The Medical ‘Claim-Back’.



As was written before, the procedure of a cataract removal involved a number of procedures of which, on the benefit of hindsight, the main one seemed to be of a financial nature more than a medical one. More time was spend on writing and printing the bills than on the actual cataract operation which might not have lasted more than perhaps five minutes or so. The bills were very concise and clear after which it was necessary to pay them, and that took some time in processing with the usual presenting of a card that was swiped or tapped on a special device. There is always the usual moment of suspense to see if the payment would be accepted or not. I always feel a bit anxious with this form of payment. A few times in the past my payments by card did not work and my guilt always goes into automatic when this happens, as if I am trying to gain an advantage through deceit.

After an appointment with the optician some months ago, it was deemed an eye surgeon ought to be engaged and after the corona hold-up, the operation was done some days ago. The total cost was several thousand dollars of which the cost of the operation was small compared with cost of the hospital. A private hospital. I was told by the surgeon that to get this operation paid for by social benefits it would mean waiting a prolonged period and no definite date could be given, worse it was hinted, that ophthalmic ( four consonants) students often sharpen their burgeoning skills by doing minor operations.

Out of the goodness of Australia’s social security’s heart, one can make a claim on the surgical part but not on the private hospital costs, which as mentioned before was the major part of the expenditure. The grand total of $ 579.- was claimable. But let me tell you, that the Private Hospital sandwich was superb and with a glass of juice to boot. The nurses were friendly and so was I, and refrained from a silly remark when I noticed that the lapel on one attractive nurse’s shirt had ‘Gina’ on it.

Years ago I had a number of colonoscopies done in a public hospital and at one stage almost was wheeled into a room to get an hysterectomy done instead, because I had ‘Mary’ on my wrist-band. I still shudder thinking about it. What a blunder. No fear this time of that happening as I had two wristbands, one for each arm. No mistake in a Private Hospital!

So, two days ago I went to the Bowral ‘Centre-Link’ government office to make my claim for the $ 579.-. Helvi and I sometimes had to go there in order to prove we were still alive and not getting benefits by deceit pretending we were alive instead of being dead. It always takes time, to prove life. The atmosphere in Government offices is usually of an all pervading gloom. The room, the people, the whole atmosphere is grey and of totally leeched out despair. This time it wasn’t too bad. Because of the corona virus they only let in five people at the time. Many were in a listless queue waiting outside. I, because of my senior countenance was given preference and was herded in by a man with a large stomach who proceeded asking me questions about my corona history and if I felt giddy or off colour. I was let in and seated at a suitable distance away from others.

There was a jolly woman and friendly husband making the best of the situation, nodding friendly in my direction. I am a sucker for friendly laughing people and my mood went skywards, here is a chance to connect with another soul! It wasn’t long before I had my case dealt with and was told the money would go automatically into my account which I could check the next day.

I did, and it was there.


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24 Responses to “The Medical ‘Claim-Back’.”

  1. Sandie Says:

    Guess I was lucky as all my op was covered by my insurance as my Dr. only charged what I got back. Hope urs as good as mine as I had my op several years ago.

    Liked by 2 people

    • gerard oosterman Says:

      I never had private medical insurance. Both Helvi and I came from countries where costs for, education, health, pensions etc are provided by governments that raise the expenditure through taxation in one form or the other.

      Liked by 1 person

  2. leggypeggy Says:

    A success all round, except for having to pay the hospital bill.

    Liked by 2 people

  3. Big M Says:

    I’m sure that Centrelink is designed to be as soul destroying as possible. I guess most of the staff assume that the money is coming out of their own purses. I took my mother there recently to submit some Medicare statements to the Commonwealth ‘Safety Net’ department. After sitting for half an hour Mum’s request was examined. “No, you could have left that with the receptionist.” We approached the receptionist. “Why are you giving those statements to Centrelink, we don’t want them!!” I pointed to the sentence on the statement that instructed us to submit the information via Centrelink. She took the statements with much eye rolling. It’s easier to mail these things in.

    Glad you got it all sorted.

