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Remicade and Insurance in Australia

Hello everybody!

As I am new to the forum I will introduce myself briefly. I´m 24 years old, live in Rotterdam in the Netherlands, and have been diagnosed with Ulcerative Colitis four years ago. Fortunately, I haven't had any major physical or other issues with UC since I started my Remicade treatment about three years ago. However, currently I find myself facing my first challenging situation. I hope you can help me figure this out!

I am planning on spending 12 months in Australia (both working - at farms - and travelling) with a Working Holiday Visa (subclass 417). This means that I will have to receive my Remicade treatment in Australia (a total of 6 times, as my treatment is every 2 months). As I will be working in Australia, this means (because of certain regulations) that my existing Dutch insurance will be stopped. Furthermore, as my UC is considered an "existing condition", Dutch health insurance companies providing so called "backpacker insurances or temporary abroad insurances" are not covering the costs of these treatments in Australia. So now I am trying to figure out the best way to go forward with this situation. In previous threads I have found some pieces information on this topic, however, I am still unclear on my personal situation (and this is where I hope you can help me).

It is for sure necessary to have health insurance. Then, could I get health insurance in Australia? I understand that Australia has Medicare, and with the Working Holiday Visa (subclass 417), a Dutch citizen is eligible for Medicare. However, does this mean that I would also be covered for my Remicade treatment (thus an existing condition)?
And if this is not the case, should I pay for the treatments myself? And what would the cost be of these treatments?

I look forward to your responses,

Best,
Mathijs
 

DustyKat

Super Moderator
Hi Mathijs and welcome,

I have done a bit of a search and from what I can fathom pre existing conditions won't be covered under your medicare card. it is for unexpected issues that arise when you are here:

What’s covered?

Medicare covers treatment that is deemed ‘medically necessary’. This means any ill-health or injury which occurs while you are in Australia and requires treatment before you return home. This includes:

Free treatment as a public in-patient or outpatient in a public hospital

Subsidised medicines under the Pharmaceutical Benefits Scheme

Medicare benefits for out-of-hospital medical treatment provided by doctors through private surgeries and ‘bulk bill’ community health centres.

* Resident of the Republic of Ireland and NZ are not entitled to Medicare benefits for non-hospital medical care and will not be issued with a Medicare card. To access these benefits you should show your passport at hospitals or pharmacies.

All other nationalities must pay for treatment and claim from their personal travel insurance policy, if covered.

What’s not covered?

Many treatments are not covered, including that not considered immediately necessary:

Medicines not subsidised under the Pharmaceutical Benefits Scheme

Dental work and allied health services

Treatment arranged before your visit to Australia

Accommodation and medical treatment in a private hospital

Accommodation and medical treatment as a private patient in a public hospital.
https://www.travellers.com.au/plan-your-trip/medicare/

With that in mind, I doubt your Infliximab would be covered. I imagine there is no restriction to buying it privately but you would still need an Australian prescription.

http://www.chemistwarehouse.com.au/buy/61098/Remicade-100mg-Injection-Powder-1

The other thing to consider is where you are going to have the infusions done. Outside of the major capital cities the only place would be a public hospital. I don't know how that works with the medicare card. You could always email Medicare and enquire.

https://www.humanservices.gov.au/individuals/enablers/rhca-health-care-visitors-australia

The search below brings up most of the health insurance companies that offer working holiday insurance for 457 visa holders. I didn't search further than that so I don't know what the rules are with pre existing conditions.

For resident Australians private health insurance companies aren't allowed do discriminate against those with pre existing conditions applying for coverage but there may be a waiting period.

https://www.google.com.au/search?q=....69i57j0l5.24839j0j8&sourceid=chrome&ie=UTF-8

There is also this government website regarding 457's and private health insurance:

http://www.privatehealth.gov.au/healthinsurance/overseas/457visa.htm
 
Hello DustyKat,

Thank you very much for your elaborate response. It thus seems that this might become more of an issue than I initially expected. Using your search I found Bupa insurances, who told me that they do cover the cost, however, only after a period of 12 months (which is exactly the length of my stay in Australia).
 

DustyKat

Super Moderator
I feared that a waiting period would be the case as it is the same for residents :( unless moving from one insurer to another and retaining the same coverage.

How many doses of Remicade are you able to obtain in one purchase in the Netherlands?
 
Hello everyone!
My name is Philine, I'm from Germany and I'm 19 years old:

I also want to spend 12 month somewhere in Australia, but as a AuPair :)

I am planning to go with "AIFS" which is a company/agency to help you find a host family etc.
With this company i'm going to have medicare as my insurance, but they don't pay for my Remicade treatments (i need to get every two month) and the blood test i need to have one week before my infusion (to check if everything is "ok").

@Mathjis01 Did you found a health insurance company which covers the costs for the treatments or did you pay everything yourself?
And how much did you pay per month or per treatment? :)
 
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