Private Health Insurance Policies For After Hours GP Care

Getting sick can happen at any time, not just during business hours.

So what should you do when you or a family member is ill and your doctor's office is closed?

Resist the temptation to turn to Dr. Google, because there are better options in place for after-hours care.

What is after-hours GP care?

After-hours GP care is not meant to be a replacement for routine doctor visits or a substitute for emergency care.

If the condition can wait until your GP's office hours, you should contact them the following day to make an appointment.

If you are having a medical emergency, you should dial 000.

After-hours care is for urgent medical conditions that occur outside of normal business hours.

For example, you may need after-hours care in the following situations:

• You have an infant who is running a fever or vomiting

• Someone in your household has an infection like tonsillitis or the flu

• Someone in your household is suffering from gastroenteritis, which may include symptoms such as vomiting or diarrhoea

If you need to see a doctor and it can't wait until the next day, that's when you may need to consider after-hours care.

Who Should i call?

Non-Urgent medical Situation: Call your GP when the office re-opens

Urgent medical situation during office hours: Call your GP

Urgent medical situation outside of office hours: Call the GP After-Hours Helpline

Emergency Situation: Call 000 immediately

After-hours helpline

In the past, the only option for after-hours health concerns was to visit an emergency room, where you could face a wait time of several hours.

Australians nationwide now have the option of calling the After-Hours GP Helpline at 1800 022 222.

The service is funded by the Australian government and acts as an extension of the 24-hour healthdirect helpline.

After-hours helpline schedule

The helpline's hours of availability differ based on location.

Rural areas were identified as needing expanded support, so the hours of operation have been extended outside of major cities.

Outside major cities the helpline is available:

• Monday to Friday 6pm to 7:30am

• Saturday from 12pm

Within major cities the helpline is available:

• Monday to Friday 11pm to 7:30am

• Saturday from 6pm

It is available all day on Sundays and public holidays nationwide.

After-hours helpline nurse

Callers are put through to a nurse, who will assess the caller's situation. If appropriate, the nurse will refer them to a GP or to dial 000.

The nurse can also reference information in the National Health Services Directory to help the caller find the relevant local services and alternatives to emergency departments in their area.

GP call back

If the nurse determines that you could benefit from speaking with a GP, they can arrange to have a GP call you back.

The call back will come within 15 minutes or within an hour, depending on the urgency of your condition.

You can also choose to have a summary uploaded to your My Health Record and sent to your regular GP.

Other after-hours options

There are other ways to access medical care after hours, such as after-hours clinics, at-home doctor services, and special support services offered through private health insurers.

After-hours clinics

To find a clinic or pharmacy in your area that is open after hours, you can use the following services:

• The Healthdirect website, a government-run initiative that allows you to search for open clinics near you

• HealthEngine, a website that lets you track down healthcare professionals across Australia and book appointments online 24/7

At-home doctors visits

Bulk-billed services are also available to patients with a Medicare or Gold DVA card who wish to have a GP visit their home after hours.

Call lines are generally open from 6pm weekdays, 12pm Saturdays, and all day Sundays and public holidays.

• National Home Doctor Service: Arrange for a home visit by calling 13SICK or using the mobile app.

• Doctor Doctor: Available to people in Melbourne, Perth, Brisbane and Sydney. Includes telephone advice and bulk-billed home visits after hours.

• Dial a Home Doctor: Available in Queensland and NSW only. Bulk-billed home visits can be organised over the phone or via the mobile app.

Health fund after-hours support

Health funds offer varying levels of support for after-hours care.

Ask your fund about what services are available to you.

Here are two examples of extra support that private health insurers provide:

Bupa

Bupa members receive free membership to the National Home Doctor Service's After Hours Plus program.

There is no need to register because members are given access to the service automatically.

The membership allows policyholders to receive common medications on the spot during a bulk-billed after-hours visit.

Medibank MiHealth

Members with a Medicare hospital policy are granted access to the 24/7 advice line.

You'll speak to an experienced nurse who can advise you of the best course of action.

If the nurse believes you should see your GP, they can talk to your preferred clinic and arrange to help get you an appointment as soon as possible.

Will my health fund cover after-hours care?

Access tor after-hours care via your insurer depends on your health fund and the type of policy you have.

The benefits may include access to home visits and provision of on-the-spot medication through an after-hours GP service such as the National Home Doctor Service.

It may include additional support through a private after-hours hotline that is exclusive to the fund.

Each fund determines its own level of after-hours cover, so keep this in mind as you compare funds.

Which option should I choose?

First, be aware of the after-hours health care options your health insurance policy offers.

That will help you determine which option suits your situation.

You can start by calling an after-hours helpline, such as the one offered by the government or one run by your fund.

From there, you can get professional advice as to whether you'd benefit from seeing a doctor right now or waiting until your regular GP is available.

Depending on your location, you may want to arrange an at-home GP visit from an after-hours service.

Making health decisions happens 24/7, so look for a health fund that can be with you around the clock.

How else can private health insurance help?

In addition to GP visits, extras cover with private health can cover you for specialist visits to chiorpractry & physiotherapy. Be sure to compare policies

Chris Stanley is the sales & operations manager of health insurance at Compare Club. With extensive experience and expertise, Chris is a trusted leader known for his deep understanding of health insurance markets, policies, and coverage options. As the sales & operations manager of health insurance, Chris leads a team of dedicated professionals committed to helping individuals and families make informed decisions about their health insurance needs.

Meet our health insurance expert, Chris Stanley

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