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Balimed - Health Care Assistance for People Affected by the Bali Tragedy
October 2003
What is Balimed?
Balimed is an Australian Government scheme. It covers:
- all reasonable out of pocket health care expenses to the victims of the Bali bombing; and
- reasonable costs of counselling and psychological care for their families and close friends;
for expenses arising from conditions caused by the bombing which are not
covered by Medicare, private insurance (health insurance or other insurance)
or other disaster related assistance.
Where appropriate, this can mean continuing assistance with medical treatment
over the lifetime of the person.
HIC Balimed Assistance Telephone Line
The Health Insurance Commission (HIC) operates a Balimed assistance line
during office hours - ring 1800 660 026 (toll free when calling
from within Australia).
Who is eligible?
The Scheme will provide assistance to people in the following categories:
People in Bali at the time of the tragedy:
A person who meets ALL of the following criteria:
- he or she is fully eligible for Medicare; and
- he or she was in Bali on 12 October 2002; and
- one or more of the following apply to the person:
- was physically injured by the explosion; or
- was present at or near the scene of the explosion during the aftermath
and saw injured persons or remains of deceased victims; or
- assisted injured persons, either at the scene of the bombings, or
in a hospital in Bali, or in providing support (eg counselling) in Bali;
Family and friends:
A person who is:
- a member of the immediate family of a person who is covered by the “People
in Bali at the time of the tragedy” category, or of a person whose
death was caused by the bombing, or
- a close friend or associate of such a person (as defined in the detailed
Balimed Guidelines) and who has a health condition arising from that relationship.
Note: people in "Family and Friends" category are eligible
only for a restricted range of assistance.
Registration Requirements
To be eligible for assistance the person must be registered with the Health
Insurance Commission (Medicare). Eligibility can be backdated on registration.
Registration is limited to those residing and present in Australia.
If the person is already being assisted by the Red Cross, the Red Cross may
arrange registration with the appropriate consent from the person. Otherwise
the person applying may need to complete a registration form.
To request the registration form or inquire about registration requirements,
ring the Balimed assistance line on 1800 660 026 (toll free when
calling from within Australia)
or write to:
HIC
Attention: Bali - Medicare Claims
Reply Paid 66085
GREENWAY ACT 2900
Applications for registration can be lodged at Medicare offices.
The Health Insurance Commission (HIC) mails an information and claim kit
to each newly registered person.
Goods and Services Covered
Only goods and services provided in Australia are covered.
All reasonable costs will be covered. Decisions on claims are subject to
the discretion of the Health Insurance Commission (Medicare) and/or the Australian
Government Department of Health and Ageing. These bodies aim to respond to
queries and claims quickly, sympathetically and flexibly.
For people present in Bali at the time of the tragedy
For people eligible under the “People in Bali at the time of the tragedy”
category, the Scheme covers costs for the following kinds of services and
goods, reasonably required to treat conditions arising directly from the bombings
in Kuta, Bali on 12 October 2002:
- For services covered by Medicare benefits, the difference between the
amount charged by the doctor and Medicare Benefits Schedule benefit, to
the extent that that amount is not covered by insurance;
- Out of pocket costs associated with the use of private health insurance,
including front-end deductibles (“excess” payments) and gap
payments;
- Hospital costs where not otherwise covered by public patient arrangements
or private insurance (special requirements may apply if an uninsured person
wishes to use private hospital services);
- Full out-of-pocket costs of pharmaceuticals covered by the Pharmaceutical
Benefits Scheme (PBS);
- Full costs of most other pharmaceuticals
- but usually complementary and alternative medicines will not be covered;
- The costs of allied health services, such as dentistry, audiology, physiotherapy
and psychology, less any amounts covered by private health insurance or
other insurance;
- Prostheses, whether fitted surgically or not (including artificial limbs);
- Other aids and appliances;
- Reasonable costs of transport necessary to receive health care;
- Reasonable costs of accommodation of the patient and one other person
where the patient lives in a different town or region from the health care
provider and must travel at least 50 kilometres to receive care;
- Psychological counselling for the effects of a person’s Bali injuries
or experiences;
- Other goods or services that are necessary to enable treatment or care,
provided these are not ordinary living expenses.
For family and friends
(as indicated above under “Who is Eligible?” and defined
in the detailed Balimed guidelines)
A person who is eligible under this category will be assisted for:
- The costs of counselling, psychological care and/or psychiatric treatment
(including medicines prescribed by doctors);
- Reasonable costs of transport necessary to receive this health care;
and
- Reasonable costs of accommodation of the patient and one other person
where the patient lives in a different town or region from the health care
provider and must travel to receive care.
Long term counselling or psychological services
When a person is to receive assistance for long term counselling or psychological
services, the counsellor or psychologist may need to provide the HIC with
a report on the need and plans for future care.
Need More Information?
This document is a summary of more detailed and technical guidelines. For
more information contact the Balimed assistance line during office hours -
ring 1800 660 026 (toll free when calling from within Australia).