    Liked by 4 people

    • gerard oosterman Says:

      Through the decades in Australia social services have been portrayed as charity and not an entitlement that caring societies work towards.

      Even a pensioner is loaded with a kind of negative connotation implying failure for not having somehow been able to be so successful as being self-funded in retirement.

      The atmosphere at Centrelink is loaded with that. On a few occasions I have seen police being called in to calm irate clients. There are signs that aggression will not be tolerated.


  4. algernon1 Says:

    A sandwich and a fruit juice. Huh! All I go was a muffin cut into quarters, three jatz with three small pieces of cheese and a cup of tea. Private hospital, didn’t cost me through the health fund, might get a bit extra for the surgeon but a significant amount of out of pocket.

    Had the second eye done today, sight looked good before they covered it up again. Patch off tomorrow.

    Liked by 2 people

    • gerard oosterman Says:

      The sandwiches were nice, Algy. Glad you got your second eye done. Let us know how the eye is.
      I am still feasting on my successful operation and made a stunning chicken curry to celebrate.

      Liked by 1 person

      • algernon1 Says:

        That’s great Gerard making the curry. I roasted a chook the other day with all the veg.

        The second eye is marvelous, some bruising from the anesthetic injections, can start driving next week, but I’ll have to prop my glasses on the end of my nose until I get my licence changed. The worst thing is the glare. But being able to see clearly is what I like. Don’t need glasses for the computer and may even be able to read without them as well once it settles.

        If your getting the second one done you will notice the difference.


  5. auntyuta Says:

    Peter and I, we are both so lucky that onece a month we get a small German pension: This is on top of our Australian pension! Once a year we get some papers sent from Germany that we have to take to Centrelink. And Centrelink has to write on one of the papers that we are still alive, and we have to sent this paper back to Germany as prove that we are still alive. And this means then, we can still get our German pension. This extra pension money is coming regularly from Germany, that is we do find it in our bank accounts. It really works well, like clockwork. As I said, for this we have to visit Centrelink once a year. I think this occasion is going to arrive next month again. Hopefully, we might still be alive by next month! 🙂

    Liked by 2 people

    • gerard oosterman Says:

      I too get a small Dutch pension which was increased after Helvi passed away. In a total contrary way, my Australian pension was cut off because I was ‘deemed’ to have enough to go without.

      This shows starkly the differences between the European idea of social welfare as a necessary entitlement for a society that is working towards compassion for all.

      Australia is not in that league at all and usually tries to cut back and minimise social entitlements portrayed as charity.
      I would not call that being ‘lucky’.

      Liked by 2 people

      • auntyuta Says:

        Well, I think that we do get a bit of German pension because we both worked for a certain time in Germany, that is kind of lucky. We only qualified for this pension because our contribution to the German pension lasted for more than five years. We both had very low incomes in Germany. This is why our pension we get out of this, is very low indeed and does not effect our Australian pension. 🙂

        Liked by 1 person

  6. Robert Parker Says:

    Despite the gloomy gov’t offices, it sounds like a decent system. Here in the U.S., Social Security is often inadequate, and under threat of being privatized or being allowed to dwindle away. Getting seriously ill is a financial catastrophe – the primary reason for 2/3 of personal bankruptcies, something like half a million people a year. Even the insurance companies and hospital systems calling themselves “non-profit” are expensive and greedy.

    Liked by 3 people

    • gerard oosterman Says:

      Yes, I know it is worse in the US which seems to now be at the end of the worlds greatest empire. China here we come!
      I see footage of food queues in America, unheard off till recently. In the UK hey are now threatening Cecil Rhodes statue and even Churchill had to be boarded up.
      Here too food kitchens are busy feeding people.

      Liked by 1 person

  7. auntyuta Says:

    Yes, it seems to me that the ‘rich’ US does not treat its citizens the right way. As pensioners in Australia we do not need any medical insurance. Ambulance and hospital stay is for free for us. If we want some elective surgery done, there is a waiting list of about 12 months. If we are not prepared to wait for 12 months, we have to go for private, which is expensive. So for ‘elective’ surgery we only have to pay, if we do not want to be put on that waiting list. Otherwise even elective surgery and all other surgeries are free. A lot of medical prescriptions are subsidised, also specialist consultations are partly subsidised. General Practitioner consultations are basically free unless the GP has too many patients and does charge an additional fee that is not covered by Medicare.

