The Norfolk Island Healthcare Scheme is a Fund established for meeting CATASTROPHIC medical costs incurred by the people of Norfolk Island.
WHAT HEALTHCARE WILL COVER:
A nuclear family's approved medical costs in excess of $2,500.00 in a financial year (1 July to 30 June), including -
~ Hospital, medical and outpatient treatment in Norfolk
Island.
~ Diagnostic, laboratory and specialist services in Norfolk
Island.
~ Hospital accommodation and medical treatment in Australia or
New Zealand when a patient is Healthcare referred there for treatment but only to the
equivalent of a public shared ward rate in a Public Hospital.
There is a $200.00 limit per member each financial year on services provided by a physiotherapist, chiropractor an chiropodist.
There is a $200.00 limit per member each financial year on transportation which includes airfares and local and overseas ambulance. The cost of escorts and their expenses are also included in this category.
Prescribed medicines and medical appliances.
Diagnostic, laboratory and specialist services while overseas which are related to the original healthcare referral issued by the Norfolk Island Government Medical Officer.
HEALTHCARE WILL NOT COVER:
Elective or cosmetic surgery or treatment.
Theatre fees as this is a fee charged only by Private Hospitals.
Accidents or illnesses that started overseas. It is therefore most important that you obtain travel insurance when travelling overseas.
New members are not covered for any pre-existing illness or injury for a period of five (5) years.
Dental services.
Travel costs that exceed $200.00 per member.
MEMBERSHIP:
All persons who intend to reside in Norfolk Island for a period of more than 120 days, become eligible for Healthcare membership.
Persons 18 years of age or older, who on arrival are unsure how long they will stay, do not become members of the Scheme until they express the intention to remain for longer than 120 days. Usually this is done by applying for a work permit, or it may simply occur when the time has expired.
This is an important issue as it determines whether you pay local or overseas rates for medical attention received at the Norfolk Island Hospital.
LEVY DAYS:
Levy days are 1 March and 1 September of each year.
As from 1 March 1999 the levy is $250.00 each adult member for six months (Children under 18 are not levied).
POINTS TO KEEP IN MIND:
Healthcare will not cover you for ALL medical expenses once you have exceeded $2,500.00. Please study the exceptions.
If you wish to be referred to a Private Hospital you should be prepared to pay the difference between Public Hospital rates and Private Hospital rates (i.e. theatre fees) OR take out additional private medical insurance.
You can ask to be referred to a Public Hospital but waiting times vary state by state. In NSW, emergency cases are accepted immediately, in not so urgent cases delays are minimal, however this may not be so in Queensland and New Zealand.
Medical treatment received overseas can only be counted as part of "approved" medical expenses if a Healthcare referral is issued by the Government Medical Officers at the Norfolk Island Hospital.
When you travel it is recommended that you take out travel insurance to cover you for illnesses or injuries incurred overseas.
If you are referred away for medical treatment, you are only covered under Healthcare for that specific referral.
The $2,500.00 threshold is accumulated by approved medical expenses by the "nuclear family. A nuclear family is 2 persons who are the spouses of each other together with 1 or more qualifying children. In other words the first $2,500.00 liability is not per member but per nuclear family.
Only approved medical expenses can be accrued to the $2,500.00 threshold, for example only $200.00 of transport costs can be accrued to the threshold.
The Healthcare Act 1989 requires members to claim a refund from their private medical insurance before claiming form Healthcare.
Dental services are not covered by Healthcare.
If you are a new arrival to the island or a resident returning, you may be required to fill out a medical history questionnaire because the Healthcare Scheme will not cover any pre-existing illness or injury for the first 5 years of membership.
Members who have adequate private medical insurance may apply to the Minister for Health for a "suspension" to pay the levy.
Once the Minister grants an application for a suspension, applicants are no longer eligible for coverage under Healthcare.
Persons who have applied for and were granted a suspension application should be aware, that if they wish to return to the Healthcare Scheme the pre-existing illness and injury exclusion will apply for five (5) years after they again become members.
Application forms for exemption are available from the Healthcare Manager and when lodged should include evidence of up to date or in advance contributions together with details of the coverage offered.
Members who earn an amount of $3,500.00 or less ($7,000.00 for a married or a bone fide de-facto couple) in the six months prior to a levy may apply to not pay the levy based on income.
Application forms are available from the Healthcare Manager and when lodged should provide details of income received.
HOW TO CLAIM:
Claim forms are available from the Hospital or the Healthcare Manager.
When lodging a claim please attach ALL invoices, receipts and a $2,500.00 report from the Norfolk Island Hospital which is proof that you have exceeded $2,500.00 in medical expenses for that financial year.
Please lodge claims -
if they amount to $300.00 or more,
or if it is 6 months since you lodged your last claim.
If you are being referred overseas for medical treatment and the matter is likely to be expensive, please talk to the Healthcare Manager if you require assistance. In considering the circumstances of a case, the Healthcare Manager can provide a direct charging authority which authorises the medical
provider to charge Healthcare for the costs of the service. One of the conditions why this authority may be provided is when the member has exceeded the $2,500.00 limit.
DID YOU KNOW?
Private health insurance typically costs $3,000.00 to $4,500.00 per annum per family to cover you for local and offshore treatment, whereas currently the Healthcare Levy is $1,000.00 per year per family.
Most private health insurance covers have annual limits, whereas Healthcare presently has no such limit.
Private insurance has no guarantee of renewal.
Private health insurance does not cover any airline fees, whereas Healthcare covers $200.00 per referred member per year for transport costs.
Top Private health insurance only covers outpatients diagnostic services at the rate of the Medicare schedule, whereas Healthcare presently covers 100%.
IF YOU REQUIRE FURTHER INFORMATION ON ANY MATTER RELATED TO HEALTHCARE PLEASE CONTACT THE HEALTHCARE MANAGER ON phone 22001 BETWEEN 8.30AM AND 4.30PM.