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Medicare: Australian Healthcare System

Medicare: Australian Healthcare System

Before leaving abroad it is important to learn about the healthcare system of the country you plan to settle/travel. The Australian health care system, called Medicare, is unique to Australia and it is important to understand how it works. To get a clearer understanding of Medicare keep reading.

Australia’s Health Care System: Medicare

The Australian Healthcare system is called Medicare. It is similar to, for instance, social security in France or the Netherlands. Coverage under Medicare is limited to Australian citizens and permanent residents. Foreign residents can not claim the benefits of this system and must therefore subscribe to private insurance.

Certain countries such as United Kingdom,the Republic of  Ireland, New Zealand, Sweden, the Netherlands, Finland, Italy, Belgium, Norway, Slovenia, Malta have signed bilateral agreements with Australia. Nationals these countries can benefit from Medicare. However, coverage is lower than that provided to Australian themselves and only essential care will be covered. Note that in certain situations coverage is completely excluded (accidents that occur while working for instance). Therefore it is important to check the scope of coverage when you come from a country with a bilateral agreement.

What is covered under Medicare?

The Australian system covers certain situations such as

  • Consultations with a general practitioner or a specialist;
  • Treatment in a public hospital
  • Surgery
  • Subsidised medicine under the pharmaceutical Benefits Scheme (PBS)

Treatments such as dental expenses, alternative medication, physiotherapy, Ambulance services, Glasses or contact lenses are not covered under Medicare.

In practice, if doctors are licensed, they apply the rates set by Medicare. Medicare will then refund 75% of the quoted price. The patient is required to pay the gap between the Medicare rate and the non-contracted doctor’s fee.

Some doctors practice Bulk Billing. In this case they will not charge you anything when you present your Medicare card.

If you are hospitalised in a public hospital and are considered a ‘public patient‘ you will not have to pay any fees. In this case everything is covered by Medicare. On the other hand, if you go to a hospital, public or private, and are deemed a ‘private patient‘ Medicare will only cover 75% of the costs. The rest will come from your pocket or through your supplementary health insurance if you have it.

In all cases you will be required to present your Medicare card at all medical appointments and when hospitalised.

How is Medicare funded?

Australian employees participate through an assessment levied directly on their salary (the so-called ‘Medicare Levy’). This charge is automatically deducted from any salary earned and equals 2% of the total salary.

Temporary residents are exempt from this Levy. To enforce the exemption you must mention it when you file your tax return at the end of the financial year. For this it is necessary to fill in form 3169 ‘Application for Medicare levy exemption certification’ which is available on the governments website.

How to sign up?

Any permanent resident or Australian citizen automatically and compulsorily subscribes to Medicare. The affiliate receives a card allowing reimbursement for medical expenses.

To become affiliated visit a Medicare center or call 132011. You can also find more information of the government’s website.

It is recommended to take out additional insurance even if you benefit from Medicare. All those who can not qualify for Medicare will have to buy private health insurance to cover your health expenses.

Medicare: Australian Healthcare System
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Joshua Waleson
Written by Joshua Waleson

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