Getting sick or injured in a new country can be confusing and scary, and sometimes it’s hard to know where to go or what to do. We’ve put together a guide to the Australian healthcare system, to help you know how to get help should you or your family need it while you’re here.
What kind of healthcare is available in Australia?
The Australian healthcare system is divided into two sectors: public and private.
Australian permanent residents, and some visitors to Australia, have access to Medicare, which provides free or subsidised access to the public health care system as a public patient. For greater flexibility and control over their treatment, patients may decide to either be treated privately in the public health care system, or use the private health care system instead.
Can I use Medicare?
If you are here on a temporary visa, you generally won't be eligible for full Medicare entitlements, although some visitors from certain countries may be eligible to enrol for limited Medicare entitlements under Reciprocal Health Care Agreements.
Whether you have access to Medicare or not, private health insurance can help pay towards the additional costs that are not subsidised by Medicare when treated as a private patient in either the public or private health care system.
How does private health insurance work?
If you are not eligible for free or subsidised treatment through Medicare, you’ll generally be responsible for the full cost of services provided in the healthcare system while you are in Australia (e.g. when going to hospital). Private health insurance may help with these costs as well as for emergency ambulance trips and, some treatments outside of hospital depending on the level of private health cover that you take out.
Depending on the visa you arrive on, you may have ‘condition 8501’ applied, which requires you to “maintain adequate health cover” while in Australia.
For Student visa holders, Overseas Student Health Covers (OSHC) meet this requirement.,
The Department of Home Affairs offers a guide to what is considered “adequate health cover” for holders of other visa subclasses
You can choose to take out additional coverage for services you may need, such as dental, physiotherapy and optical.
How can a general practitioner doctor (GP) help?
A GP can help you by diagnosing and treating pain, diseases and other health issues. They can also help with mental health support, vaccines, referrals for tests or scans, managing and treating wounds, prescribe medication if required, as well as referring you to specialist doctors, who have completed advanced training in a specific area of medicine. Some GPs also have areas of special health interests, such as women’s health, mental health, sexual health or dermatology.
If you need to see a doctor, your first step is to find a general practitioner (GP) near where you live, work or study. GPs can work in private practices, public clinics and medical clinics, and the fee for seeing a GP can vary.
If you need emergency medical help, call 000. This will connect you immediately to the national ambulance, police, and fire services. Click here for more important Australian phone numbers and websites.
Do I have to pay to see a general practitioner doctor?
If you are not eligible for subsidised treatment through Medicare, you’ll need to pay for the service in full, unless you have a suitable private health insurance cover.
Most Medibank private health insurance covers designed for international visitors coming to Australia (known as Overseas Health Covers), will pay towards the cost of seeing a GP, at least equivalent to 100% of the Medicare Benefits Schedule (MBS) Fee set by the Australian government. You may have an out-of-pocket cost where the charge by the GP is more than the benefit payable by Medibank under your chosen cover.
To help minimise any out-of-pocket expenses, always ask your GP if they’ll bulk-bill, and if not, ask how much they’ll charge above the MBS fee before your appointment.
If you hold cover with Medibank OSHC or ahm OSHC, you have access to a large network of Direct Billing GPs who have an agreement to send the bill directly to us. Attending a Direct Billing GP helps to reduce any out-of-pocket expenses you’ll need to pay upfront1.
- Medibank OSHC members can find an OSHC Direct Billing clinic here.
- ahm OSHC members can find an OSHC Direct Billing clinic here.
With Online Doctor, Medibank OSHC and ahm OSHC policy holders have access to virtual consultations with a qualified medical doctor through the OSHC app2.
Hospital visits
In Australia, the doctor or specialist is generally free to set their own fees when you are being treated as a private patient. Medibank Overseas Health Covers will pay at least 100% of the MBS fee for included services, but where they charge above the amount we pay, you’ll have to pay the difference as an out-of-pocket expense.
If you attend a public hospital, they will generally provide you the first suitable doctor available, so it’s important you ask for ‘Informed Financial Consent (IFC)’ so you can know upfront how much they will charge you and your likely out-of-pocket expense. If you plan to attend a private hospital, you are free to choose your own specialist doctor. Likewise, you should discuss any out-of-pocket expenses before entering into an agreement with them to be your treating doctor.
For emergency and unplanned admissions, you’ll generally be treated in a public hospital (as this is where most emergency departments in Australia are located), while private hospitals generally deal with elective and non-urgent procedures, as well as management of chronic conditions.
Whatever hospital you attend, Medibank Overseas Health Covers can help towards hospital costs for included services. Plus, it’s worth knowing that if you visit a Members’ Choice private hospital, you may generally get better value for money compared to a non-Members’ Choice private hospital.
Click here for more information on how to choose a specialist.
Click here to find out when you may need to visit a hospital in Australia.
Do I have to pay for prescription medicine?
For prescription medicines provided in a community setting, such as from a pharmacy, Medibank Overseas Health Cover can help you, where your cover includes benefits for prescription medicines, less any co-payments payable under your cover and up to the applicable annual limits. You can also take out separate Medibank Extras cover to help pay towards eligible prescription medicines if they are not included in your Overseas Health Cover.
For medications which form part of a hospital admission, the benefits we pay will depend on a range of factors, such as the cover you hold, the hospital you attended, whether they are PBS (Pharmaceutical Benefits Scheme) listed and whether they were administered while you were an admitted patient, provided upon discharge, or in an outpatient setting. Contact Us for more information on how we may be able to help you pay towards the cost of any pharmaceuticals related to a hospital admission.
