Tag Archive | family separation

The Safety Net mystery

In Australia, our universal healthcare system is called Medicare.

To give you a basic rundown (mainly for the Americans who have a totally different system) anytime we use a public hospital it’s totally free. Our public hospitals are extremely high standard and often better equipped than private hospitals, so we tend to use them majority of the time.

No matter whether you go in for a sprained ankle and spend five hours in the emergency department, or attend three times a week for cancer treatment over the course of two years, or have a serious car accident and need five surgeries then spend three months in a ward…all totally free.

Other things outside the hospital setting are charged differently and attract different levels of “benefits”.

If you are a low income earner you get a healthcare card and then things like visits to your local doctor’s clinic, x-rays, psychiatry, pathology and dental treatments are free for you.

If you aren’t a low income earner then these benefits are partial subsidies. So for example, if Medicare decides that the scheduled fee (benefit) to visit a local doctor is $35 then that’s the subsidy amount you receive.

If Doctor A charges $65 for a visit then he is charging $30 above the scheduled fee and you will be required to pay $30 out of pocket rather than the full amount. If Doctor B charges $40 then you will only be required to pay $5 out of pocket, because it’s only slightly above the scheduled fee. And if Doctor C bulk bills then that means they only charge the scheduled fee so it costs you nothing.

(I do have a point to all of this by the way. I’m not just giving you a quick lesson in universal healthcare. I promise.)

To make life easier for people who have higher than average medical costs (for example people who often need to see doctors or get medical tests…in other words, people like me…) the Government has something called the Medicare Safety Net.

Depending on your individual circumstances, each citizen is set a threshold amount. Once you reach this threshold in out of pocket medical expenses, the Medicare Safety Net provides a higher Medicare benefit for all eligible services for the rest of the calendar year.

So for the example used above, if you haven’t met the Safety Net threshold then you get a $35 benefit if you see a local doctor. But once that threshold is reached your benefit may increase to $50 for each visit so your out of pocket expenses obviously become much less.

Now see there’s an added benefit to being married in Australia. Because the Medicare Safety Net for a single person without a healthcare card is $2030. So once a person reaches $2030 in out of pocket costs, they get the added benefits.

But if you are married or in a de facto relationship, you can combine both partners medical expenses and still only need to meet that same threshold of $2030. Twice as easy!

For all the years my ex-husband and I were going through IVF this was fantastic because I would reach the Safety Net almost immediately at the start of the year (egg collections, specialist visits, ultrasounds etc were only billed under my name) and then Doug would also get cheaper medical treatment for the rest of the year.

Well this pregnancy has unfortunately fallen across two calendar years in a very awkward way. I was 20 weeks pregnant when the clock struck midnight on New Years Eve.

So exactly half of my costs were in 2015, and half in 2016. For example the Harmony test and initial ultrasounds ($750 out of pocket) were in 2015, but my obstetrics management fee for the private hospital where I’m going to give birth ($1250 out of pocket) was in 2016.
So even though I’ve spent a lot of money, unfortunately it took me until the end of February to finally hit my threshold for the year and start accessing the higher medical benefits.

Except here is the thing (and here’s the point to this blog post that you’ve all been patiently waiting for)…

I logged into my online Medicare account last week and realised with a sickening dread that my ex-husband and I were still registered as a “family” for Medicare purposes.

He and I have been registered as a family for years, and obviously when our divorce was finalised last year some lawyer somewhere forgot to tell us to separate our Medicare files. So we were still linked.

I was outraged.

“Oh hell no!” I shouted. “There’s no way in damnation that man is accessing cheap medical care for the entire year because of my medical expenses. No way. No how. Not going to happen.”

So I phoned Medicare, explained the situation, and asked them to legally separate our Medicare files so that we were no longer sharing a Safety Net.

At that point, I was feeling pretty smug about myself.

That buffoon of a man clearly thought he could just slip in undetected and access cheap medical because of my expenses? Because of my child’s expenses? Well how rude!

But today I’ve logged back into my Medicare account online and something terrible has happened.

I’ve gone from sitting well above the threshold to dropping well below the threshold.

I’ve dropped right back down to having accumulated only $1500 in out of pocket expenses for the year. I still have another $530 to go!

I honestly don’t know how this is possible. It must mean that some of my medical expenses that I’ve paid this year aren’t listed on the schedule of benefits.

