Australia's healthcare system is one of the best in the world, with high-quality care, short wait times, and good patient outcomes. Both public and private healthcare is available in Australia; Medicare is the universal health insurance scheme used by Australians; it guarantees all Australians (and some overseas visitors) access to a wide range of hospital benefits for low or no cost. In Australia, both the state and federal governments are responsible for running the health system.
What is Medicare, and what does it cover?
Medicare is Australia's publicly funded universal health care system. It provides access to a wide range of medical and hospital services for Australian citizens, permanent residents, and some visitors from countries with reciprocal healthcare agreements (more on this later).
In terms of coverage, all services and procedures that are covered by Medicare are detailed on the Medicare Benefits Schedule (MBS). When you visit a doctor or specialist who bulk bills, meaning they accept the Medicare benefit as full payment, you won't have to pay out of pocket for the services covered by Medicare.
Medicare partly covers the cost of visiting general practitioners (GPs) or specialists. However, it's important to note that doctors can choose to charge more than the Medicare benefit, which may result in out-of-pocket expenses for the patient.
In-patient care in public hospitals in Australia is either free or heavily subsidized. However, elective procedures will have waiting lists. Private hospitals offer more choices and shorter wait times for non-emergency treatments, although you will pay out of pocket for these services.
Medicare includes the Pharmaceutical Benefits Scheme, which subsidizes the cost of prescription medications. Patients contribute a co-payment amount for each prescription, while the government covers the remaining cost.
In general, Medicare will help cover the costs for part or all of the following services:
- seeing a GP or specialist
- tests and scans, like X-rays
- most surgery and procedures performed by doctors in public hospitals
- eye tests by optometrists.
Medicare won't cover:
- ambulance services
- most dental services
- glasses, contact lenses and hearing aids
- cosmetic surgery
If you are eligible for Medicare, you can apply for a Medicare card, which will be delivered with your personal Medicare number. The card is necessary to get medical treatment or to pick up pharmacy prescriptions. To apply, you must fill out the Medicare enrolment form, which is called "Enrolment for Medicare card" (form MS004). You can access the form from the Medicare website or visit a local Medicare Service Centre to pick up a copy. You may also be able to complete the form online through the MyGov portal.
Eligibility for Medicare as an expat in Australia
In Australia, eligibility for Medicare is primarily based on citizenship, permanent residency, or specific visa categories. Eligibility criteria for expats can be complex and subject to change, so please make sure you have a thorough understanding of your visa restrictions before emigrating.
Luckily for some, Australia has reciprocal healthcare agreements with several countries, including the United Kingdom, New Zealand, Ireland, Sweden, the Netherlands, Finland, Belgium, Norway, Slovenia, Italy, and Malta. Under these agreements, visitors from these countries can access medically necessary care through Medicare during their stay in Australia. This is not the same as full access to Medicare, but it covers anything urgent.
As you might expect, Australian citizens and permanent residents are eligible for Medicare. If you hold citizenship or permanent residency in Australia, you can access the full range of Medicare benefits. However, expats who hold certain temporary visa types may be eligible for limited Medicare coverage. For example:
- Temporary residents from countries with a reciprocal healthcare agreement: If you are a temporary resident from a country with a reciprocal healthcare agreement (such as the United Kingdom or New Zealand), you may be eligible for Medicare coverage during your stay in Australia.
- 457/482 Visa Holders: Temporary work visa holders (such as those on a 457 or 482 visa) are typically required to maintain adequate private health insurance as a condition of their visa. However, they may be eligible for Medicare for medically necessary treatment that arises during their waiting periods for private health insurance coverage.
- Student Visa Holders: International students with a valid student visa (subclass 500) are generally required to obtain Overseas Student Health Cover (OSHC) as a condition of their visa. OSHC provides limited coverage for certain medical services, but it is not the same as full Medicare coverage.
Private health insurance in Australia
Expats in Australia may consider having private health insurance because it can offer a broader range of coverage compared to the services provided by Medicare. Even those with full access to Medicare will choose to also have private insurance. Benefits include access to private hospitals, choice of doctor or specialist, shorter waiting times for elective surgeries, and coverage for services like dental, optical, and physiotherapy.
Private health insurance allows more control over healthcare options. It provides the flexibility to choose preferred doctors or hospitals and can offer additional services and treatments not covered by Medicare. And, if you are a high-income earner without private health insurance, you may be liable to pay the Medicare Levy Surcharge. Having private health insurance that meets the required standards can help you avoid this additional tax.
Some major health insurance providers in Australia that are highly recommended include:
Regarding international health insurance providers, you can choose among the following:
Always thoroughly read through policy coverage to determine if it fits your needs. You can also get a free quote on Expat.com's Health insurance for expats in Australia page.
