Everything you need to know about the Overseas Student Health Cover (OSHC) for Australian international students

Everybody applying for an Australian student visa (subclass 500) must have a valid OSHC.  Perhaps for many, the OSHC is just one of those requirements they must comply with, and little thought is actually spent when buying one.  There are only six (6) health insurance companies in Australia currently allowed to offer OSHC to international students and they share many common features, so maybe it’s not actually a terrible idea to just pick whatever.  Or is it? 

In order to better understand OSHC, and thus make better buying choice, we will discuss the Australian health care system, we’ll talk about what exactly is OSHC, we’ll also compare the features of OSHC products being offered by different companies, and discuss how you can get the most out your OSHC.  As mentioned, the OSHC product in the market offer many common features but that doesn’t mean some aren’t better than others.  Short of recommending a particular product, we will point out to some features of some OSHC’s that we believe stand out.

The Australian health care system

Health care in Australia is among the world’s best.  The ratio of doctors to the population is among the world’s highest.  We have many world-renown doctors and specialists.  The equipment, technology, and techniques utilised in medical treatment and medical care are cutting edge.  And it’s all essentially free.  At least for Australian citizens and permanent residents.  This universal health care system is delivered or provided to the people of Australia through a scheme called Medicare, a government-funded (through income tax and Medicare levy) health care insurance for all Australians.

As a citizen, whenever I see my GP (General Practitioner, or family physician), I don’t pay him anything directly, he charges the full cost of the consultation to Medicare.  How much does he charge Medicare?  He charges the amount what Medicare say the cost of the consultation should be.  Indeed, Medicare has a schedule that lists all medical treatments that it pays, and how much it pays for each of those items.  This list is called the Medical Benefits Schedule (MBS).  The list of treatments MBS covers is pretty exhaustive and includes most illnesses or conditions, or medical needs, except for dental treatment (except those done in hospitals), ambulance, cosmetic related procedures, prosthetics, medicines (although subsidies exist via the Pharmaceutical Benefits Scheme (PBS), eye glasses (although eye examination is included in MBS), etc.      

               

For example, the MBS says it’s paying $38.20 for a less than 20-minute GP consultation wherein the GP performs a medical examination, take note of medical history, arranges any necessary investigation, implements a management plan, or provides an appropriate preventive health care to a patient, in his or her clinic during normal business hours during weekdays.  If the GP is ok with this rate, he/she doesn’t need to bill individual patients, and will instead just bill Medicare in bulk for all the patients he /she saw.  This is called bulk billing.  GP’s who have a sign “Bulk bill” posted on their clinic pretty much means patients don’t need to worry about the consultation bill.  It’s all taken cared of by Medicare.  In contrast, there are GP’s who do not bulk bill.  Meaning they charge consultation fee that is more than what Medicare pays therefore patients need to pay that portion of the consultation fee that is beyond what Medicare pays.  This is called a gap fee. 

Whether a GP does or doesn’t do bulk bill doesn’t have anything to do with his or her capability or competency.  An overwhelming number of top-notch GP’s do bulk bill, and perhaps 90% of GP’s do bulk bill.  On the other hand, the reverse is true for specialist doctors, e.g., cardiologist, orthopaedic doctor, etc.  Some of them may do bulk bill but an overwhelming number of them do not (meaning they charge more than what Medicare pays).  So, when seeing a specialist, it’s typical for patients to pay a gap fee.

In Australia, unless it’s an emergency health situation involving an accident, pain, or serious health risk or risk of death for which you need to be attended to straight away in a hospital’s emergency department, your first stop for any health concern is your GP. If you need to undergo diagnostic procedure like blood test or x-ray, or you need to see a specialist, you need your GP to make a referral for you. You cannot go straight to a specialist, or have your blood tested without referral from a GP. The same is true if you need treatment provided in a hospital, like endoscopy or MRI scan, you will need a referral from your GP or specialist.

In Australia most of the big, highly equipped and modern hospitals are public hospitals.  These public hospitals are literally comparable, if not better, to many expensive, private hospitals in western nations.  Public hospital costs, such as accommodation, surgery, medications, etc., usually subscribe to what Medicare says the costs should be.  Thus, when a citizen or permanent resident gets hospitalised they generally have no out-of-pocket expenses (out-of-pocket means things you’ve paid for out of your own money or pocket) for their world class treatment. 

Understanding the Overseas Student Health Cover (OSHC)

Because international students are neither Australian citizens nor permanent residents, they generally do not have access to Medicare (except for nationals of some countries like Belgium, Norway and Sweden, etc., which Australia has a Reciprocal Health Care Agreement with). Medicare is not a requirement to get medical treatment in Australia, but without Medicare or some form of health insurance, the cost of medical treatment or care (if you happen to need one) can get very expensive. OSHC ensures that international students will have access to medical care or treatment if ever they need one, and that they will not be unduly burdened financially as a result of. In a nutshell, the Overseas Student Health Cover (OSHC) is a health insurance for international students that mimics the health care benefits ordinary Australians enjoy under Medicare, and more. OSHC also covers care and treatment not covered by Medicare such as ambulance service, prosthetics, costs of being a private patient in a private hospital, etc.  

As an international student with OSHC you can see a GP for a wide range of health concerns or reasons for an unlimited number of times.  Exactly what Australians also enjoy because of Medicare.  As an international student with OSHC you’re entitled to free emergency ambulance, unlike Australians who must pay for it because it’s not covered by Medicare.  As an international student with OSHC, in case you need, for example, an endoscopy procedure, you generally don’t need to wait in line to get it done unlike ordinary Australians relying on Medicare who are subject to a waiting list for some treatments.  As an international student with OSHC, in the event you need hospitalisation you are entitled to get admitted as a private patient in either a private or public hospital.  Whereas Medicare only pays for hospitalisation in a public hospital.

