Document ID: chunk:federal_register_of_legislation:F2025C00160:reg:2:p26
Version: federal_register_of_legislation:F2025C00160
Segment Type: reg
Provision Reference: reg 2 (pt 26/51)
Character Range: 3359209–3365043

a Medicare benefit in Australia.
    b.                                                                                                                                                                                           Medical goods or services that are covered by another Australian Government funded scheme that meets all of the following.
                                                                                                                                                                                                 i.                                                                                                                          The eligible person would be entitled to receive the goods or services through the scheme in Australia.
                                                                                                                                                                                                 ii.                                                                                                                         The CDF is satisfied that the medical goods or services the eligible person would be entitled to receive under the scheme are not otherwise provided for by local arrangements in the member's overseas posting location.

15.5.7A Minimum Thresholds

1.  For the purpose of section 15.5.7, a member must reach the following minimum threshold in out-of-pocket medical expenses for the eligible person.
    a.                                                                                                                                                                                                                      If the eligible person is less than 15 years old at the beginning of the financial year, the minimum threshold is AUD 25.
    b.                                                                                                                                                                                                                      If the eligible person is 15 years or older at the beginning of the financial year, the minimum threshold is AUD 69.
2.  If a member is only eligible for part of the financial year, the minimum threshold is reduced using the following formula.

    Where:
    A                                                                                                                                                                                                                       Is the threshold that applies to the eligible person under subsection 15.5.7A.1.
    B                                                                                                                                                                                                                       Is the number of days that the eligible person will be in the posting location that financial year.
3.  If a member incurs a cost for an eligible person's medical treatment in Australia in a financial year, the minimum threshold for that person in the financial year is reduced by the out‑of‑pocket cost to the member.

    Note: The threshold is not reduced by any amount refunded by Medicare or under an Australian Government funded scheme.

15.5.8 Hospital costs

1.  A member is eligible to be reimbursed costs for hospital accommodation, treatment and related charges incurred for an eligible person. This is if the hospital facilities are similar to the standard for a public hospital patient in Australia.
2.  The member may incur additional costs because hospital facilities of that standard were not available at the posting location. The CDF may approve payment of an amount of additional costs the CDF considers reasonable in the circumstances. The CDF must consider all these criteria.
    a.                                                                                                                                                                                                                                                                                          The nature of the illness or condition of the eligible person.
    b.                                                                                                                                                                                                                                                                                          The standard of available hospital accommodation, treatment and medical equipment at the posting location.
    c.                                                                                                                                                                                                                                                                                          Any other factor relevant to the treatment of the eligible person.

15.5.9 Pharmaceutical costs

1.  A member is to be reimbursed costs for pharmaceutical products for an eligible person. The following conditions apply.
    a.                                                                                                                                                                                                                                                                              The pharmaceutical product must be a drug or medicinal preparation prescribed by a doctor.
    b.                                                                                                                                                                                                                                                                              The amount payable is any amount by which an item exceeds AUD 31.30.
2.  During a calendar year, a member may pay