Australian Health Care Benefits

Moving to Australia is an exciting prospect. However inevitably the question of health care is raised. No one wants to become ill or injured while living in Australia and then be left with an enormous bill to pay.

Does Australia have free health care?

Medicare is Australia’s publicly funded health care system however it does not provide 100% coverage. Medicare provides eligible individuals access to free or subsidised medical, optometrical (eye care) and public hospital care. Medicare does not pay towards ambulance costs, physiotherapy, spectacles, podiatry, chiropractic services, or private hospital accommodation.

Medicare also does not cover dental costs, with some exceptions for low-income earners. A nationwide Denticare Australia program may be extended in the next government budget, however the specific details are yet to be announced. Some dental organisations provide interest free payment plans, member discounted services that attract an annual fee, or discounts for regular patients to help manage costs.

Individuals can also choose to access private health services that charge for their services, and may choose to take out private health insurance to cover these types of costs.

Will I be eligible for a Reciprocal Health Care Agreement?

The Australian Government also has Reciprocal Health Care Agreements with some countries that provide ‘restricted access’ to public health care while in Australia. Restricted access usually limits care to ‘medically necessary’ treatments eg. Ill health or injury which occurs while you are in Australia and which requires treatment through a public hospital before you return home.

Individuals from New Zealand and Ireland do not get issued with a Medicare card and instead present their passport at public hospitals or pharmacies. Non-hospital care, such as attending a local GP doctor, is not covered. Other reciprocal agreements will pay Medicare benefits for out-of-pocket medical treatment provided by doctors through private surgeries and community health centres. All agreements cover subsidised medicines under the Pharmaceutical Benefits Scheme (PBS).

Note: Reciprocal agreements technically only cover individuals if they have come directly from the reciprocal country eg. If you were previously living in another foreign country prior to coming to Australia you may not be eligible, as you have not been recently been part of the health system for your country of nationality. However application of this requirement varies between Medicare staff.

Medicare Information Kits for migrants are available in 19 different languages.

What amount is subsidised by the government?

The benefit (or refund) that you receive back from Medicare is based on the Medicare Benefits Schedule (MBS) for that specific service which is set by the government. Doctors and other health service professionals can choose to charge over the schedule fee or bulk bill. Bulk billing is when doctors bill Medicare directly, accepting the Medicare benefits as full payment for the service. If doctors charge a higher amount the patient wears the extra costs.

Many doctors now offer to process Medicare claims electronically at the end of the appointment. Alternatively you can lodge most claims online, visit a Medicare office or post in your claims. Refer also to How does Medicare work?

Patients may also be required to pay for additional tests or vaccinations that their doctor requests as part of their treatment.

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