Comparison of the features being offered by OSHC providers            

Table below compares some of the salient features of all six (6) OSHC products.  

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Observations: 

1. Only Bupa and CBHS pay 100% of the MBS cost for out-of-hospital specialist and diagnostic services fees. This is a good deal as the potential benefits can be substantial.  For example, assuming you need to have several blood tests done, and the pathology clinic charges the same amount as what MBS says they should cost, say $200.  Because Bupa and CBHS will pay 100% of the MBS cost, they’ll pay the whole $200 and you have zero out-of-pocket cost.  Notice how other OSHC products say they will only pay 85% of the MBS cost.  Using our example scenario, this means that they will only pay an equivalent of $170, leaving you to shoulder the $30 difference.  Your out-of-pocket cost can further grow if you also need to see a specialist.
   
   
2. For out-patient prescription medicines, Medibank offers the best benefit as it will reimburse you whatever you pay that is beyond $30. For example, you were prescribed antibiotics that costs $50, you’ll be responsible for $30 and Medibank will pay for the remaining $20, up to a maximum of $70 per medicine per script.  Note that there is a maximum yearly amount that you can get reimbursed regarding the cost of your prescription medicine, and it’s the same for all OSHC, namely $300 for individuals, and $600 for family.
   
   
3. Most OSHC are silent on whether they’ll pay for your medicine if you get hospitalised, except Bupa who categorically said in their policy that they will pay for any medicine you’ll need while in the hospital and they don’t count towards your maximum prescription benefit limit as discussed above. Some, like CBHS, mention in their policy that medicines provided while hospitalised count towards the maximum medicine benefits.  Medibank told us over the phone the same thing, i.e., any medicine received while you’re in the hospital counts towards your maximum benefit of $300 per year for singles, or $600 per year for couples or families.  We believe this is a very important consideration given that medication while hospitalised can be a significant cost.
   
   
4. We’ve tried to get a quote for a one-year OSHC coverage from all six (6) providers and the difference between the cheapest and the most expensive is a little more than a hundred dollars. The price range of OSHC is between $413 and $529.

Tips on maximising your OSHC benefits

Hopefully you will never have a need for your OSHC, apart from the fact that you bought it because it’s a requirement of your student visa.  But in case you will need it here are some tips on how to maximise its benefits:

1. Typically, if you visit a GP you’ll need to pay their fee out of your own pocket first and then claim the amount from your OSHC provider. To save your self this hassle, go online to your provider’s website or call them first and ask for their affiliated GP’s near you and go see one.  As the case with all OSHC providers, if you see a GP affiliated with your provider you won’t need to pay anything upfront.  The GP will bill your OSHC provider directly.
   
   
2. Remember what we talked about bulk billing, choose a GP who does bulk billing. As a matter of fact, when you call your provider make them know that you prefer to see a GP who does bulk bill.

   

3. If you need to have blood test or x-ray, do the same thing. Ask your OSHC provider for pathology or radiology clinics who charge based on MBS fee to lessen or eliminate your gap or out-of-pocket cost.
   
   
4. Again, same procedure applies when you need to see a specialist. Some OSHC providers say that if you see specialists who are affiliated with them your contribution or out-of-pocket cost can be reduced, if not eliminated.  So ask your provider for their affiliated specialists.
   
   
5. If you need to go to a hospital and it’s not an emergency case, it’s best to call your OSHC first. Tell them your situation, and they should be able to tell you which hospital you should go (their partner private hospital, or public hospital), help you coordinate with the hospital, and give you the financial picture of your possible out-of-pocket cost (when you call them establish early on that you’re looking forward not to have any out-of-pocket cost, if this is what you want), etc.  Note that OSHC would have tie ups with private hospitals.  Usually they will cover all your hospitalisation expenses (sometimes with very little out-of-pocket cost) if you’re admitted to their affiliated private hospital or to a public hospital.  But if you choose to be admitted at a non-affiliated hospital you might incur significant out-of-pocket cost.

   

6. If you’re unwell and need to see a GP outside of office hours (like anytime between 6 pm and 6 am), there are GP’s who do home visits that you can call. These GP’s usually do bulk billing.  This arrangement can be veruy convenient when you cannot go out, or you’ve been busy during the day, or you just need prescription or medical certificate.  When you call an after hours home visit GP it’d be best if you clarify that you have OSHC and confirm that you’re not going to be charged any out of pocket cost.  Or, again, call your provider for their recommended after hours home visit GP.
   
   
7. Save your OSHC provider hotline numbers in your phone. Also, there are some providers who have multilingual staff that you can talk to, that’s handy when you wish to talk to someone in your own language.  Most OSHC providers have registered nurses that you can talk to as well.  

Be aware that you need to have a valid OSHC at all times while in Australia, from the first day you arrive continuously up to the day you leave.  You can transfer between OSHC providers as long as there is no day that you’re not covered.  If you failed to get a student visa, or didn’t end up studying in Australia, you can refund the money you’ve paid for your OSHC.  Everybody gets sick and everybody is subject to any random unfortunate events.  The Overseas Student Health Cover (OSHC) is a student visa requirement that’s, for all practical purposes, clearly for the direct benefit and welfare of the international students.