Medicare ineligible patients Peter Mac is a specialist, public health cancer centre. In addition to treating public patients, we also treat and care for people who may not meet the criteria for public health access (entry). If you think you do not meet the criteria, it is important to read and understand the following information.

Who can get treatment and care from Care and treatment for Medicare ineligible Peter Mac? patients is subject to the following: Peter Mac can treat all patients that hold a Peter Mac will treat and care for Medicare current Australian Medicare card as a public ineligible patients as described in this patient. Medicare is an Australian healthcare information sheet. It is important to system. It provides access (entry) to medical understand there are criteria (rules) that may and hospital services and is available to all affect this. Australian residents. Access criteria (rules) are: • In addition to providing care to public Peter Mac is unable to treat a Medicare patients, Peter Mac also provides care to the ineligible patient if it will delay the following patients: treatment of an eligible Australian • patients from countries that have a resident. Reciprocal Health Care Agreement (shared • Peter Mac is required to inform the agreement between two countries) Department of Health (Victorian State • refugees and asylum seekers Government) of the intent to treat an individual or individuals who do not have a • Medicare ineligible patients (patients Medicare card. without an Australian Medicare card). • Peter Mac is required to ensure that What does Medicare ineligible mean? overseas patients have the right Medical If you are a visitor to and do not hold Treatment Visas in place before any a Medicare card, you are a Medicare ineligible treatment starts person. • Peter Mac cannot guarantee that an overseas patient will be accepted for Medicare ineligible patients are required to treatment and care. There is a process pay for all their hospital services. The cost (described below) to assess every overseas (charges) they are required to pay will depend case request. on the: • treatment What are Reciprocal Health Care • if there is Australian Health Insurance Agreements? policy coverage A Reciprocal Health Care Agreement (RHCA) is • guarantee of payment from an overseas where Australia has agreed to provide some insurance institution. health services and subsidised (cheaper) medicines to visitors from some countries.

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You may be entitled to these if you are from: 4. A decision will be made and you will be • informed of the outcome. • • Ireland What happens after considering a patient’s • Sweden medical history? • Netherlands If Peter Mac can offer treatment, a written • Finland cost estimate (quote) will be provided. It is • Belgium hard to give an exact cost/quote for charges • Malta until the patient is seen and/or treated in • Slovenia person. Please note there are costs associated with all modes of treatment, • Norway including clinical trials. • Italy.

We will advise of any over or under The RHCA only applies to treatment that is payments, usually after treatment. When this needed for ill health while you are visiting happens, we will either ask for more funds or Australia. It does not apply to planned or refund money where it has been overpaid. elective treatment. Eligible patients from

RHCA countries must show their current Deciding to go ahead with treatment passport. To go ahead with treatment, the following

must happen: What is the process to assess overseas 1. the cost estimate (quote) must be paid in patients for treatment and care? full before treatment begins. To assess overseas patients, we must 2. After payment is made, Peter Mac will consider the patient’s medical history. contact Australia’s Department of Health and advise of the intent to treat a This includes: Medicare ineligible person. 1. A full medical history, written in English, 3. A Medical Treatment Visa must be in must be provided to Peter Mac. It will place. need to include: ― We can give you information on how ― a summary letter from patient’s to apply for this Visa. Please note: treating doctor, hospital or treatment Medical Treatment Visa applications centre. are done through the Australian ― all previous and/or planned cancer Embassy or Consulate in your country. treatments If you are already in Australia you ― diagnostic imaging (scans and x-rays) need to apply through the with reports Department of Immigration and ― pathology (specimen collection eg: Border Protection. bloods/biopsy) reports Please note: A Medical Treatment Visa 2. A pre-payment of a non-refundable AUD can take days or months to process. $500 review fee. Peter Mac has no control over processing 3. A comprehensive review of the medical times. history will be undertaken by our Medical 4. If the patient has international or private Officer who will also involve our relevant health insurance, we will need to cancer experts. complete an insurance check to confirm Peter MacCallum Cancer Centre Fact Sheet / www.petermac.org Page 2 of 4 Medicare ineligible patients

level of cover. This may mean that you Mac’s bank details, please contact our will have to pay some or all of your costs Medicare Ineligible Coordinator. upfront. 2. Pay in person by cash, EFTPOS, bank Before starting treatment cheque or credit card. Visit our cashier After the required upfront payment is made on: and a Medical Treatment Visa(s) is approved, ― Level 2 (next to the Pharmacy) we will arrange the first appointment. Peter MacCallum Cancer Centre, 305 Grattan Street Before your first appointment, you will be VIC 3000 asked to sign a payment agreement that says you are responsible for all costs relating to Hours: Monday to Friday your treatment and care. 8:30am to 4:00pm

Please note: Peter Mac does not have onsite If paying in person, you will need to bring accommodation available to overseas the following: (Medicare ineligible) patients. If • Passport accommodation is required, we can provide a • Overseas residential address basic list of what is available locally. • Health insurance details • Payment upfront What about asylum seekers and/or • Peter Mac quote letter. refugees? If you are a refugee or asylum seeker you are 3. Pay over the phone with your credit entitled to free medical care. You will need to card. Have your credit card details show documents that confirm your status ready and call: (asylum seeker or refugee) from either: ― 03 8559 6084 • the Department of Immigration and Hours: Monday to Friday Border Protection 8:30am to 4:00pm. OR • a recognised asylum support agency such How to contact Peter Mac as- If you have any questions or queries about ― Red Cross or International Health and this information or on accessing our services Medical Services (IHMS). as an overseas visitor, please call: • Medicare Ineligible Coordinator on Paying for treatment 03 8559 5267 If you are an overseas visitor and Medicare - Monday to Friday ineligible and accepted for treatment at Peter from 8:30am to 4:30pm Mac, you will need to pay for all of your email: [email protected] treatment. • Private Patient Liaison Officer on How to make payment: 03 8559 5723 1. Overseas patients can pay for both the - Monday to Friday review and treatment quote by internet or from 8:30am to 4:30pm international money transfer. For Peter email: [email protected]

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What are the costs for overseas visitors? The following information provides cost/fee information that applies to overseas visitors. These fees/costs are subject to change without notice. Service or Treatment Type Cost / fees Outpatients: • First or initial consult from $280 • Follow-up or subsequent consults from $250 • Procedure at first or initial consult from $280

• Procedure at follow-up or subsequent consult from $250 • Radiation Therapy contact Medicare Ineligible Coordinator • Allied Health $110 per consult Inpatient medical service and accommodation: • Day only from $1000 • Overnight from $1600 Inpatient surgical service and accommodation: • Day only from $1400 per day • Overnight from $1800 per day Other services: ICU - Overnight from $4900 per night HDU - Overnight from $3800 per night Hospital in the Home from $1200 per visit Prosthesis full cost recovery Cancer imaging as per Medicare Benefit Schedule plus 50% Pathology as per Medicare Benefit Schedule plus 40% Pharmacy full cost recovery Interpreter Service $100 per session

The above cost/fees for Peter Mac services and treatments may incur a 40% Medicare Benefit Schedule loading.

For more information regarding the Medicare Benefit Schedule loading please call our Private Patient Liaison Officer on 03 8559 5723.

If you would like more information about Peter Mac or the services we offer, please visit www.petermac.org

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