Medicare - the health system and healthcare in Australia Tile Thumb

Medicare - the health system and healthcare in Australia

19th May 2017

There is a reciprocal agreement between the Australia and some countries: the UK, Ireland, New Zealand, Sweden, the Netherlands, Finland, Belgium, Norway, Slovenia, Malta and Italy. This means you are covered during the length of your stay in Australia, except for Malta and Italy where the cover is limited to 6 months.

The Medicare system is a subsidised system where you may incur out-of-pocket expenses for medical treatment. Even optional health insurance does not secure fee-free medical treatment, as doctors and hospitals often charge more than the rebate amount. This will leave you with what is called a ‘gap’ to pay. Don't worry, you will find more on this in the Home in Australia section when you need to set up.

In general, the health system in Australia is sophisticated, efficient, and offers a great standard of care. This shouldn’t be a topic for concern, outside of the fact that you may have out-of-pocket expenses. Medicare is the government healthcare system in Australia. Residents eligible for a Medicare card can access the subsidised medications and treatment available from healthcare providers. 

As a resident or expat, it is essential that you find a general practitioner (GP) as soon as possible once you arrive in the country. With the exception of emergencies, where you should go to a hospital emergency section, your GP will be your first point of contact for all health-related issues and will refer and recommend if specialist expertise is required.

How Medicare works

Medicare is a subsidised system. Free access is available (this is called 'Bulk-Billing'). You can start by finding bulk-billing GPs at sites like HealthEngine, which some practices use as a convenient online booking system. Bulk-billing is where the Doctor charges only what Medicare pays as a rebate for that service or appointment. For example, a GP may choose to charge $80 for a standard 15-minute consultation. Medicare will only rebate a value of $36.30 (at time of writing) for that appointment. Therefore, you will be 'out-of-pocket' the difference, $43.70.

Medicare will pay the rebate in a number of ways. You can register your bank account and the practice should automatically be able to click a button on payment to request it gets paid directly to you. Popping in to a Medicare centre or Human Services centre is a slow alternative, or some doctors can rebate the money straight into your bank account if you have your bank card handy.

If you have a lot of medical expenses in a calendar year, Medicare has a 'Safety Net'. This ticks over when you reach a certain amount of out-of-pocket expenses (at the time of writing, it's $2,030). Medicare will then automatically rebate you a larger proporition of the out-of-pocket expense. So you will pay the amount, less the Medicare rebate + 80% of the out-of-pocket expense. For example, in the case of a GP appointment, once the safety net kicks in, you will be out-of-pocket $8.75. (Paid $80, receive the $36.30 rebate, plus 80% of the $47.30 difference).