    Liked by 1 person

    • DisandDat Says:

      Hello Auntyuta. Yes Oz generally has a good system with Medicare. I have though been on the waiting list in the public health system for a hip replacement for over two years. And yes visiting Centrelink for health or whatever other reason is a degrading experience. You are treated as a number, very impersonal.

      Liked by 1 person

  8. doesitevenmatter3 Says:

    YAY! So many good things to be grateful for!
    And so so SO glad they did NOT think you were Mary this time! 😮 😛
    But, so glad you found the merry in your experiences! 🙂
    HUGS!!! 🙂

    Liked by 1 person

  9. rangewriter Says:

    I love how you tell a tale. And are you telling me that you had a hospital stay that cost only $579? I suspect this was not an overnight stay? Perhaps this was for that short time that you had to complete all the mounds of paperwork and the few seconds the doctor did his/her thing. Then a brief recovery and then home?

    Liked by 1 person

    • gerard oosterman Says:

      No, the total costs including operation and one hour stay in hospital cost over $6000.-. The$ 579.- was the refund that the government gave back to me. I was back home before lunch!

      Many people can’t afford that sort of expenditure and are on a waiting list that sometimes can take years

      I noticed that in Africa volunteer doctors from Australia operate on cataracts and the costs are $25.-


  10. shoreacres Says:

    When it comes to medical costs, I operate by the dictum: “You never ask, you never know.” I can’t remember if I recounted the tale of my hysterectomy. The surgeon’s cost was negligible, because he and his wife, also a surgeon, were customers of mine; I varnished their boat. When he found out that I needed the surgery, he had a proposition. If I would keep their boat in fresh varnish, he would do the surgery. That was fine by me.

    As it turned out, he was quite the innovator, and was perfecting his technique with a laser. That meant no interminable hospital stay; it would be an over-nighter. However, the hospital bill was going to be around $5K, as I recall. When I met with the lovely hospital bean-counter, and explained there was no way I could pay that kind of money, she pondered for a while, and then asked if I could pay cash rather than being billed. When I said I didn’t have that much in savings, she said, “Well, don’t you have a credit card? Credit’s the same as cash in our book.” When I agreed that I could do it that way, she said, “It’ll save you some, too. The cash price is $1,500.”

    I’ve never forgotten that. How much padding is being done by the insurance companies? Etc, etc. In any event, I’m glad you’re done with your little experience. Here’s to clear vision, and the occasional helpful bureaucrat!

    Liked by 1 person

    • gerard oosterman Says:

      Glad you had that done, Lynda. You must have checked the correct name (and sex) on your wristband. In my case I nearly had an operation that you had done because my wrist showed ‘Mary’. Although surely, they would have checked first before diving in. I had the colonoscopy done without too much drama instead. I well remember the nice lunch afterwards. Boy was I hungry!

      The ideal arrangement and bartering is one of the things that might become more important in the future. I never though but perhaps I could have given the surgeon a couple of my etchings too. Mind you, I did not really know him apart from a couple of minutes during the initial appointment. In any case, the surgeon’s fee was modest.

      It was the private hospital fee that was really the killer. The hospital is part of a large consortium listed on the stock exchange and they were merciless but friendly right from the moment I entered the door to their ‘day-time surgery’, department. I had to keep social distance and as an extra precaution was warned not to lean on the counter and keep behind the tape on the floor. The first thing after signing lots of disclaimers and given carte blance to the hospital and their billing arrangements, I was given this large bill of more than $4700.-

      I coughed up but could not reach the little credit card machine without touching the counter. But, they said it was alright just for this occasion. The sandwiches were nice and so was the orange juice. But an hour’s stay for close to 5K not including anesthetics and the cost of the surgery?

      Liked by 1 person

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