Australia‘s health care system is considered one of the best in the world. Not only is the clinical care excellent, it’s affordable. Although you will hear the locals complaining about the system, compared to many countries health care is efficiently and quickly provided when needed.

Health care in Australia is a complex mix of government funding and private individual insurance. The rule as they apply to migrants depends on your type of Australian visa.

What is Medicare?

Medicare is the basic government funding which pays for Australians’ public hospital treatment, and some GP services. Coverage also includes tests, examinations, and specialists’ fees.

Medicare does not cover:

  • Ambulances
  • Treatment in a private hospital
  • Cosmetic procedures
  • Most dental treatment
  • Glasses, contact lenses and hearing aids
  • Most physiotherapy, occupational therapy and similar
  • Home nursing

The Pharmaceuticals Benefit Scheme subsidises prescriptions and medicines, meaning that Medicare-eligible patients only pay a maximum of £20 GBP per a prescription – with an annual maximum payment, above which prescriptions are fully funded.

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Paying for Medicare

Medicare is part-funded by Australian taxpayers who pay a 1.5% levy on all taxable income. If you earn over £52,434 GBP (individual) or £104,868 GBP (family) and do not have private hospital cover, you will be charged an additional 1% levy, rising to 1.5% for incomes over £23,304 GBP£163,128 GBP.

Australian private health insurance

Around 50% of Australians have private health insurance. There are three main types of cover:

  1. ambulance cover
  2. hospital cover (private hospitals)
  3. general treatment cover (extras cover) which cover the many services not covered by Medicare, and may also provide cover for the “gap” in funding between Medicare benefits for GPs and the fee charged.

Insurance cover is guaranteed, although there is a waiting period of up to 12 months for pre-existing conditions, and pregnancy. There are however many options available depending on your location and which industry and/or professional group you are part of. You can control costs by choosing limited cover, or higher excess.

How to find private health insurance in Australia

The government run website lists all private health insurers which are recognised for the tax rebate on insurance. Their policy comparison tool can give you an idea of costs, but here are a couple of examples:

Average private health insurance costs

Single adult living in NSW extras only cover would pay anything from £70 GBP to £105 GBP a month for premiums (before rebate or loadings).

A family of 2 adults and 2 children in Queensland wanting top hospital cover and comprehensive extras with no excess or co-pay in hospital would pay between £291 GBP£699 GBP a month on premiums.

Lifetime health cover

In order to encourage younger people to take out health insurance, the government requires that any health insurance policy adds an extra 2% loading on top of your premium for every year you are over age 30 that you have not had private hospital cover.

Migrants who are over 30 have 12 months from when they first register for Medicare to get private hospital cover to avoid this loading. Alternatively, you may use this calculator to find out whether you need to pay the LHC loading.

Private health insurance rebate

Most Australians with private health insurance are eligible for a tax rebate of around 30% of their premiums paid for hospital, extras and ambulance insurance. The actual rebate varies by age, income and number of dependent children – use the Private Health Insurance Rebate calculator to get an exact figure.

Note that this rebate does NOT apply to overseas visitor or student cover policies.

Reciprocal Health Care Agreements

Australia has reciprocal agreements with some countries. Citizens of those countries can often get emergency medical treatment while in Australia. The current list of countries is New Zealand, UK, Ireland, Malta, Italy, the Netherlands, Norway, Sweden, Finland, Belgium and Slovenia.

There are some exceptions and limits though:

  • Retirement visa holders who applied after 1 December 1998 are noteligible for Medicare and are not covered by RHCA.
  • Visitors from Belgium, the Netherlands or Slovenia need to show their European Health Insurance Card (EHIC) to enrol in Medicare and are only eligible for cover until the expiry date on that card (or they leave Australia).
  • Visitors from Malta and Italy are covered for a period of 6 months from initial arrival.
  • Students from Norway, Finland, Malta and the Republic of Ireland are not covered under the RHCA.

Australian citizens and permanent residents

When you get permanent residence, or once you arrive in Australia with permanent residence or citizenship, you need to register for Medicare.

How to apply

A Medicare enrolment application form is available online but you need to lodge it in person at any Medicare Service Centre. You will be issued with a Medicare card which should be used when accessing healthcare in Australia.

When seeking treatment

If you need treatment in a public hospital you will not have to pay any bills direct. If you are seeing a GP or specialist outside of hospital you may be asked to pay a fee, if the clinician is charging more than the figure reimbursed from Medicare. In some circumstances you may need to pay the full charge and then claim a part-rebate from Medicare.

If a clinician does not charge a top up fee, this is known as “bulk billing” and you will have nothing to pay.

Rules for Temporary Residents

In general temporary residents (which includes anyone who does not a hold an Australian permanent resident visa), are not eligible for Medicare.

If you have certain visa categories (class 457 or 458) you will be required to have a specific level of health insurance.

Temporary residents can generally claim the 1.5% Medicare Levy back at the end of the tax year. As you are not eligible for Medicare, you also don’t have to pay for it. You will however have to remember to claim the refund each and every tax year.

Download the Medicare levy exemption application

Rules for Student Visa holders

Unless you are a student from Belgium, Norway, Sweden or New Zealand you are required to take out Overseas Student Health Cover as a condition of your student visa.

These insurance products are designed to protect those who are not covered by Medicare, so that you have the same basic cover for urgent hospital and GP care.