Ambulance services in Australia
Ambulances in Australia are for medical emergencies only and can be summoned by calling Triple Zero or 000. Ambulances will be staffed by professional paramedics. Once onsite, paramedics will administer any necessary medical care and arrange transport to the nearest medical facility. Ambulance services in Australia are primarily administered by the state and territory governments and are generally provided at no cost to residents. However, fees may be applicable for non-residents and visitors depending on their individual circumstances. It is advisable to research the ambulance service in the specific area you plan to visit and review your international health insurance policy to determine if it covers ambulance services.
After calling ambulance services in Australia, patients are typically transported to the nearest appropriate medical facility suited to their condition. The destination can vary based on the nature of the emergency and the availability of suitable treatment options, which may include nearby hospitals, clinics, or specialized trauma centers.
Finding a doctor in Australia
Finding a new doctor can be daunting, especially if you have a doctor in your own country with whom you may have a long-standing relationship, perhaps even a multi-generational relationship. Your doctor in Australia will generally be referred to as a GP or general practitioner. It's important to have a doctor you trust and respect as they are often the person who will refer you to specialists and act as a gatekeeper for various treatments. They are your first port of call when you need medication or have concerns about your physical and mental health, so it's worth making sure your doctor is someone you feel comfortable with. Your doctor will generally be aware of how you manage your prescriptions so if you are someone who takes prescription medication in your own country, you will need to quickly enrol with a doctor in order to make sure you can continue your medication. Remember, drug names can vary country by country so it might be worthwhile researching what your medication is referred to as in Australia.
To sign up with a doctor in Australia, you can follow these general steps:
- Research and find a doctor: Use online directories, recommendations from friends or family, or local healthcare resources to identify doctors in your area. You can also check the websites of medical clinics or practices to gather information about the doctors working there.
- Check availability and make your first appointment: Contact the doctor's office or clinic to inquire about their availability and schedule an appointment. You may need to provide some basic information such as your name, contact details, and reason for the visit.
- Prepare necessary documentation: Depending on the doctor's requirements, you may need to bring certain documents to your first appointment. This might include your Medicare card, health insurance information, relevant medical records, and any medications you are currently taking.
- Attend the appointment: Arrive at the doctor's office or clinic at the scheduled time. Be prepared to discuss your health concerns, medical history, and any symptoms or questions you have. The doctor will evaluate your condition, provide appropriate advice or treatment, and may refer you to specialists if necessary.
- Establish an ongoing relationship: If you are satisfied with the doctor's care, consider establishing an ongoing relationship for your healthcare needs. It's generally beneficial to have a regular GP who can monitor your health, provide preventive care, and coordinate any necessary referrals or specialist consultations.
Mental health care in Australia
Australia values mental healthcare, and a range of services are available to support mental well-being. Australians have access to different mental health professionals, including psychologists, psychiatrists, and mental health social workers. These professionals provide assessment, counselling, therapy, and treatment for various mental health conditions. Mental healthcare in Australia focuses on a holistic approach, encompassing prevention, early intervention, and ongoing management of mental health concerns. There is also an emphasis on promoting mental health awareness and reducing the stigma associated with seeking help for mental health issues like depression and anxiety.
Medicare plays a vital role in supporting mental health care in Australia. It provides subsidized access to mental health services through the Better Access initiative. Under this program, individuals with a mental health care plan from a GP can receive Medicare rebates for up to 20 sessions per calendar year with an eligible psychologist, social worker, or occupational therapist. These sessions may include assessment, therapy, and counseling. Medicare also covers a portion of the fees for psychiatric services provided by psychiatrists. The availability of Medicare benefits helps make mental health care more affordable and accessible to Australians, including eligible expats residing in Australia. It is important for expats to explore their eligibility for Medicare and understand the specific requirements and limitations associated with mental health services coverage. Additionally, private health insurance may provide additional benefits and options for mental health care beyond what is covered by Medicare.
Alternatives to visiting the GP in Australia
If your complaint is mild or you are unsure if you need serious medical intervention, there are a few alternatives to making an appointment with a GP or showing up at the emergency department. Healthline services, such as Healthdirect or nurse helplines, provide phone-based advice from registered nurses for non-emergency concerns. Pharmacies staffed by qualified pharmacists offer guidance, over-the-counter medications, and health checks. After-hours medical services cater to urgent needs outside regular clinic hours, while telehealth enables remote consultations with healthcare professionals. In emergencies, visiting the emergency department is crucial but do not use this valuable service if you are not in need of it.
We do our best to provide accurate and up to date information. However, if you have noticed any inaccuracies in this article, please let us know in the comments section below.
