Australian Medicare grants all its native citizens — and eligible overseas visitors or permanent residents — access to health care at a reduced cost or no cost at all.

Quality health insurance and medical care is one of the biggest considerations for any immigrant when deciding which country to relocate to and Australia has its own medical scheme for eligible immigrants.

In this article, we will unpack the health care system in Australia:

• What is Medicare? 
• What it Covers (and Doesn’t)?
• How it All Works?
• Who is Eligible To Apply?
• What You Need To Apply?

Let’s get right to it.

What is Medicare?

Medicare is Australia’s universal health care system that helps to subsidize the cost — either partially or fully — of necessary health care for Australians and visitors from 11 other countries that have reciprocal agreements.

This health insurance scheme is publicly funded and provides coverage for most primary health care services in the public and private health care system.

A levy, known as the Medicare Levy, is an income tax surcharge that is used to nominally fund Medicare. This is a contribution that equates to 2% of a tax paying resident’s taxable income. 

When Was Medicare Introduced in Australia?

The history of Medicare and the introduction of this scheme dates back to 1 February 1984. Unlike its predecessors that were limited to paying customers only, Medicare became reinstated as universal health care to help pay for “out of hospital health” services for Australia’s entire population.

Once you are enrolled into Medicare — provided you submit certified supporting documents — you will get a Medicare card that will help you to pay for some (or all) of the costs of your necessary health care.

What Does Medicare Cover in Australia?

Medicare covers most specialities and allied health services that include psychology, psychiatry, ophthalmology, physiotherapy and audiology.

The Medical Benefits Schedule (MBS) lists all the services that are covered by Medicare that also includes:

1. Seeing a GP (General Practitioner/Doctor) or specialist
2. Prescription medicines
3. Hospital costs are covered if you are a public patient being treated in a public hospital 
4. You can choose to be a public or private patient when you go to hospital
5. Public patients will have costs covered, including the costs of going to an emergency department 
6. Tests and scans (such as X-Rays and ultrasounds)
7. Most surgery and procedures performed by doctors
8. Eye tests by optometrists

What is Not Covered By Medicare?

Medicare doesn’t cover:

1. Most dental services
2. Costs of glasses, contact lenses and hearing aids
3. Cosmetic surgery
4. Ambulance services 

Queensland and Tasmania are the only States where their respective State Government provides free emergency ambulance services. 

All other States/Territories (NSW, VIC, WA, NT, SA, ACT) ambulance services are covered either by your private health insurance or are out of pocket

What Medicare doesn’t cover is often covered by private health insurance, which is subsidized by the Australian government for most Australians.

How does Medicare Work in Australia?

Health care professionals/services that bill Medicare directly (known as bulk billing) means patients don’t have to for the medical care they receive.

If, however, your doctor doesn’t offer “bulk billing,” you will need to pay the upfront cost for your doctor’s visit, and then claim back a portion from Medicare.

This service is sometimes offered on the spot from the doctor’s offices.

If not offered, you can claim online, by mail or at a service centre.

Here follows an example of what a visit to a bulk billing doctor might look like in Australia:

1. Maya went to her GP to discuss a few health concerns. While she was there, her GP advised her to get a flu vaccination and a blood test to check her iron levels.
2. Maya’s GP bulk billed her. This means she didn’t have to pay for her appointment.
3. Maya did have to pay for her flu vaccine. This is because Medicare doesn’t cover the flu vaccine for most adults. Maya paid a total of $20 to cover the flu vaccine.
4. Maya asked her GP how much the blood test would cost. Maya didn’t have to pay for this test because the pathology lab that tested the sample chose to bulk bill.

Who is Eligible To Apply For Medicare?

Now that you have a better understanding of what Medicare is and what it covers, it’s important to understand who is eligible to take advantage of this universal health care scheme:

• Australian citizens
• NZ citizens living in Australia
• Permanent residents of Australia
• Persons applying for permanent residency
• Temporary residents covered by a ministerial order

Most immigrants will fall into the permanent resident/applying for permanent residency/temporary residency visa categories.

You may be eligible for Medicare if you are a:

1. Holder of the new Regional Provisional Visa — these are the skilled work/skilled employer-sponsored subclass 491 and 494 visa
2. Permanent visa holder or resident return visa holder — these are permanent business visas you may wish to consider: 132, 188 – 888 visa
3. Holder of a temporary visa (including a bridging visa) that has applied for a permanent visa — excluding a parent visa
4. Permanent visa applicant with a visa that has work rights or you have a parent, spouse or child that is an Australian/New Zealand citizen that lives in Australia — this includes if you have applied for a combined 309/100 or 820/801 partner visa
5. Permanent protection visa applicant — those seeking asylum after arriving in Australia
6. Holder of one of these other temporary visas:

• Contributory Parent visas (subclasses 173, 143, 884, 864)
• Witness Protection (Trafficking) Temporary visa (subclass 787)
• Support for Victims of People Trafficking Program
• Temporary Humanitarian Concern visa (subclass 786)
• Temporary Protection visa (subclass 785)
• Removal Pending Bridging visa (subclass 070)
• Illegal maritime arrivals holding a Bridging E (Class WE) visa
• Illegal maritime arrivals holding a Humanitarian Stay visa (subclass 449)
• Secondary Movement Offshore Entry visa XB (subclass 447)
• Safe Haven Enterprise visa (subclass 790)

How To Apply For Medicare?

When it comes to applying for Australian Medicare, one should provide the following documentation to a DHS Service Centre:

1. A completed Medicare enrolment application form (MS004)
2. Identity documents in the form of a birth certificate/drivers licence for all applicants
3. Your current passport or Immicard
4. Proof of your visa status that can include:

• Print out from VEVO of your current visa 
• A visa grant notification confirming the grant of a specific visa
• ‘Acknowledgment of application received’ for a permanent visa application from the Department of Home Affairs for all applicants

5. Proof of your Australian citizen or permanent resident parent, spouse or child including:

• Birth certificate
• Marriage certificate
• Joint bank/home utilities account statement 
• Proof of you owning a home together

Interested in Exploring Options For
Permanent Residency in Australia That Offer Medicare?

Speak to our registered Australian immigration agents and lawyers to discuss your unique situation and immigration options.

Take a look at our free Australia visa check to identify the most suitable way forward for you and your loved ones!