Australia’s Health System
Australia’s health care system is divided into the public and private sectors.
Medicare – Australia’s national health care program
Eligible Australian residents are covered by Medicare, which is the national health care program. Medicare is partially funded by a levy on income and for eligible people it provides access to free treatment as a public (Medicare) patient in a public hospital, and free or subsidised medical treatment by practitioners such as doctors, specialists and participating optometrists.
All Australian residents have access to Medicare. Some overseas visitors to Australia from certain countries with reciprocal health care agreements are entitled to limited access to Medicare, but only for immediately necessary treatment, and post arrival limits and other restrictions may apply.
Medicare does not provide cover for emergency ambulance assistance or ambulance transport to hospital. Ambulance services in Australia are on a ‘fee for service’ basis provided by State Governments, and because of the Australian geography may be expensive.
Overseas Students are not covered by Medicare even if they come from one of the countries with which Australia has a reciprocal health care agreement. All overseas students (
except some Swedish & Norwegian students) coming to Australia are obliged, as a condition of their student visa, to have private health insurance.
Reciprocal Health Care Agreements
The Australian Government has signed reciprocal health care agreements with the United Kingdom, New Zealand, Italy, Malta, the Netherlands, Sweden, Finland, Norway and the Republic of Ireland.
All visitors or temporary residents from countries covered by these reciprocal health care agreements are encouraged to seek information on their Medicare eligibility at the Australian Embassy or visa issue agency before travelling to Australia.
Pharmaceutical Benefits Scheme (PBS)
Australia also has a national system for subsidising listed prescription medicines. The Pharmaceutical Benefits Scheme subsidises the cost of over 1,350 essential items, ensuring all Australian residents have access to necessary and lifesaving medicines at an affordable price. Access to this scheme is restricted to people with Medicare eligibility, and is not available to people who have Overseas Student Health cover.
Private Health Insurance
Private health insurance is available for those who wish to cover the costs of becoming a private patient. Private patients have more control in choosing their treating doctor in hospital and in some instances can reduce their waiting time for elective surgery by having treatment in a private hospital.
Private health insurance also offers cover for some or all of the costs of other services not covered by Medicare, such as ambulance transport, dental, optical appliances, physiotherapy, pharmaceutical (non PBS) and a wide range of other services.
The Australian Government regulates private health funds but rules regarding membership vary between funds and in some cases will vary between States. All health funds have certain waiting periods and other conditions that apply before benefits are payable.
The Federal Government offers a 30% rebate on private health insurance premiums for those aged under 65. Those aged 65-69 are eligible for a 35% rebate and those aged 70 and over are eligible for a 40% rebate. This rebate is available to Australian residents who are eligible for full Medicare benefits. It does not apply to overseas students or visitors.
Lifetime Health Cover is a Federal Government initiative that came into effect on 1 July 2000. People who took out hospital cover before this date and maintain it will pay a base rate regardless of their age. After 1 July 2000, new members will pay a loading of 2% on the base rate hospital premium for each year that their age exceeds 30. People born on or before 1 July 1934 can take out hospital cover at any time and pay only the base rate. Lifetime Health Cover does not apply to overseas students and visitors.
Medibank Private provides cover for nearly 3 million people, and offer a comprehensive range of health covers for Australian residents as well as overseas students and visitors to Australia to suit most life stages and budgets.
The Medibank Private products for Australian residents generally are not suitable for visitors to Australia.
Getting Treatment
When people are in need of medical attention they usually consult a general practitioner or attend the outpatients clinic at a public hospital if their needs are urgent. If the illness requires further expert attention, the doctor will refer them to a specialist. Special payment arrangements are available to patients who have Medicare eligibility. Overseas students usually pay the doctor and claim a refund from their private health insurance fund.
Hospital Admissions
When overseas students or visitors are admitted as patients to a hospital they will need to show their Overseas Students Health Cover or Visitors Cover membership card as evidence of their health insurance to pay for their treatment.
If you are a Medibank Private member most hospitals send their accounts to Medibank Private for direct payment.
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