Australia's healthcare system is generally regarded as reliable, offering high-quality care. Both public and private healthcare are available in Australia, and both the state and federal governments are responsible for running the country's health system. But for newcomers, the Australian healthcare landscape might seem complex. This article provides a practical guide to understanding how the system works, what is covered under Medicare, who qualifies, and what alternatives or supplemental options exist.
What is Australia's 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 covered by Medicare are detailed in 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.
Inpatient care in public hospitals in Australia is either free or heavily subsidized. However, elective procedures will have waiting lists. Private hospitals offer more choice and shorter wait times for non-emergency treatments, although you will pay out of pocket for these services unless you have private health insurance, which will cover some of the costs.
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 surgeries 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 mailed to your home. You will need your Medicare card to receive medical treatment or to pick up your pharmacy prescriptions. To apply for a card, 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 it is essential to have a thorough understanding of your visa restrictions before emigrating.
Fortunately 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 Medicare coverage, but it does cover urgent care.
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:
- If you have applied for permanent residency, you are eligible for Medicare.
- 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 and are not eligible for Medicare.
- 491/494 visa holders: Skilled regional workers can access Medicare while they are in Australia.
- 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 and are not entitled to Medicare benefits. OSHC provides limited coverage for certain medical services.
Private health insurance in Australia
It is recommended that expats in Australia take out private health insurance. In some cases, where you are not eligible for Medicare, you are required to obtain Overseas Visitors Health Cover (OVHC) to secure your visa to Australia. Most OVHC policies should cover you for medically required hospital stays and a portion of doctors' fees. As temporary visitors to Australia aren't typically covered by Medicare, taking out OVHC will give you peace of mind in the case of a medical emergency, ensuring you aren't left thousands of dollars out of pocket.
Many Australians who are covered by Medicare also choose to take out private health insurance. This is because it offers a broader range of coverage as well as access to the private health system. Benefits also include the choice of doctor or specialist, shorter waiting times for elective surgeries, and coverage for services such as dental, optical, and physiotherapy.
Private health insurance gives you more control over your healthcare options. And, if you are a high-income earner without private health insurance, you may be liable to pay the Medicare Levy Surcharge — a 1% to 1.5% levy on high-income earners without private health insurance, to encourage private hospital cover in a bid to reduce demand on the public hospital system. Having private health insurance that meets the required standards can help you avoid this additional tax.
Ambulance services in Australia
Ambulances in Australia are for medical emergencies only and can be reached by dialing triple zero (000). Ambulances are staffed by professional paramedics. Once on-site, paramedics will assess the medical emergency, administer urgent medical care and transport the patient to the most appropriate medical facility.
Ambulance services in Australia are primarily administered by state and territory governments. And while ambulance transfers to hospitals are free for residents of Queensland and Tasmania, they are not free in the rest of the country. Ambulance services are not covered by Medicare either. To ensure you are not left out of pocket, it's essential to either include ambulance services in your private health insurance or take out ambulance membership in the state or territory where you reside.
As an expat in Australia, it is vital to research the ambulance service in the specific area you plan to stay in and review your international health insurance policy to determine if it covers ambulance services, because an ambulance trip to the hospital isn't cheap. For instance, the ambulance call-out fee to an emergency in South Australia costs AUD 1,171 (USD 768), plus an additional AUD 6.70 (USD 4.40) per kilometer.
After calling ambulance services in Australia, patients are typically transported to the nearest suitable medical facility, depending on their condition. The destination can vary based on the nature of the emergency and the availability of appropriate treatment options, which may include nearby hospitals, clinics, or specialized trauma centers. Unfortunately, some of the country's states and territories are experiencing an ambulance crisis, with wait times skyrocketing and ambulances being turned away from the nearest hospital due to emergency department delays, putting patients' lives at risk.
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 one. 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 function 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 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 the reason for your 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 on 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.
Alternatives to visiting the GP in Australia
If your complaint is mild or you are unsure if you need serious medical attention, there are a few alternatives to making an appointment with a GP or visiting the emergency department. Healthline services, such as Healthdirect or nurse helplines, provide phone-based advice from registered nurses for non-emergency concerns. 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; however, do not use this valuable service unless absolutely necessary.
Pharmacies in Australia
Another alternative to the GP is your local pharmacy. Staffed by qualified pharmacists, your neighborhood chemist can offer guidance, over-the-counter medications, and health checks. If your medical concern is urgent but not serious, or even just a common minor ailment, your pharmacist is a great place to start. There is no need to make an appointment, and many pharmacies are open late and on weekends as well. Chemists can offer advice on sore throats, cold and flu, allergies, conjunctivitis, rashes and headaches. They also provide vaccinations.
If you need to take medication regularly, your pharmacist can fill your doctor's prescription for you. You will also be able to purchase a wide range of over the counter (non-prescription) medicines at your local chemist including pain relief such as paracetamol and ibuprofen, cold and flu tablets, first aid creams, heartburn and reflux medication, vitamins, and herbal and natural remedies.
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 10 individual and 10 group 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 some eligible expats residing in Australia. Expats need to explore their eligibility for Medicare and understand the specific requirements and limitations associated with coverage for mental health services. Additionally, private health insurance may provide additional benefits and options for mental health care beyond what is covered by Medicare.
Unfortunately, Australia's mental health system is also stretched to the limit, with a record number of Australians needing access to mental health services and sometimes waiting for months for an initial appointment. There has been a steady rise in anxiety and depression — especially amongst young people — and Australia's regional and rural communities are doing it the hardest.
Dentists in Australia
As an expat in Australia, you'll find a new dentist the same way you found your new GP. It is important to note that Medicare does not cover dental services, which can be very expensive. Therefore, it is important to consider dental cover when choosing a private health insurance policy, with your health fund paying part of the cost and you paying the rest yourself. Dentistry will be part of the 'extras' section of your policy, and some health funds have preferred providers. If you choose to visit a dentist that they recommend, you will enjoy lower fees and higher rebates.
Private dental clinics provide the majority of dental care in Australia, and dentists typically see patients every six to 12 months for check-ups. States and territories also offer public dental services for children and adults, but you will need to hold a Centrelink Concession Card or a Health Care Card to be eligible.
You can find out what services are available by visiting the following websites:
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