What Is Medicare?
Medicare is Australia's universal public health insurance scheme, administered by Services Australia. It provides eligible residents and citizens with access to a wide range of medical services either free of charge or at a subsidised cost. Funded largely through the Medicare Levy, the scheme is designed to ensure that no Australian has to go without basic medical care due to financial hardship.
Who Is Eligible for Medicare?
You are generally eligible for Medicare if you are:
- An Australian citizen
- A permanent resident of Australia
- A New Zealand citizen living in Australia
- A citizen or permanent resident of a country with a Reciprocal Health Care Agreement (RHCA) with Australia (these include the UK, Ireland, Sweden, the Netherlands, Belgium, Finland, Italy, Malta, Norway, and Slovenia)
- An applicant for certain temporary visas who meets specific criteria
If you are on a temporary visa not covered by an RHCA, you will generally need Overseas Visitor Health Cover (OVHC) instead.
What Does Medicare Cover?
Medical Services (MBS)
The Medicare Benefits Schedule (MBS) sets out the services Medicare subsidises. These include:
- Consultations with GPs (general practitioners) and specialist doctors
- Pathology tests (blood tests, cultures, etc.)
- Diagnostic imaging (X-rays, ultrasounds, MRIs — in certain circumstances)
- Eye tests performed by optometrists
- Many surgical and specialist procedures performed in hospital
Bulk Billing
When a doctor bulk bills, they accept the Medicare benefit as full payment — meaning you pay nothing out of pocket. Not all doctors bulk bill, and many charge a gap fee above the Medicare rebate. It's always worth asking your doctor or clinic whether they bulk bill before your appointment.
Public Hospital Care
As a public patient in a public hospital, Medicare covers the full cost of your treatment — including accommodation, nursing, and doctors' fees. You do not choose your doctor, and waiting times can apply for elective procedures.
What Medicare Does NOT Cover
Medicare does not cover everything. Key exclusions include:
- Dental treatment (except for limited programs for eligible children and concession card holders)
- Ambulance services (these vary by state — some states include ambulance cover in their state schemes)
- Physiotherapy, occupational therapy, and podiatry (except under GP Management Plans)
- Optical aids such as glasses and contact lenses
- Cosmetic surgery
- Overseas medical costs
Private health insurance can be used to cover many of these gaps.
The Pharmaceutical Benefits Scheme (PBS)
The PBS is a separate government program that subsidises the cost of a wide range of prescription medicines. With a valid prescription from an Australian doctor, PBS-listed medicines are available at a capped price. Concession card holders pay an even lower co-payment. Ask your doctor whether a prescribed medication is PBS-listed, as some medicines are available only at full cost.
How to Enrol in Medicare
- Gather your documents: proof of identity, proof of residency status or citizenship, and any relevant visa documentation.
- Visit a Services Australia service centre or submit an online enrolment application through myGov.
- Once enrolled, you'll receive a Medicare card in the mail, usually within a few weeks.
You can also manage your Medicare details — including updating your address and viewing claim history — through your myGov account.
Medicare Safety Net
If you and your family spend a certain amount on out-of-pocket medical costs in a calendar year, you qualify for the Medicare Safety Net, which increases the rebate you receive for future services. You can register your family as a unit through your myGov account or by calling Services Australia on 132 011.