Important Things to Know About Medicare

Australia has one of the best healthcare in the world.


Australia’s public healthcare program, Medicare, provides Australians with free or affordable medical, optometric and hospital care. This is all possible through funding from the Australian government, and state and territory governments. Each citizen’s contribution to the healthcare system comes from the taxes.


The government puts emphasis on prevention of illnesses and encourages regular medical and dental check-up among its citizens.


At the same time, the government also promotes private medical insurances and gives 30% discount on the premium amount of the insurance for every individual who avails it.


Australia’s Medicare


Medicare is available for everyone with Australian Citizenship or permanent resident visa in Australia except for those who live in Norfolk Island.


You are also entitled for Medicare if you have applied for permanent visa, granted permission to work or can prove a relationship to an Australian citizen or permanent resident.


What are the benefits of enrolling for Medicare?

  What are the benefits of enrolling for Medicare?  

Public healthcare benefits cover a range of out-of hospital services. You get an 85% rebate on the amount you need to pay.


Medicare covers consultation fees for regular check-ups and consultations with your doctor and specialist, however, consultation with specialist needs a recommendation from your GP.


In addition, several tests to treat illnesses are covered. These are laboratory tests and examinations including X-rays and pathology tests. Eye tests done by optometrists are included as well. You do not need a recommendation from your GP to consult with an optometrist.


If you are in need of out-of-hospital surgery or other therapeutic procedure as advised by your doctor, this procedure would also most surgical and other therapeutic procedures performed by doctors.


Medicare can also cover cost for some surgical procedures performed by approved dentists.


Specified items under the Cleft lip and Cleft Palate scheme are also included in Medicare benefits.


Moreover, for out-of-hospital treatments, individuals are automatically enrolled with Medicare Safety Net.


Medicare Safety Net is handy for people who visits a doctor or have tests done regularly. Once a patient reaches the threshold, these fees may cost less.


All families and couples interested should register even if all members are already enrolled with Medicare. Registration is free and done only once.


Services that count towards the Safety Net are: doctor’s consultation fees, blood test, X-ray, pap smear, ultrasound, CT scan, MRI, radiotherapy, tissue biopsy, and psychiatry.


Medicare benefits also cover in-hospital patients:

Medicare benefits also cover in-hospital patients

Image Credit: iStock


Medicare provides free treatment for public in-hospital patient. You do not have to pay for care, treatment and after-care by treating doctors.


You are a public hospital patient if you choose to be admitted for treatment in a public hospital.


However, you may choose to be a private patient in a public hospital and have your preferred doctor to treat you. 75% of the fees for the services and procedures will be taken care of by Medicare.


However, you will be charged for other fees like hospital accommodation, nursing care, medicine, and allied health services. It is recommended to have a private health insurance provider to help cover all the extra costs.


How to get Medicare?


After landing on the land down under, wait for at least a week before applying in person at a Medicare office. Permanent residents need to submit their passport and valid visa to be enrolled in Medicare.


If you are still in the process of applying for a permanent residency, you need to submit your passport, valid visa and supporting documents from the Department of Immigration and Citizenship.


A Medicare staff will assist your enrollment to the system. You will be given a Medicare card number as soon as you satisfy all requirements. Your card will be available in ten days.


Always bring your Medicare card or card number on visits to the doctor, treatment in public hospitals, having prescriptions filled in a pharmacy, and inquiring or claiming cash benefit.


Claiming benefit

  Claiming benefit  

You may claim your reimbursement in Medicare offices around the country. You may complete a form or just submit a receipt together with your Medicare card.


You may also register your bank details with Medicare to electronically claim your money. You may register in any Medicare office or register online through or register by calling 132 011*. Make sure your doctor has your correct Medicare card number and address.


Another way to claim your reimbursement is through your doctor’s office. If your doctor has Medicare electronic claiming, you may use this service to transfer your cash directly to your EFTPOS card (electronic funds transfer using debit or credit cards).


However, if your doctor uses bulk billing, you do not need to claim your money with Medicare anymore. Bulk billing is when a doctor bills Medicare directly for full payment of service. Your doctor cannot charge you additional fees for booking, administration, record keeping or bandages although vaccine may cost additional charges.


Other traditional ways for claiming benefit:


You may claim your reimbursement through mail. Send your completed claim form together with original accounts and receipt. DO NOT mail your Medicare card. The mailing address is:


Medicare Australia

GPO Box 9822

in your capital city


Or you may call 1300 360 460* to give your claim details. You still need to mail your receipt and accounts to the address above. Claims will be transferred electronically to your bank account or a cheque will be mailed to you.


Medicare Access Pointe are also available in remote areas. Medicare Access Pointe are booths found in pharmacies, rural transaction centres, and some shops. You can use the booth to phone Medicare service officers for requests of claims and other services.


Medicare Two-Way, on the other hand allows you to lodge your Medicare claim forms at participating private facilities and at the same time, lodge your private health forms at Medicare offices.


Australia’s national health scheme also includes Phamaceautical Benefits Scheme or PBS. After a PBS rebate is deducted, the maximum cost of medicine should be at a maximum of $23.10 provided that the medicine is listed in the PBS.


Private Healthcare Insurance

  Private Healthcare Insurance  

Citizens and permanent visa holders are encouraged to acquire private health insurance cover.


The government gives its citizens a 30% private health insurance rebate on the premium amount of the insurance. Not availing one increases an individual’s levy at 1% for high-income earners.


Private healthcare insurance is also required for international students and other temporary visa holders.


There are different types of private healthcare insurance depending on the state and coverage you want for yourself and your family.


Private Health insurance usually covers the 25% unsubsidized cost as a private patient. You may also arrange your private insurance provider to cover most dental examinations and treatment, different therapies, glasses and contact lenses, hearing aids and home nursing. Also, depending on the insurance you bought, it may cover certain medicines not listed in the PBS.


Step by Step Guide for Migrants


If you are new in Australia, the website recommends the following steps in making sure you get your health insurance needs covered:

  1. Obtain medical records of all your family members including immunization records of your children.

  2. Research Private Health Insurance available in your state.

  3. A week after arrival, call or visit a Medicare office. Remember to bring necessary documents for you and all your family members.

  4. Consider registering for the Medicare Safety Net

  5. Visit The Australian Childhood Immunization Register if you have children with you.


Australia’s national health scheme ensures that each person living in the country receives the best treatment and get an overall best health. Take advantage of it and be proactive in taking care of your health and your family’s.

Rica J

I am a mother, a wife and a technology loving Filipina who loves reading hi-fiction books (dragons!) , good stories, dancing, laughter, lying on the grass and eating balut. I am born and raised in the Philippines and now resides in Australia but finds myself in the Philippines for at least 3 months a year. I am part of the Filipino Australian Community and have been living between Australia and the Philippines since 2007.


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