Medicare in Australia — how to register, what it covers, private insurance

Introduction

Medicare is the Australian public healthcare system. It covers most costs for general practitioners (GPs), public hospitals, and some specialists. Funded by the "Medicare Levy" (2% of your income). Available for citizens, PR, and some temporary visa holders.

Who qualifies

• Citizen of Australia
• PR (Permanent Resident)
• Some temporary visas: partner visa, 482 (through Reciprocal Health Care Agreement — Poland DOES have RHCA)
• Working Holiday (417): NOT covered by Medicare — requires private insurance (OVHC)
• Students (500): NOT Medicare — OSHC (Overseas Student Health Cover) required

Reciprocal Health Care Agreement (RHCA)

• Poland has an agreement with Australia since 2008
• Polish tourists can access Medicare for emergencies
• Covers: GP, public hospital (medical emergencies)
• DOES NOT cover: planned chronic illnesses, optics, dentistry
• Requires: EHIC (or Polish passport + documents) at the border

How to register for Medicare (after PR/citizenship)

Step 1: Online (myGov)

• Create a myGov account
• Link to Medicare
• Complete the application
• Card in 2-3 weeks

Step 2: At Service Centre

• Go to a Medicare Service Centre (Centrelink/Services Australia office)
• Bring: passport, visa documents, proof of address
• Card usually ready on the spot or in 1-2 weeks

Step 3: Temporary number (before card)

• You receive a Medicare number immediately
• You can visit a GP right after registering
• Plastic card later

What Medicare COVERS

• GP (general practitioner) — fully or mostly covered
• Public hospital — free (as a "public patient")
• Specialists — partially (difference to private rate)
• Tests (blood, imaging) — partially or fully covered
• Some surgeries — free in public hospital (waiting list)
• Pediatrics — vaccinations, check-ups
• Mental health — 10 visits to a psychologist per year with a Mental Health Care Plan

What Medicare DOES NOT COVER

• Dentistry (unless for children under 17 with Child Dental Benefits)
• Optics (glasses, contact lenses) — partially sometimes
• Physiotherapy, chiropractic, acupuncture (usually private)
• Cosmetic surgeries
• Visits to private specialists (difference between rebate and fee)
• Private hospital (except ER)
• Medications — Pharmaceutical Benefits Scheme (PBS) covers most, but you pay 7-30 AUD per prescription

Bulk Billing vs Out-of-Pocket

• Bulk billing — the doctor accepts the full Medicare rate as full payment; 0 AUD out-of-pocket
• Standard billing — the doctor charges, for example, 90 AUD, Medicare reimburses 41 AUD, you pay the difference of 49 AUD
• Bulk-billing GPs are quite common, but some doctors (mainly in affluent areas) do not
• Check before your visit — practice website or ask the receptionist

General Practitioner (GP)

• Choose any GP — there is no "assignment"
• You can visit different GPs (but it's good to stick to one for continuity)
• Time: usually 10-30 min visit
• A referral to a specialist must be from a GP (except ER)

Hospital — public vs private

• Public (Medicare): free; you do not choose the doctor; waiting list for non-urgent procedures (6-12 months for planned)
• Private: you choose the doctor, shorter waiting times; requires private insurance (Hospital Cover)
• ER is always free in a public hospital (even without Medicare)

Private Health Insurance

• Two types: Hospital Cover (private hospital) and Extras (dentistry, optics, physio)
• Common companies: Medibank, Bupa, HCF, NIB, AHM
• Cost: 100-400 AUD/month for a couple; family 200-600 AUD
• Tax bonus: Medicare Levy Surcharge (1-1.5%) if you earn >97,000 AUD and do not have Hospital Cover; insurance cheaper than additional tax
• Lifetime Health Cover Loading: 2% surcharge per year if you do not purchase Hospital Cover before age 30

Pharmaceutical Benefits Scheme (PBS)

• Subsidized prescription medications
• Co-payment: 31.60 AUD (2026), 7.70 AUD for concession card holders
• Without PBS — full price of medication (e.g., 200-500 AUD)
• The doctor must prescribe a "PBS prescription"

Common mistakes

• Not obtaining a Medicare card after arrival — large bills when sick
• Using a private hospital without Hospital Cover — 10-50k AUD bill
• Lack of Hospital Cover after age 31 — Lifetime Health Cover Loading forever
• Bulk-billed GP not always — check before your visit
• Not verifying if the doctor is PBS-approved — full price of medication