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Table 1 Arrangements for out-of-hospital medical (MBS) and pharmaceutical (PBS/RPBS) services in Australia for individuals with and without DVA Gold Cards

From: Does Government subsidy for costs of medical and pharmaceutical services result in higher service utilization by older widowed women in Australia?

All Australian residents Australian residents with DVA Gold Card
Medicare Medicare
· Medicare pays 85-100% of scheduled fee for GP/specialist visit up to threshold (see below) · Always bulk-billed i.e., no gap or out-of-pocket costs
· Person pays gap of up to 15% plus out-of-pocket costs (difference between scheduled fee and GPs/specialist’s charge) · DVA pays GPs higher fees according to its own schedule 
· GPs/Specialists may accept Medicare payment (bulk billing). This is most common for concession card holders and in areas of lower SES · Covers a comprehensive range of Allied and Dental Health services
  · Provides for rehabilitation appliances
  · Funds in home nursing and domestic support services
· Medicare Safety Net threshold (2012 Figures):  
· All Medicare card holders (Australian residents)  
· Once $413.50 for gap payments has been met annually, Medicare will pay 100% of scheduled fee  
· Once $1198.00 for out-of-pocket costs for extended Medicare Safety Net services has been met annually, Medicare will pay 80% of out-of- pocket costs  
· Concession card holders – Once minimum $598.80 for out-of-pocket costs for extended Medicare Safety Net services has been met annually, Medicare will pay 80% of out-of-pocket costs  
PBS Co-payment PBS/RPBS Co-payment
· General patient - $34.40 per scripts up to threshold · $5.80 per script up to threshold of $348.00
· Concession card holder - $5.80 per script up to threshold  
PBS Safety Net threshold (2012 Figures): PBS Safety Net threshold:
· All Medicare card holders (Australian residents) - Once $1363.30 has been spent annually on pharmaceuticals listed on the PBS, further pharmaceuticals are maximum $5.80 · Once minimum $ 348.00 has been spent annually on pharmaceuticals listed on the PBS/RPBS, further pharmaceuticals are free 
· Concession card holders – Once $348.00 has been spent annually on pharmaceuticals listed on the PBS, further pharmaceuticals are free  
  1. PBS – Pharmaceutical Benefits Scheme; RPBS – Repatriation Pharmaceutical Benefits Scheme; SES - Socio-economic status.