What Is Medicare?

Medicare is Australia's universal public health insurance scheme. It provides eligible residents with subsidised or free access to a wide range of medical services. Funded through the Medicare Levy (a percentage of taxable income paid by most Australian taxpayers), it is administered by Services Australia.

Who Is Eligible for Medicare?

You are 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, such as the UK, Italy, and Sweden (limited coverage applies)

Temporary visa holders are generally not eligible, though specific exceptions exist. Enrol in Medicare through Services Australia or via your myGov account.

What Does Medicare Cover?

Medicare covers a broad range of health services, but not everything. Here is an overview:

What Medicare Covers

  • Visits to bulk-billing GPs (no out-of-pocket cost to you)
  • Specialist consultations (with a referral from your GP)
  • Diagnostic tests such as blood tests and X-rays
  • Treatment as a public patient in a public hospital
  • Some allied health services under specific care plans (e.g., physiotherapy under a GP Management Plan)
  • Mental health services under a Mental Health Care Plan (up to a set number of sessions per year)

What Medicare Does NOT Cover

  • Dental care (except limited emergency hospital treatment)
  • Optical (glasses and contact lenses)
  • Ambulance services (covered separately by state-based schemes or private insurance)
  • Cosmetic surgery
  • Most overseas medical costs
  • Private hospital accommodation and theatre fees beyond the Medicare benefit

Medicare Safety Net

If your out-of-pocket medical costs reach a certain threshold in a calendar year, the Medicare Safety Net kicks in and increases the rebate you receive for future out-of-hospital services. You can register a family on the Safety Net so combined costs count toward the threshold faster.

How to Claim Medicare Rebates

There are several ways to claim:

  • Bulk billing: Your doctor bills Medicare directly — you pay nothing at the point of care.
  • At the counter: Pay upfront and claim at a Services Australia service centre or Medicare kiosk.
  • Online via myGov: Submit a claim through your linked Medicare account in myGov.
  • Express Plus Medicare app: Claim directly from your smartphone.

The Pharmaceutical Benefits Scheme (PBS)

Closely related to Medicare, the PBS subsidises the cost of many prescription medicines. With a valid prescription from a registered Australian doctor, you pay a government-set co-payment rather than the full price. Concession cardholders pay a reduced co-payment. Check the PBS website for the current list of subsidised medicines.

Getting Your Medicare Card

Once enrolled, you will receive a Medicare card. You can also access your Medicare card digitally through the Medicare app or your myGov account. Keep your Medicare number handy when visiting health providers.