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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. Therefore all permanent residents of Australia are entitled to a Medicare card. Citizenship is not necessary to be eligible for a Medicare card. However, Foreign residents can not claim the benefits of this system and must subscribe to a private health insurance.

Some 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 of these countries can benefit from Medicare. However, coverage is lower than that provided to Australian citizens, which means Medicare only covers essential care. 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 (partially covered)
  • 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, treatments in private hospitals are not covered under Medicare.

In practice, if doctors are licensed, they charge 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 don’t charge you anything when you present your Medicare card. Most of the medical centre will charge you a consultation fee (from $70 to $120 if it is a long consultation). You will hav to pay the gap between what Medicare will cover and the cost of the consultation.

If you are hospitalised as a ‘public patient‘ in a public hospital, you will not have to pay any fees. In this case, Medicare covers everything. On the other hand, if you go to a hospital, public or private, as 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 one.

In any case, you need to present your Medicare card at all medical appointments and when hospitalised.

How is Medicare funded?

Medicare is funded by the Australian Government through taxation revenue, including a Medicare Levy and Medicare Levy Surcharge. 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. Therefore, 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 centre or call 132011. You can also find more information on the government’s website.

We recommend you to take out additional insurance even if you benefit from Medicare. All those who don’t qualify for Medicare will have to buy private health insurance to cover their health expenses.

Updated on the 13/12/2021.

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  1. Thank you so much for sharing the post with everyone. People can easily understand the terms of this health care system. The post is full of information, and it talks with the process of signing up with this program, what is covered under the policy and also how it is funded. People can really get proper help after reading the post.


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