits Schedule (MBS) the Government provides a set rebate towards the cost of a wide range of health services.
New patient contributions
From 1 July 2015 previously bulk-billed patients can expect to contribute $7 towards the cost of standard GP consultations and out‑of‑hospital pathology and imaging services.
For concessional patients and children under 16 years the contribution will be for the first 10 services each calendar year — for any combination of standard GP, pathology and imaging services.
Patient contributions will not be expected for many GP services that target patients with particular health needs, such as Health Assessments and Chronic Disease Management items. The Government is also continuing to provide grant funding for Indigenous primary health care.
For each $7 patient contribution, $5 will be invested in a new Medical Research Future Fund.
MBS rebates
This $5 investment will come from reducing MBS rebates for standard GP consultations and out‑of‑hospital pathology and imaging services by $5.
The remaining $2 of the $7 patient contribution will go directly to providers to strengthen primary care and help with administration costs.
Providers will still be able to set their own fees and will have discretion whether to charge the $7 patient contribution.
From 1 July 2014 MBS items, except for GP items, will not be indexed for two years.
Low Gap Incentives
From 1 July 2015, bulk‑billing incentives that are paid to providers will be replaced with new Low Gap Incentives.
These will have the same value as under current arrangements. For example, $6.20 for a standard GP consultation in 2015.
The incentives will only be paid to providers when they collect the $7 patient contribution and no more from concessional patients and children under 16 years for their first 10 services each calendar year. After this, providers will continue to receive the incentive if they do not charge the patient for the rest of the year.
Hospitals
The States and Territories will also be able to introduce patient contributions for GP equivalent visits to emergency departments.
New patient contributions — extra costs
A concession card holder using 10 services per year, and contributing $7 per service, can expect to contribute $70 for their services. The Government will contribute over $380 (based on a standard GP consultation* and a Low Gap incentive**).
A concessional family of four with each parent using three services and each child using 11 services per year, each contributing $7 per service up to the cap, can expect to contribute $182 more — up to a maximum of $280 extra per year. The Government will contribute over $1,000 (based on a standard GP consultation* and a Low Gap incentive**).
- * Standard Level B GP consultation with an estimated MBS fee in 2015 of $37.70.
- ** Low Gap Incentive with an estimated MBS fee of $6.20 in 2015.