Imaging Costs With a Concession Card: What You Pay

Medical imaging can be one of the bigger out-of-pocket healthcare costs in Australia, especially for MRI scans and some ultrasounds. If you hold a concession card, you'll often pay significantly less - and in many cases nothing at all.

Many radiology clinics have a two-tier billing policy: they charge a gap fee for general patients but bulk-bill concession card holders, meaning Medicare covers the full cost and you pay $0.

The catch is that every clinic sets its own policy. Some bulk-bill everyone, some bulk-bill only concession holders, and some charge a (reduced) gap even with a card. That's why it pays to check before you book rather than assuming your card guarantees a free scan.

The cards most commonly recognised by imaging clinics are:

• Pensioner Concession Card - issued to Age Pension and some other Centrelink payment recipients • Health Care Card - issued to lower-income earners and some payment recipients • Commonwealth Seniors Health Card - for self-funded retirees of pension age who meet an income test • DVA Gold Card - covers treatment for all conditions for eligible veterans • DVA White Card - covers treatment for accepted service-related conditions

Each clinic decides which cards it recognises for its concession billing policy, and some also extend concession rates to children under 16, full-time students, or aged care residents. Always bring your physical or digital card to your appointment - clinics need to record the card details to bill correctly.

Bulk billing is when the clinic accepts the Medicare rebate as full payment, so you pay nothing. Concession cards make bulk billing much more likely:

• X-rays: very commonly bulk-billed for everyone, and almost always for concession holders • Ultrasound: many clinics bulk-bill concession holders even where general patients pay a gap • CT scans: frequently bulk-billed for concession holders • MRI: the least likely to be bulk-billed because Medicare licensing is limited, but some clinics do bulk-bill Medicare-eligible MRIs for concession card holders • DEXA scans: often bulk-billed for concession holders when Medicare criteria are met

Remember that a scan must be Medicare-eligible in the first place (valid referral, eligible item) for bulk billing to apply. Your referring doctor can tell you whether your scan qualifies.

Veterans' cards work a little differently from Centrelink concession cards.

With a DVA Gold Card, the Department of Veterans' Affairs pays for clinically necessary imaging for any condition. You generally pay nothing at clinics that accept DVA arrangements - which most radiology providers do.

With a DVA White Card, DVA pays for imaging related to your accepted conditions only. Imaging for other conditions falls back to the usual Medicare arrangements.

When booking, tell the clinic you're a DVA card holder and mention which card you have. Make sure your referral notes the relevant accepted condition if you hold a White Card, as this helps the clinic bill DVA correctly and avoids surprise invoices.

A quick phone call or online check can save you a substantial gap fee. Useful questions include:

• "Do you bulk-bill concession card holders for this type of scan?" • "Is this scan Medicare-eligible with my referral?" • "If there's a gap fee, how much will it be with my card?" • "Do you accept DVA Gold/White cards?"

Get the answer for your specific scan, not just a general policy - a clinic might bulk-bill concession X-rays but charge a gap on MRI. If the first clinic you call charges a gap, remember your referral is valid at any clinic, so you're free to shop around.

Rather than ringing around, you can use Radly to compare imaging clinics across Victoria in one place. Radly shows which clinics offer bulk billing, along with prices, opening hours, and patient reviews - so concession card holders can quickly shortlist clinics likely to charge little or nothing out of pocket.

Once you've found a clinic that suits, check the concession policy for your specific scan when you book, and bring your Medicare card, concession card, and referral on the day.

This guide is general information only. For advice about which scan you need and whether it's Medicare-eligible, speak to your GP.