Help: Insurance Coverage for 485 is the worst

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Help: Insurance Coverage for 485 is the worst


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Old 10-29-2019, 11:31 AM
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Exclamation Help: Insurance Coverage for 485 is the worst

Hi

I am rising this issue as I have NEVER seen anyone complaining about it but it's serious. For the 485 visa we are required to maintain a health insurance coverage throughout the entire visa duration.

To do so, I signed up for Medibank 485 Visa cover, and I pay almost $80 per month for meeting the visa condition. However, last week I got very sick and I needed to see a GP, and here comes the surprise!!!! Not a single General Practitioner in Melbourne would accept the Worker insurance for bulk billing. I searched and visited over 15 clinics, all asked for upfront payment. I saw the Dr twice, I had to pay $230 in total. When I submitted the claim for the insurance company, they gave me back $74 only!!!

This mean that EVEN if I am paying $80/pm for private health insurance, I still have to pay for GP every time I see a Dr for consultation (Fees range from $60-$120 per doctor visit) as they bill me as a private patient, and the insurance company would only refund me later with $38 (MBS fees only). No gap fee covered. Total ripoff !!!!!!

So in summary:
The insurance coverage for workers is the worst among all. Students (OSHC) and Visitors (OVHC) have much much better coverage and most clinics will bulk bill their visits without any payment from patients. However, work visa holders - beside having the most expensive insurance, still have to pay full price upfront at every visit.

My question now.
I'm a 485 visa holder (worker)
Can I switch to a Visitor Health Coverage instead of a Worker Health Coverage and still fulfill the visa condition?

(Condition # 8501 to maintain adequate health coverage)


Last edited by Rosee; 10-29-2019 at 11:38 AM.

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Old 10-29-2019, 09:43 PM
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There are many different policies available for 485 visa holders, so it pays to shop around. Some include GP fees, others donít.

Here is one of many comparison sites, where you can check what is covered by the different providers:

https://485insurance.com.au/en/quote...-quote-builder

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Old 10-29-2019, 10:17 PM
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Sorry to hear about your experience - but when I was on a 485 I chose OVHC cover - I still had many surprises.

For e.g. in the ACT public hospitals charge you ~3 times the Medicare rate - wtf right - and my OVHC policy would only cover 85% of the Medicare rate - so for a $300 bill I would only get $15 - and the one time I actually had to get a some scans I was slapped with a huge out of pocket bill.

On the OVHC you will likely have to pay upfront too out of pocket though, even at bulk billing GPs, and then put in a claim down the line for the monies.

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Old 10-30-2019, 12:16 AM
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Insurance policies are notoriously difficult to compare and understand. Very few people read the small print and understand exactly what they are covered for.They really can only be relied on for emergencies and even then you have to hope that you will be fully covered and not too much out of pocket.

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Old 10-30-2019, 03:04 AM
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Old 10-30-2019, 03:20 AM
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Don't think you are alone. A friend of my wife had a baby via C-section.
She is an Australian citizen and entitled to Medicare, as she had private health insurance she opted to go private instead of public, her out of pocket expenses, after claiming against her health insurance was close to $5000!
My wife had our daughter via C-section in a public hospital and our out of pocket expenses were $0.

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Old 10-30-2019, 03:57 AM
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One of my clients paid the top rate for everything and copped a $10k bill for a confinement.

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