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Surge in older people eligible for health card
Changes designed to ease cost of living pressures will create thousands more cardholders, but GPs are being reminded that bulk billing is at their own discretion.
While GPs are committed to helping the most vulnerable, making that distinction is not always easy, according to the RACGP President.
Thousands more patients are now eligible for the Commonwealth Seniors Health Card, entitling them to more PBS discounts as well as lower PBS and Medicare safety net thresholds.
Around 44,000 new cardholders are expected over the next 12 months following a significant hike in the upper income limit as a result of legislation introduced under the new Federal Government.
The upper income eligibility for single older Australians seniors has now gone up 56% from $57,761 per annum to $90,000, while the income limit for a couple is now $144,000, a rise of $51,584 (also 56%).
For couples separated by illness, respite care or prison, the limit increases by the same proportion from $115,522 to $180,000.
An additional 52,000 cardholders overall are expected by 2026–27, according to the Government’s own estimates.
In addition to PBS discounts and extended PBS and Medicare safety nets, a number of Government ministers have also flagged that cardholders should expect reductions in the cost of GP care.
However, RACGP President Adjunct Professor Karen Price is keen to reinforce that, while GPs will look to bulk bill those who cannot afford healthcare, there is no obligation to do so for those who are able to pay for treatment – which is now likely to include more people with the health card.
‘There are many practices now who have moved to mixed billing, and that means that people may expect a gap fee depending on the circumstances of the clinic and the circumstances of the patient,’ Professor Price told newsGP.
‘We’re here to help the most vulnerable but making that determination can be really difficult. It needs to be on a case-by-case basis.’
Professor Price also says many patients are unaware of how bulk billing works, putting the onus on GPs to engage with patients to explain the system.
‘A lot of people feel entitled to this, and it’s not an entitlement,’ she said. ‘We’re not paid by the Government – it’s [the patients’] insurance.
‘If they feel [it] is inadequate, they should talk to the insurer, which is the Government.’
She encourages GPs to access RACGP resources to help explain the system to patients (see below).
‘It can be difficult for patients to bring [charging a fee] up,’ Professor Price said.
‘It is worth GPs checking in with people to make sure it’s okay, particularly if they see people’s visits drop off.’
The eligibility change also underlines the need for appropriate indexation and MBS rebates, according to the RACGP President.
‘GPs for too long have been wedged by our own altruism,’ she said.
‘It’s a great disservice to the population because it has created a lack of workforce. We should really talk about the fact that bulk billing is a 50% discount.
‘Where else do you go with any kind of seniors’ card and get a 50% discount for a private business? Not Woolworths or anywhere else.’
The office of Federal Health and Aged Care Minister Mark Butler was approached by
newsGP for context and comment about the changes, including a query about whether general practice is expected to subsidise the Government initiative.
In response, a spokesperson directed
newsGP to
a July media release from the Minister for Social Services Amanda Rishworth.
As well as the PBS discounts and safety nets, the release references bulk billed doctor visits although clarifies that they would be ‘at the discretion of the provider’.
The RACGP has a range of resources around billing, including mixed billing case studies, a patient fact sheet and waiting room poster, as well as webinars. All are available on the RACGP website (login required).
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