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Australia – Healthcare

Healthcare – 1. The Basics

Australia’s health system is made up of both public and private care and is considered one of the best systems in the world.

The public system is called Medicare and is available to all Australian citizens, permanent residents and temporary visa holders who come from a reciprocal health agreement country.

Private health insurance is encouraged for everyone and there are tax benefits associated with taking it out. For visitors, including temporary workers, private health insurance is often mandatory and a prerequisite for visa approval prior to arriving in Australia. It is important to note that if an individual plans to bring their partner or family to Australia, everyone must be covered by the private health insurance.

Not all private health insurance policies will meet the Department of Immigration’s requirements for ‘adequate health insurance’, so ensure the type of cover you buy is sufficient based on your nationality and visa type.

Children will see a GP for most complaints and will only see a paediatrician for specialist needs (which would require a referral from the GP).

Healthcare – 2. Medicare

Medicare is Australia’s public health system provided for all Australian residents and some categories of visitors. It allows you access to good quality medical and hospital services for free or at a low cost. You can be seen in a public hospital free of charge and by a health professional (including doctor, optometrist, specialist) free of charge or for minimal cost.

Am I entitled to Medicare?
The Australian Government has signed Reciprocal Health Agreements with the following countries: New Zealand, United Kingdom, Republic of Ireland, Sweden, Netherlands, Finland, Italy, Belgium, Malta, Slovenia, and Norway.

These agreements mean that residents of these countries are entitled to subsidised health services for essential medical treatments whilst in Australia. To be eligible, you must have been resident in the home country for the past 12 months.

There are some limitations to the type and period of cover depending on your home country so check the Medicare website for more information.

As the care offered is usually limited to immediate and essential medical treatment, it’s a good idea to maintain your private medical insurance for the duration of your stay in Australia.

If you are a temporary resident waiting on a permanent residency visa to be approved, you may be issued with an interim Medicare card.

How do I apply for a Medicare card?
Download and complete a Medicare enrolment form and take it with original ID to a Medicare office (locations on the Medicare website).

Note: You cannot apply for a Medicare card until you have arrived in Australia and all family members must attend the Medicare office in person.

What is Bulk Billing?
Bulk billing is where a doctor charges Medicare directly with no additional cost to you. However, most doctors will charge a fee (typically around $75) to see you. If you are charged a fee you can claim up to 85% of the cost from Medicare as a rebate. Visitors from reciprocal health care agreement countries who are entitled to Medicare are not entitled to bulk billing services; it is only available to Australian citizens and permanent residents who receive full Medicare benefits.

Healthcare – 3. Private Health Insurance

Private health insurance is not mandatory in Australia, yet over 13 million people have some form of cover. This is because of long waiting lists and lack of choice of specialists through Medicare. There are also tax penalties for not having private health insurance, such as the Medicare Levy surcharge, which is an additional 1-1.5% tax on top of the Medicare Levy of 2%.

In some cases, where a visitor is a resident of a country with a reciprocal health care agreement (such as the UK), they would be entitled to apply for a Medicare card after arrival in Australia and could cancel their private health insurance. However, for the reasons mentioned above, it is wise to approach this decision with caution and discuss with a tax advisor before doing so to understand tax implications.

If you are not entitled to Medicare, it is recommended that you have private medical insurance for the duration of your stay in Australia as treatment can be expensive. You would not be denied emergency treatment, but you would have to pay for it in full, out of pocket.

It is important to note that many private health policies will have waiting periods (e.g. 2, 3, 12 months), which means for that period you are not covered for certain treatments e.g. pre-existing conditions or pregnancy related services.
Temporary Residents can obtain health insurance from the following companies:

Insurance rates vary between funds. Full cover is approximately $2,280 for singles and $5,100 for families per annum.

Healthcare – 4. Using Our System

Here are a few basic points to help you navigate the system:

  • There is no need to register with a doctor, you are free to see any General Practitioner (GP) of your choice regardless of where you live.
  • Referrals must be obtained from your GP before making an appointment with a specialist such as a paediatrician.
  • Similar to GPs, you can see a dentist of your choice, but you must obtain a referral to see an orthodontist or other dental specialist.
  • Optical: there are many shop front companies offering eye tests and prescription glasses or contact lenses (OPSM, Specsavers etc.). However a referral must be obtained from your GP to see an Ophthalmologist.
  • All visits to the above must be paid for at the time of your appointment and later claimed back from your private insurance and/or Medicare.

Immunisations
There are no specific immunisations required to enter Australia, however, you are required to declare your health status on your visa application form.
Children in Australia follow an immunisation program from birth to five years against: diphtheria, tetanus, polio, hib, measles, mumps, rubella amongst others.
The Public Health Act requires all children in childcare facilities to produce proof of immunisation. You will need to have these papers available when enrolling your child in schools or childcare.

For more information see Immunise Australia.