It also means Doug has spent a huge amount of money on out of pocket medical expenses in the first three months of the year.

This is just…unheard of.

In the whole time we were married I only ever remember him being seriously ill once, when we both had whooping cough. All his other expenses were fertility treatment related.

So of course my first reaction was to freak out – like, oh my god he’s sick. Is he okay? Is he dying? What’s wrong with him? He can’t die he’s the love of my life. I’ll die if he dies.

My second reaction was one of terrifying realisation – majority of his medical expenses over the past ten years have been fertility related. I know he has a new love in his life (thanks to a blabber-mouthed acquaintance filling me in on the news at the end of last year).

Does that…..is he…..could this….I mean….is that evil fucker doing…fertility treatment? With her? With the new girl?

And then I think back to the night he left me.

The night he told me he had to leave because he wanted to have children so badly, but I was incapable of giving them to him without IVF. And he couldn’t do IVF ever again because it was just too hard.

Has he changed his mind? Does he love this new girl more than he ever loved me? And so he is willing to do IVF with her?

The mere thought of it makes me want to vomit. And then kill him with my bare hands. And then vomit again.

Then I think about what my doctors told me when I fell pregnant this time around – the real reason I’d been unable to have children previously was a male fertility factor. He’d been the main cause of our infertility. Not my endometriosis, not my PCOS, not even my blocked Fallopian tubes.

So maybe he knows this now too. Maybe he knows now that IVF is actually his only option.

But not with me.

With the new girl.

The problem wasn’t actually the IVF. It was just me. I wasn’t good enough. He just didn’t love me.

And I’m 34 weeks pregnant.

And I’m super hormonal.

And I sometimes still miss my husband.

And I sometimes still dream about my husband.

And in my dreams he is the father of my unborn child.

And the idea that he’s undergoing fertility with someone else makes me want to cry and cry and cry and cry.

What if our lives were supposed to be a Nicholas Sparks novel?

Like we divorce but then re-discover each other years later, only for Doug to gasp in shock when he meets my precocious young daugher. Instead of being upset he thinks she is wonderful because she has my eyes. The eyes of his true love…

Then we each realise we’d never stopped loving each other, and even though I’m trapped in a loveless marriage, we share one amazing night of passion. I go home to tell my husband I’m leaving him, but then find out Doug has been killed trying to rescue stranded puppies in a freak tornado.

Devastated by my loss, I only find a reason to go on living when I discover a month later that our one soulful night of love-making had created miraculous new life. A son that I name Doug junior…

WELL NOW I CAN’T HAVE THAT.

Now there can be no Nicholas Sparks ending. He has RUINED it.

This is ridiculous I know! Because I am having a baby with a man who isn’t my husband! I can clearly see how hypocritical I’m being.

But you guys my baby was a total accident. There’s a difference between a whoopsie accidental pregnancy and seeking fertility treatment.

If he’s doing fertility treatment it means he’s fully in love and super happy and wanting to start a family with this stupid trog.

I’m also aware that this freak-out is totally illogical. I mean I have no idea why he’s managed to incur so many out of pocket medical expenses.

Maybe he was in a car accident and needed a lot of x-rays.

Maybe he has something wrong with his back and needed lots of physiotherapy.

Maybe he has decided to have a sex change and he is paying for hormone treatment.

Maybe someone finally decided he was a smug little jerk and beat the shit out of him, so now he needs cosmetic surgery to fix his face…

In the end it doesn’t matter.

I know it doesn’t matter.

His medical expenses are none of my business. He is no longer my business.

But damn it I want to know!

What are you up to, Doug? What exactly is going on here?

It kills me that I can’t know.

It still hurts me so badly that I’m finally having a child, but that amazing event in my life has nothing to do with my ex-husband.

The man who was my forever. Who promised to love me until the day I died. And all the other blah blah blah lies that he told and I foolishly believed.

Nothing to be done about it, and I’m very aware that it’s silly I’m upset over this.

Just needed to vent, I guess.

If you’ve taken nothing else from this ridiculous blog post, at least now you will pass a pop quiz on the Medicare system and the Safety Net threshold.

This is a very important life skill.

You’re welcome you guys. You’re welcome…

Sadie xx

p.s if you steal my romance novel idea I’m going to be super pissed at you

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