Visitors from India, especially parents of Australian residents, are getting increasingly anxious because of their low stock of medication. With no access to Medicare, inadequate insurance covers and restrictions on their import by courier, what is the recourse available to them?
Jaspal Singh, in his mid-60s, has diabetes. Last year, he came to visit his children in Sydney for nine months and brought with him enough medication to last him his stay in Australia.
But now, he is left with only four days’ supply of this life-saving medication.
- Indian parents visiting Australia are concerned about their depleting medicines
- Australian health insurance policies cover medical costs better than overseas policies
- Importing medicines to Australia by courier is difficult due to heavy regulations
With the coronavirus outbreak and the border closures that ensued in Australia and India, Mr Singh was unable to fly back to India last month as per his schedule.
Being a tourist, he doesn’t have access to Medicare. Mr Singh’s medicines can’t be bought without a local prescription or ‘script’, as it is known in Australia.
He had no choice but to visit a local general practitioner (GP) to get a script for the same medication that he has been taking for years. Mr Singh’s troubles got confounded when the GP told him that his prescribed Indian medicines are not available in Australia.
This visit cost the diabetes patient greater stress plus $60, as medical consultations for visitors are not covered by Medicare.
Common problem for aged visitors
Hundreds of visitors in Australia, especially senior citizens on regular medication, are facing similar anxiety. Often enough, they happen to be parents or aged relatives of Australian residents.
“The GP told me that I won’t get the same medicines here. In India, we are often prescribed a combination of medicines in one tablet or capsule. So, to tide over my time in Australia, I’ll have to buy all medicines separately which will not only increase the cost but also the number of my daily tablets,” says Mr Singh.
He also had to undergo blood tests upon the GP’s advice before medicines could be prescribed.
“Three tests were done, each cost $25. I’m awaiting the results before going back to the GP – all for a script,” Mr Singh says.
“I wonder when this travel ban will be lifted and I’ll be able to return to my country,” he adds ruefully.
Bringing someone’s medicine
Mr Singh’s other son, who lives in India, visited Australia during the Christmas holidays. Luckily, he brought with him some more of his father’s medicines that last him an extra month.
But with the travel ban in place in both countries, visitors stranded in Australia can’t resort to that opportunity.
Gurmeet Singh Arneja, also in his late 60s, is currently visiting Melbourne. He had a heart by-pass surgery a few years ago and needs to get his heart functioning tested regularly.
His wife, Harjit Kaur, is diabetic and on daily medication, just like her husband.
“We would have requested someone visiting from India to get our medicines along with a valid prescription from our doctors in India but now that is not possible,” he said.
“To replenish our stock of regular medicine, we consulted a GP locally and got our tests done. It cost us $300. Luckily, we have Australian health insurance, which covered some part of that cost,” Mr Arneja says.
Australian health insurance vs Indian
A follower of SBS Punjabi, on conditions of anonymity, cites how this choice between Australian and Indian insurance companies can make all the difference to your experience as a tourist in Australia.
He narrated the challenges currently being faced by an elderly couple visiting him from India, who came with an Indian insurance policy, against his advice.
“The lady is diabetic and is now running low on her stock of daily medication. Because the couple doesn’t have Australian health insurance, they realise they’ll have to pay a GP to get a script for buying medication in Australia. To avoid that expense, the couple is prepared to halve the diabetes medication so that it lasts longer,” he says with a sense of shock.
He elaborates that when he heard this idea, he “completely lost it”.
“How can a patient decide the dosage of medicine for serious ailments like diabetes? I got anxious about the fallout of this likely scenario and requested them to make alternate arrangements for their stay because I wasn’t prepared to put my guests at risk while they were at my place,” he adds.
“If you are a tourist, you have to loosen your purse strings,” he sums up.
Rx for visitors: Australian health insurance
Dr Bhajanpreet Singh Rawal, a GP in Melbourne’s Melton, says he has one or two such patients visit him every day.
“They are often parents of my regular patients. Often, they request me to for a script based on their current Indian medication, and I do it free of charge. But if they need any pathological investigation or a specialist’s consultation, that is beyond the help I can offer as a GP,” says Dr Rawal.
