One of the most important things to know when moving to Australia is how the health system works. At first glance, it might seem like there’s a lot of information to take in, but there’s nothing to worry about. To keep things simple, we’ve broken down the essential details in this quick guide so you’re ready to make the right decision for your circumstances.
How health care works in Australia
Australia has a public health system called Medicare. Funded by taxpayers, it provides medical services to citizens and some immigrants, either at no cost or at subsidized prices. However, it is important to note that more than half of Australia’s population also have private health insurance. It provides paid access to health care services and treatments not covered by Medicare.
Who can access Medicare?
Medicare, the public health system, is available to:
Australian citizens
New Zealand citizens
Immigrants who have become permanent Australian residents, for example by obtaining permanent work visas.
Immigrants applying for permanent residence.
Visitors from countries with Reciprocal Health Care Agreements with Australia, specifically Belgium, Finland, Italy, Malta, the Netherlands, New Zealand, Norway, the Republic of Ireland, Slovenia, Sweden and the United Kingdom.
What does Medicare cover?
Medicare covers some or all of the costs for a huge range of health care services listed in Australia’s Medical Benefits Schedule , including:
Consultations with a general practitioner or specialist
hospital care
Diagnostic tests and scans
Most surgical procedures
Eye exams by optometrist
Some dental treatments
People enrolled in Medicare can also receive prescription drugs at discounted prices through the Schedule of Pharmaceutical Benefits. All you have to do to receive the discount is show your Medicare card at the pharmacy.
What Medicare doesn’t cover
Although Medicare is a comprehensive system, there are some important costs that it does not cover. These include:
Ambulance services (except in Queensland and Tasmania, where the state government covers ambulance costs)
Most dental checkups and treatments
Glasses or contact lenses
Most physical therapy, speech therapy, and psychological services
Treatment that is not clinically essential
How to access Medicare
If you are eligible for Medicare, you can enroll by downloading and completing the form found here . As part of your application, you will also need to provide certain documents that will vary depending on your circumstances.
For example, if you are an immigrant on a permanent resident visa, you will need to provide your current password and proof of residency status from the Department of the Interior. If you are currently in the process of applying for permanent residence, you will need to provide your current passport, your visa, and proof that an application for permanent residence has been filed with the Department of the Interior.
After your application has been processed, your Medicare card will be sent to you. When you receive medical care, for example at your doctor’s office, you may have to pay the fee and then file a request for reimbursement from Medicare. You can do this at your doctor’s office, through your Medicare online account , through the Express Plus Medicare mobile app , and by mail using the Medicare reimbursement form. The good news is that many of Australia’s medical professionals choose ‘bulk billing’, which means the government pays them for the work they do, and you don’t have to go through the whole process. to pay the fees and request reimbursement from Medicare.
Do you need private health insurance in Australia?
As we mentioned earlier in this guide, many permanent resident Australians and immigrants choose to pay for private health care beyond what Medicare provides. Ultimately, this has significant benefits, such as shorter wait times for surgery and coverage for treatments that don’t fall under Medicare’s jurisdiction (for example, most dental and physical therapy services).
In an effort to take some of the pressure off the public health system, the Australian government is also providing people with incentives to sign up for private health insurance. For starters, the government pays a private health care reimbursement that contributes to the cost of insurance premiums for those who qualify within income categories. There is also an initiative known as Lifetime Health Coverage (LHC), which means that anyone who purchases private insurance (specifically, for hospital care) before their ‘LHC Start Day’ will avoid paying an annual surcharge each time older in his cousin. For immigrants, the ‘LHC Start Day’ is the July 1st after your 31st birthday or the first anniversary of your Medicare enrollment (whichever is later).
If you are not eligible for Medicare, say you have a temporary work visa that allows you to live in Australia for four years, you will most likely want to purchase private health insurance or you will risk paying higher fees whenever you need medical treatment. Of course, depending on your visa, you may be required to purchase health insurance as part of the application process. For example, most international students will need to purchase International Student Medical Coverage which should cover hospital treatment and ambulance services.
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How private health care works for Medicare users
If you are eligible for Medicare, there are two main types of private health cover in Australia. You can purchase one or both options shown below.
hospital coverage
This will allow you to receive care in private hospitals, which tend to provide more comfortable settings (and often your own room), better food, and other benefits. You will be able to choose your own doctor and you can expect surgeries and other treatments much more quickly. In addition, you can also be treated as a private patient in a public hospital, if that is more convenient for you.
Hospital coverage is divided into four levels : basic, bronze, silver and gold. The scale of coverage provided by the policy is reflected in these levels. For example, gold policies will cover joint replacements and childbirth, which are not included in any of the lower tiers.
General coverage or ‘extras’
This kind of policy covers things like dental services, physical therapy, and the cost of glasses and contact lenses. Please note that you will normally only receive partial coverage, for example 60% of the price of root canal treatment. It is also possible to purchase ambulance coverage to cover transport to the hospital, although some states and territories allow you to pay a recurring subscription fee for ambulance services in that region.
How private health care works if you can’t access Medicare
If your visa does not make you eligible for Medicare, you will not need to see the tiered policies described above. Instead, you can purchase International Visitors Medical Cover (or International Student Medical Cover if you are coming to study in Australia). What is included in your International Visitors Medical Coverage package will vary between insurers, some will include consultations with general practitioners and medicine prescriptions, others are limited to hospital treatment.
health care costs
Most Australian residents eligible for Medicare must contribute to this public health scheme at a rate of 2% based on their taxable income. When it comes to private health insurance, the average cost of hospital-only coverage in Australia is estimated to be around $166 per month. Sure, the price of private health insurance varies greatly, depending on the specific policy you purchase. For example, a combined hospital and extras gold policy will cost significantly more than just purchasing an extras policy. For this reason, it is important to analyze your needs properly. Let’s say you’re young with no pre-existing health conditions, then you might decide to purchase lower level coverage.
A good idea is to use comparison tools to evaluate the various health care packages on offer. Here are some sites that may be helpful:
PrivateHealth.gov.au , official private health insurance brokerage site that compiles all registered insurers and allows you to compare policies for residents eligible for Medicare
iSelect , a popular Australian price comparison site with an extensive health insurance section
Finder , another of the best price comparison sites that allows you to specify exactly the kind of policy you are looking for
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