Medicare

Medicare provides access to a range of medical services, lower cost prescriptions and free care as a public patient in a public hospital. All eligible Australian residents and certain categories of visitors to Australia can enrol in Medicare and access these services. We administer Medicare and pay Medicare benefits on behalf of the Department of Health, which is responsible for developing Medicare policy.

If you are eligible, Medicare covers:

• free or subsidised treatment by health professionals such as doctors, specialists, optometrists, and in specific circumstances, dentists, and other allied health practitioners
• free treatment and accommodation for public Medicare patients in a public hospital
• 75% of the Medicare Schedule fee for services and procedures if you are a private patient in a public or private hospital – this does not include hospital accommodation and items such as theatre fees and medicines

We pay Medicare benefits in accordance with the legislation governing Medicare and we are not able to pay benefits outside of this legislation.

The Medicare Benefits Schedule (MBS) lists services that are subsidised by the Australian Government under Medicare. Check if a service is listed under Medicare on the Department of Health MBS Online website.

Private Health Cover

There are many things to consider when looking into private health insurance:

• Who is covered? You may just need to cover yourself if you are single; or if you have family living with you such as children (dependants) you may be able to purchase cover that provides for everyone.
• What is covered? In Australia, the public health system Medicare covers most Australian residents for health care. However, Medicare does not cover everything and you can choose to take out private health insurance to give yourself a wider range of health care options and more comprehensive cover.
• How does it work? There are two types of health insurance: hospital & general treatment (ancillary or extras). You can buy them separately or most funds offer combined policies. There will be limitations on what and when you can claim with any policy you buy.
• What government incentives and surcharges affect my insurance? The Private Health Insurance Rebate is a federal government subsidy for the cost of insurance, while the Lifetime Health Cover rules are designed to encourage people to purchase private health cover earlier and to stay covered. The Medicare Levy Surcharge is a tax that affects people earning above a certain threshold who don't hold private hospital cover.
• Overseas visitors and students If you are in Australia on a temporary student visa or if you are applying for a visa subclass 457, it is a visa condition that you take out private health cover. If you are visiting Australia on any other visa, you should consider taking out some cover for the duration of your stay.