Commonly, GPs charge $40-100 for a private consultation. If a patient on a visitor visa has Australian insurance, a large part of that is covered and the patient is required to pay only remainder out of his/her pocket. This is known as ‘gap fee’.
“For elderly patients on a visitor visa, I often don’t charge the gap fee,” says Dr Rawal who claims to have “helped heaps” of such visitors.
However, he strongly advises visitors to buy Australian health insurance.
“Our community don’t have enough awareness about health insurance. They go by what their travel agents advise them, which is almost always the cheapest basic health cover of Indian insurance companies. Such covers reimburse patients with only hospitalisation costs and not consultation, tests and medication,” Dr Rawal explains.
Scripts are legal documents
Dr Kamal Parkash Singh, a GP in Sydney, is cautious about writing scripts to such patients without doing the necessary investigations.
“If I prescribe the same medicine on a patient’s insistence, I risk not only the patient’s health but also my professional status. As a GP, I need to be sure that the medicine I prescribe is beneficial for my patient based on the current health status, for which I may need to do tests and they cost money,” he says.
He adds that a script is a legal document, like a contract, between a patient and a doctor.
“I explain to such patients the possible expenses that entail a consultation with investigations, even if they are simple, like a blood pressure check. They often don’t want to hear that. I mention in the patient’s case file that he/she accepted or rejected them,” adds Dr K P Singh.
Understanding the Australian health system
Dr Yadu Singh, a Sydney-based cardiologist, says that tapping into their “Indian connection”, people often approach him directly for advice on their heart condition.
“People are either ignorant or conveniently forget that in Australia, a patient can’t directly approach a specialist. I need a GP’s referral to examine a patient. If I explain this to our community, they get upset. But Australia has rules that are meant to be followed,” he says.
Dr Singh says that such patients take this approach only to avoid paying the fee to the GP.
“But if they can’t afford a GP, they certainly cannot afford a specialist in Australia. People can approach me to help those patients who are in a desperate financial situation. I'm happy to request my GP friends to waive off their fee and refer needy patients to me, and I can then examine them for free. But there’s a system which must be followed,” Dr Singh adds.
He also strongly advises people to ring 000 and call for an ambulance if someone is unable to breathe.
“Someone from our community once called me to say that his parent was having difficulty in breathing and he wanted me to see him. I told him to get off the phone and dial for an ambulance. Our people need to understand how things work in Australia,” advises Dr Singh.
Medicines via courier
This brings us to the question of acquiring prescription medicines from overseas. There are two ways to do that: by requesting an international traveller to bring it or by booking a shipment via courier.
The travel bans in Australia and India have dashed the first possibility. The second possibility remains heavily regulated by Australian law as international courier is technically considered “import”.
While the Australian government’s Therapeutic Goods Administration (TGA) allows for medicines to be imported for personal use, there is a limit on the quantity (three months’ supply can be imported at one time), along with myriad other compliance issues to abide by.
Courier companies that specialise in shipment between India and Australia are very frequently asked if they can ship medicines from India.
Ashish Vohra, director of Excel Worldwide Logistics, has been operating a courier business between the two countries for over a decade. In his experience, courier companies are “wary” of shipping medicines to Australia.
“Most courier companies do not accept bookings for shipping medicine to Australia due to strict laws governing their import. TGA can quarantine the medicine for lab testing and the patient doesn’t get it for weeks. On top of that, the testing fee is charged to the courier company. This isn’t an attractive option either for courier companies or their customers,” says Mr Vohra.
Details about importing medicines for personal consumption can be found here.
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Coronavirus symptoms can range from mild illness to pneumonia, according to the Federal Government's website. Symptoms can include a fever, coughing, sore throat, fatigue and shortness of breath.
If you develop symptoms within 14 days of returning from overseas, you should call to seek medical attention.
If you don’t have symptoms but you have been in contact with a confirmed COVID-19 case, you should also call to seek medical attention.
If you believe you may need to get tested, call your doctor, don’t visit. Or contact the national Coronavirus Health Information Hotline on 1800 020 080.
If you are struggling to breathe or experiencing a medical emergency, call 000.