After-Hours GP Care: How Health Insurance Can Help
Getting sick can happen at any time, not just during business hours. So what should you do when you or a family member is ill and your doctor’s office is closed? Resist the temptation to turn to Dr. Google, because there are better options in place for after-hours care.
- The Australian government funds an after-hours GP helpline that is available to all Australians at no charge. Speak with a qualified nurse who will assess your query and recommend the best course of action.
- The benefits for after-hours health care vary by private health insurer. Your insurer may cover after-hours doctor’s visits or offer extra support through a private after-hours helpline.
- The best course of action for after-hours care depends on the urgency of the medical condition, the benefits offered by your health insurance, and your personal preference.
- 1 What is After-Hours GP Care?
- 2 Other After-Hours Options
- 3 Health Fund After-Hours Support
- 4 Will My Health Fund Cover After-Hours Care?
- 5 There Are So Many Choices, Which is Best?
- 6 Frequently Asked Questions About Health Insurance
What is After-Hours GP Care?
After-hours GP care is not meant to be a replacement for routine doctor visits or a substitute for emergency care. If the condition can wait until your GP’s office hours, you should contact them the following day to make an appointment. If you are having a medical emergency, you should dial 000.
After-hours care is for urgent medical conditions that occur outside of normal business hours. For example, you may need after-hours care in the following situations:
- You have an infant who is running a fever or vomiting
- Someone in your household has an infection like tonsillitis or the flu
- Someone in your household is suffering from gastroenteritis, which may include symptoms such as vomiting or diarrhoea
If you need to see a doctor and it can’t wait until the next day, that’s when you may need to consider after-hours care.
In the past, the only option for after-hours health concerns was to visit an emergency room, where you could face a wait time of several hours. Australians nationwide now have the option of calling the After-Hours GP Helpline at 1800 022 222. The service is funded by the Australian government and acts as an extension of the 24-hour healthdirect helpline.
After-Hours Helpline Schedule
The helpline’s hours of availability differ based on location. Rural areas were identified as needing expanded support, so the hours of operation have been extended outside of major cities.
Outside major cities the helpline is available:
- Monday to Friday 6pm to 7:30am
- Saturday from 12pm
Within major cities the helpline is available:
- Monday to Friday 11pm to 7:30am
- Saturday from 6pm
It is available all day on Sundays and public holidays nationwide.
After-Hours Helpline Nurse
Callers are put through to a nurse, who will assess the caller’s situation. If appropriate, the nurse will refer them to a GP or to dial 000. The nurse can also reference information in the National Health Services Directory to help the caller find the relevant local services and alternatives to emergency departments in their area.
GP Call Back
If the nurse determines that you could benefit from speaking with a GP, they can arrange to have a GP call you back. The call back will come within 15 minutes or within an hour, depending on the urgency of your condition. You can also choose to have a summary uploaded to your My Health Record and sent to your regular GP.
Other After-Hours Options
There are other ways to access medical care after hours, such as after-hours clinics, at-home doctor services, and special support services offered through private health insurers.
To find a clinic or pharmacy in your area that is open after hours, you can use the following services:
- The Healthdirect website, a government-run initiative that allows you to search for open clinics near you
- HealthEngine, a website that lets you track down healthcare professionals across Australia and book appointments online 24/7
At-Home Doctor Visits
Bulk-billed services are also available to patients with a Medicare or Gold DVA card who wish to have a GP visit their home after hours. Call lines are generally open from 6pm weekdays, 12pm Saturdays, and all day Sundays and public holidays.
- National Home Doctor Service: Arrange for a home visit by calling 13SICK or using the mobile app.
- Doctor Doctor: Available to people in Melbourne, Perth, Brisbane and Sydney. Includes telephone advice and bulk-billed home visits after hours.
- Dial a Home Doctor: Available in Queensland and NSW only. Bulk-billed home visits can be organised over the phone or via the mobile app.
Health Fund After-Hours Support
Health funds offer varying levels of support for after-hours care. Ask your fund about what services are available to you. Here are two examples of extra support that private health insurers provide:
Bupa members receive free membership to the National Home Doctor Service’s After Hours Plus program. There is no need to register because members are given access to the service automatically. The membership allows policyholders to receive common medications on the spot during a bulk-billed after-hours visit.
Members with a Medicare hospital policy are granted access to the 24/7 advice line. You’ll speak to an experienced nurse who can advise you of the best course of action. If the nurse believes you should see your GP, they can talk to your preferred clinic and arrange to help get you an appointment as soon as possible.
