Equestrian Australia Officials

Medicare is a Commonwealth Government programme that provides eligible Australian residents with free or low-cost medical and hospital care.

Medicare provides access to:

• Free treatment as public (Medicare) patient in public hospital
• Free or subsidised treatment by practitioners such as Doctors or specialists.

The medical benefits schedule (MBS) lists all treatments and Associated MBR relating to Medicare.

You can access the MBS at any time by Medicare’s website. Items commonly used by sports participants that are Medicare listed can include General Practitioners, surgeons and an anaesthetists.

The MBS lists a rebate amount for each Medicare Item.

Example: A short consultation with a Doctor = Medicare rebate of $15.36

However, doctors or specialists may charge more than the listed MBS amount.

The difference between was is charged and the MBS rebate is call the “Medicare Gap”

1. The Doctor charges $45
2. Medicare provides a rebate of $15.35
3. Medicare Gap = $29.65 (our of pocket expense).

The Health Insurance Act 1973 (Cth) strictly prohibits any general insurer from insuring any item that is listed on the Medicare Benefits Schedule.

This also means that regardless of your out of pocket expenses, it is against the law for the insurer to cover the Medicare Gap.

So what does that mean?

If your medical or other treatment has a Medicare Item number, such as the doctor fee above, it is claimable on Medicare by is uninsurable and you may not claim for reimbursement.

In the example you cannot claim the $29.65.

If your medical or other treatment does not have a Medicare Item Number, you may claim for reimbursement through Marsh . For specific insurance and Risk Protection information please visit the making a claim section of this website.

Officials are automatically covered if they are officiating at an EA Affiliated Club that has elected to participate in the EA National Insurance Program as long as they are appointed in line with EA’s requirements. The EA Club Insurance applies to all activities run by a club including competitions and any other organised club events such as training days.

Where an Official is not able to rely on the cover provided automatically from the EA Club Insurance (i.e. if the Club does not hold cover through EA or the event is not held under EA rules such as an Ag Show), coverage may be available from their insurance as an EA Member. The policies provided to EA Members (via State Branch Membership) provide cover whilst the member is engaged in “Non-Income Earning Equestrian Activities”.

The Reimbursement of incurred expenses is NOT income; however, if additional payments are made to the Official for their services, this is considered income. If the Official is engaging in an EA Insured Club Activity, then the fact that it may be income earning is not relevant, as the Club Insurance does not require the officiating to be Non-Income Earning.

In Summary, the EA Officials Top-Up Cover is required if the Official is engaging in Income Earning Officiating and the EA Club Insurance does not apply. The above information is a general summary of the EA Insurance Plan only and should be read in conjunction with the actual policy documents available from Marsh.