Adaptability to living in a foreign country is commonly acknowledged not to be easy for any overseas persons. There are quite a lot of complicated issues coming from language, cultural differences, and customs and traditions that can be very strange and difficult for most of international students and visitors who first travel to Australia. One of the things is the Australian Healthcare System since you may hardly understand terminologies properly concerning hospital treatment, health cover and so on. Thus, OSHCstudents would like to assist you with popular terms and definitions that are often used in the system. The below terminologies are extracted from current instructions and guides of leading OSHC providers in Australia. The more you learn, the more you get ready for your trip.
| 1. Accident | An unplanned or unforeseen event resulting in bodily injury that requires immediate medical treatment in a hospital. |
| 2. Accommodation | Related to in-hospital accommodation including nursing, hospital bed and patient meals. |
| 3. Benefit | This is the amount that we’ll pay towards services or treatments you or a person on your policy receive that are covered by your policy. |
| 4. Calendar year | This covers 1 January to 31 December in any given year. |
| 5. Co-payment (gap fee) | This is the amount you must contribute towards a claim. It is the difference between the amount payable under the Medicare Benefits Schedule and the amount actually charged for the medical service.
Example: Item 23 for a general practitioner short visit, the doctor charged you AU$50. According to MBS, the recommended fee for Item 23 is AU$37.05. Your OSHC provider shall pay you AU$37.05, you have to pay AU$12.95 which is called “gap fee” or “co-payment”. |
| 6. Day only surgery | This is when you’re admitted to a hospital and discharged on the same day. |
| 7. Default benefit | This is the (minimum) benefit amount as set by the Australian Federal Government. |
| 8. Dependant | Is a spouse or de facto partner; and any children or step-children of the student visa holder who are under 18 years old, unmarried, authorised to enter Australia and live with the student visa holder. |
| 9. Doctor’s surgery | In Australia, most GP Doctors operate privately and independently at a specific location. This location is usually referred to as a Doctor’s surgery. |
| 10. Extras cover | Extras are services and treatments received out of hospital that are not covered under your policy such as optical, dental, remedial massage, chiropractic and natural therapies. You have the option to take out cover for Extras. |
| 11. General Practitioner (GP) | Is a doctor who is not a specialist, however, treats a range of general medical issues. A GP is who you would normally see in the first instance for any medical issues. |
| 12. In-hospital treatment | Where you or a person on your policy is admitted to a hospital as a result of an accident or emergency or for treatment covered by your OSHC policy. In this situation, you are considered to be an “in patient”. |
| 13. Institution | This refers to a school, high school, TAFE College, English Language Centre, University or any other education provider. |
| 14. Itemised receipt | This is a receipt which is on the provider’s official letterhead. It must show the name and address of the person who provided the service, the name of the person who received the service, a description of the service, the date the service was provided and the cost of the service. |
| 15. Limits | This is the maximum amount you can claim each calendar year (January to December) for certain treatments. Unless specified, limits apply to each person covered by your policy. |
| 16. Medical centre | In Australia a medical centre is where a group of GP doctors work in the same location. You can choose to see a specific GP or whichever GP is next available. Some larger medical centres have additional services on-site such as pathology and x-ray. |
| 17. Medicare Benefits Schedule (MBS) | A list of fees determined by the Government for medical procedures and treatments provided by doctors including GPs and specialists. A doctor can choose to charge more than these fees. |
| 18. Out of hospital treatment | Where you or a person on your policy receives treatment or services without being admitted to a hospital. This can refer to GP and specialist consultations, some x-rays and pathology. |
| 19. Out of pocket costs | OSHC covers you for the benefits listed in your policy document. If your doctor or service provider charges more than the benefit amount you must pay the difference directly to your service provider. This difference is known as your out of pocket cost. |
| 20. Pharmaceutical Benefits Scheme (PBS) | The national pharmaceutical benefits scheme is funded by the Australian Government where patients pay only part of the cost of a subsidised drug. The rest of the cost is paid by the PBS. |
| 21. Pharmacy | Refers to a place that sells medicines and other health-related items. Some of these medicines are only available when prescribed by a doctor. |
| 22. Premium | Refers to the monetary payments made to a OSHC provider for the policy. |
| 23. Prescription | A prescription is a piece of paper given to you by a doctor which specifically advises a particular medication for treatment. Many medications or treatments can only be bought from a chemist if you have a prescription. |
| 24. Prostheses | Surgically implanted items such as stents (for coronary arteries), artificial hips/knees or titanium plates/screws (for reconstructions and bone breaks). |
| 25. Prescription medicines | Means those medicines that require a prescription completed by a doctor or other authorized practitioner in order to be dispensed by a registered pharmacist. |
| 26. Pre-exiting condition | You or one of your dependants has a pre-existing condition if the signs or symptoms of the ailment, illness or condition you have (in the opinion of a Medical Practitioner appointed by OHSC provider) existed at any time in the 6-month period before you or your dependant arrived in Australia on a student visa. For pre-existing medical conditions and pregnancy related services including childbirth there is a waiting period of 12 months. That means you won’t be covered for these conditions until the waiting period is over. For a pre-existing condition of a psychiatric nature, there is waiting period of 2 months. |
| 27. Provider | Refers to health service organisations and professionals such as hospitals, GPs, specialist doctors and providers of pharmaceutical and other items and services. |
| 28. Public hospital | Refers to hospitals that are owned and operated by the Australian Government. |
| 29. Theatre fees | Is a charge raised by the hospital for the use of their operating theatre where clinical procedures are performed. |
| 30. Transfer certificate | A document you need to request from your OSHC provider if you want to change to a different OSHC provider. The certificate confirms your previous OSHC membership details to your new OSHC provider and allows any comparable waiting periods you’ve already served to be acknowledged. |
| 31. Waiting period | You may have to wait before you can claim a benefit for certain services you are covered for under your OSHC policy. Waiting periods start from the date you arrive in Australia on a student visa. If you applied for your student visa whilst already living in Australia your waiting periods start on the date you join the OSHC provider. |