Will My Health Fund Cover After-Hours Care?
Access tor after-hours care via your insurer depends on your health fund and the type of policy you have. The benefits may include access to home visits and provision of on-the-spot medication through an after-hours GP service such as the National Home Doctor Service. It may include additional support through a private after-hours hotline that is exclusive to the fund. Each fund determines its own level of after-hours cover, so keep this in mind as you compare funds.
There Are So Many Choices, Which is Best?
First, be aware of the after-hours health care options your health insurance policy offers. That will help you determine which option suits your situation. You can start by calling an after-hours helpline, such as the one offered by the government or one run by your fund. From there, you can get professional advice as to whether you’d benefit from seeing a doctor right now or waiting until your regular GP is available. Depending on your location, you may want to arrange an at-home GP visit from an after-hours service.
Making health decisions happens 24/7, so look for a health fund that can be with you around the clock.
Frequently Asked Questions About Health Insurance
There are three types of health insurance in Australia. They are:
- Hospital Cover
- Extras Cover (also known as general or ancillary cover)
- Ambulance Cover
Hospital cover can ensure any unexpected surgeries, treatments or hospital stays you may require will be covered. With appropriate cover you will have the flexibility to choose your own doctor and the option of receiving treatment in a private hospital. Most hospital covers allow you to stay in a private room. One other perk is skipping the public hospital systems’ waiting list, which can be lengthy for non emergency treatment.
Extras cover pays benefits for a a range of services, often including treatments and procedures related to the fullowing:
- Dental/oral health
- Glasses and contact lenses
- Remedial massage
- Hearing aids
- Travel vaccinations
Ambulance cover, as the name suggests, will cover you should you require emergency ambulance transport. In an emergency, there is enough to worry about. Having the expenses covered for provides security and peace of mind. Many hospital covers include emergency ambulance transport If yours doesn’t, you will need to shop for this separately.
Life is unpredictable. You never know when you might need cover. No matter what life stage you’re in, there’s a policy out there for everyone. You can select as much or as little cover as you want, depending on your health needs and requirements. It’s a small price to pay for the peace of mind health cover provides.
There is no one answer here. Costs vary across providers and policy types. Just because a policy is cheap, that does not mean it is ‘value for money’ and vise versa. Make sure you check what’s included and excluded in a policy before signing up, as you want to purchase a policy that best fits your specific needs.
Premium: A premium is the price you pay for your insurance policy (it may be paid annually or on an ongoing basis).
Policy: An insurance plan. In other words, it is the type of insurance you choose to select.
Policy Holder: The owner, or ‘holder’ of a policy.
Claim: In the event that you require treatment for a service covered by your policy, you can lodge a claim for reimbursement of all or part of the cost of that treatment.. These days, most claims are submitted electronically by the health care provider (dentist, physio etc)
Lifetime Health Cover: Lifetime Health Cover was put in place to encourage young Australians to seek out and maintain ownership of private health insurance early in their lives. If you do not take out a policy before you turn 31, extra charges will be applied should you take out a policy at a later time.
This means you will pay a 2% loading on top of your premium for every year that passes after you turn 30. For example, if you take out a policy for the first time at age 32, you will be charged 4% of your premium as an extra, then at age 40, 20% and so on, up to a maximum loading of 70%.
The loading is payable for 10 consecutive years of cover - after which it is removed and you premiums will be reduced.
Pharmaceutical Benefits Scheme (PBS): Medicare offers assistance for Australians with many of their their prescribed medication costs through the PBS. This assistance is in the form of subsidies towards the cost of many medications. You can check if your prescribed medication is on the list of subsidised items here.
Medicare Levy Surcharge: The Medicare Levy Surcharge is an additional charge (tax) applied to single Australian taxpayers who earn over the income threshold of $90,000 per year, or families/couples who earn over $180,000 per year. This surcharge is only applied to those who choose not to have a private health insurance policy.
The surcharge is designed to reduce pressure on the public health system by encouraging those with higher incomes to invest in private health cover.
Private Health Insurance Rebate: The government’s Private Health Insurance rebate lowers premiums for most Australians with private health insurance Older Australians may enjoy an even higher rebate. Our calculator can help you estimate the Government health insurance rebate you may receive.
Disclaimer: The above information is correct and current at the time of publication
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