- Cancer Information
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- Cancer care and your rights
- Navigating the health care system
Navigating the health care system
Health care systems are complex and sometimes challenging to understand, particularly when you are dealing with the physical, emotional and financial impacts of cancer.
Australia’s health system has 2 parts: the public health system and the private health system. People can be treated publicly or choose to use their private health insurance to be treated privately. Most people treated for cancer use a mix of public and private services.
Learn more about:
- Public health care
- Private health care
- The cost of cancer
- Exploring medical costs
- What is Medicare?
- Informed financial consent
- Ways to manage health care costs
- Medicines and the PBS
The Australian Government provides free or subsidised medical care and hospital services through Medicare. This is known as a “universal health care system”. If you have a current Medicare number, you have the right to receive free treatment as a public patient in a public hospital (even if you have private health insurance).
Public hospitals often provide a wider range of services than private hospitals, including:
- emergency departments
- specialist surgical and medical units
- allied health services.
- you can’t choose your doctor or any other member of your health care team at the hospital
- you might have to wait longer for treatment than a private patient.
Cancer care delivered publicly includes:
- consultations with your oncologist or surgeon
- cancer treatments (e.g. surgery, chemotherapy, radiation therapy)
- tests such as blood tests, x-rays and imaging scans
- some allied health services (usually in outpatient clinics).
It’s important to remember that both public and private patients have the same access to public hospital services.
For an overview of what to expect during all stages of your cancer care, visit Your guides to best cancer care. These short guides give an overview of recommended approaches to diagnosis and treatment for a range of different cancer types.
The cost of cancer
General practitioner (GP) – When you first notice the signs and symptoms of cancer, the first health professional you are likely to see is your GP. Your GP will arrange initial tests and scans and, if cancer is suspected, will refer you to a specialist for further tests.
Diagnostic tests and scans – To confirm a cancer diagnosis, you may have a range of tests and imaging scans. These tests may be done in a public or private hospital or health service.
Medicare will cover some or all of the cost of tests and scans. Check with your health care provider what you may have to pay for these tests (out-of-pocket costs).
Treatment – Cancer treatments may be offered in both public health services and private health services. It’s very important to understand the costs that you may have to pay yourself (out-of-pocket costs) before making treatment decisions. This is called informed financial consent. You may be able to have some of your treatments in the public system and some in the private system.
Keep in mind that there may be a period of waiting if you choose to switch from private to public care.
Follow-up care – After completing your treatment, your continuing care may be organised by your GP or your cancer specialist. Medicare may cover the cost of some or all of your medical follow-up services. You may also need to see allied health professionals, such as exercise physiologists and dietitians.
Some of these services may be covered by Medicare; talk to your GP to see if you are eligible for a chronic disease management plan.
If you have private health insurance for extras, you may be able to claim for part of the cost of some allied health services.
Exploring medical costs
Understanding all treatment costs may play a role in your decision to use public or private services. It may be helpful to visit the Australian Government’s online tool Medical Costs Finder, which is a general guide to the typical fees, private health insurance contributions and out-of-pocket costs for medical services in your area. The Medical Costs Finder covers services provided in and out of hospital.
Also see Overview of Health System for a general list of what Medicare and private health insurance cover. If you have private health insurance, you will need to contact your health fund to find out what costs are covered in your policy.
Podcast: Coping with a cancer diagnosis
Prof Sarah Lewis, Faculty of Medicine and Health, The University of Sydney, NSW; Kevin Bloom, Senior Social Worker, Haematology and Bone Marrow Transplant, Royal North Shore Hospital, NSW; Danielle Curnoe, Consumer; Alana Fitzgibbon, Clinical Nurse Consultant – Gastro-Intestinal Cancers, Cancer Services, Royal Hobart Hospital, TAS; Hall & Wilcox (law firm); Johanna Jordaan, Consumer; Dr Deme Karikios, Medical Oncologist, Nepean Cancer and Wellness Centre, Nepean Hospital, NSW; Melissa Lawrie, Breast Cancer Clinical Nurse, Cancer Services, Gold Coast Hospital and Health Service, QLD; Jacqueline Lesage, Consumer Reviewer, Cancer Voices NSW; McCabe Centre for Law and Cancer, VIC; Louise Pellerade, 13 11 20 Consultant, Cancer Council WA; Andrew Potter, Consumer; Siân Slade, PhD Candidate, Nossal Institute for Global Health and Non-Executive Director (health, disability sectors), VIC; Paula Watt, Clinical Psychologist, WOMEN Centre, WA.
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