Health care in Australia

Public healthcare is available to everyone, but you can subsidize it with private insurance.

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In Australia, the government healthcare system is called Medicare and it’s widely considered to be one of the best in the world. But it doesn’t cover everything.

Medicare: Australia’s national public healthcare system

Medicare is Australia’s universal healthcare system. It provides coverage for many health costs and is a Commonwealth government program. You can choose to have Medicare coverage only or a combination of Medicare coverage and private health insurance to cover the cost of your medical needs.

Medicare usually covers:

  • Free or subsidized treatment by doctors, specialists, optometrists and other allied health practitioners.
  • Free treatment and accommodation as a public Medicare patient in a public hospital.
  • 75% of the Medicare scheduled fees for services and procedures if you’re a private patient in a public or private hospital.
  • Some healthcare services in certain countries with which Australia has a Reciprocal Health Care Agreement (RHCA).

Medicare DOES NOT cover:

  • Private patient hospital costs.
  • Additional services like dental and physiotherapy.
  • Glasses and hearing aids.
  • Medical and hospital costs incurred abroad.
  • Medical and hospital costs for procedures that are not clinically necessary.
  • Ambulance services.
  • Acupuncture.

Reciprocal Health Care Agreement (RHCA)

The Australian Government has Reciprocal Health Care Agreements (RHCA) with the United Kingdom, the Republic of Ireland, New Zealand, Sweden, the Netherlands, Finland, Belgium, Norway, Slovenia, Malta and Italy. Under these agreements, citizens of those countries are entitled to various subsidized health services for essential medical treatment when in Australia. In order to be eligible for these treatments, citizens of countries with RHCA must enroll with Medicare. Note: Migrants who applied for subclass visa 410 after 1 December 1998 are not eligible for Medicare and its health benefits under the RCHA.

Residents of New Zealand, the United Kingdom, the Republic of Ireland, Sweden, Finland and Norway are automatically eligible for a Medicare card and may be covered for the length of their stay in Australia pending the issuing of this card. Those from Belgium, the Netherlands or Slovenia will need their European Health Insurance card to enroll in Medicare, while residents or citizens of Malta and Italy may only be covered by Medicare for six months from the date they arrive in Australia.

Residents of most of the countries listed above may be able to receive:

  • Free treatment as a public patient in a public hospital
  • Subsidized medicine under the Pharmaceutical Benefits Scheme (PBS)
  • Medicare benefits for out-of-hospital treatment provided by a doctor

Residents of New Zealand and Ireland may be able to receive:

  • Services as a public patient in a public hospital for medically necessary treatment
  • Medicines available on prescription which are subsidized under the PBS

Pharmaceuticals Benefits Scheme (PBS)

PBSThe Pharmaceutical Benefits Scheme (PBS) is designed to help cover the cost of a wide range of prescription medicines, ensuring that Australians can afford the medications they need. Australian residents and visitors from countries with RHCAs with Australia may be eligible to receive medicines under PBS at a much lower cost.

If you are eligible for PBS and have relevant medicines prescribed to you, you may receive them at the reduced cost. However, you’ll need to make sure that you have all your cards with you when you get your prescription filled. You’ll need to present them to your pharmacist in order to receive your medication at the reduced cost. The cards you may need include your Medicare card, a relevant concession or healthcare card if you have one and a PBS Safety Net card if you have one.

PBS Safety Net

The PBS Safety Net acts to lower the cost of prescription medicines for individuals and families once a certain threshold has been met. The threshold rates for 2019 are below:

Rates for 2019 General patients Concession card holders
Patient contribution before meeting Safety Net threshold Up to $40.20 Up to $6.50
PBS Safety Net threshold $1550.70 $390
When PBS Safety Net threshold is reached $6.50 Free

When you get close to reaching the PBS Safety Net threshold for a given year, ask your pharmacist about the possibilities of obtaining a PBS Safety Net card. If you’re eligible for this card, your PBS medicine can be less expensive or possibly even free for the rest of the year.

Private health insurance

While it’s possible to simply have Medicare coverage, many Australians choose to take out private health insurance as well. Medicare doesn’t cover everything, so taking out private health coverage guarantees that you have a broad range of protection in place.

Health insurance can be a great idea for the many visitors who are not covered under Australia’s Medicare system. In addition, if you apply for a 457 or 485 visa or are an overseas student, you’ll need to take out a certain level of health insurance to satisfy your visa requirements.

Compare a range of health insurance policies before deciding on the right one for you. Factor in benefits, limits, exclusions, and what sort of coverage it provides hospital, general treatment or both. It’s a good idea to get multiple quotes to get a gauge on the true value of each policy.

Bottom line

If you’re visiting Australia, you’ll need to take out private health insurance before leaving. If you’re moving to Australia, you can get covered under the country’s Medicare program, but you may still want to consider taking out additional private insurance. To learn more about what to expect when you arrive in the country, read our guide to moving to Australia.

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