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How long before I can get on Australia’s Medicare?

by Brett Andrews

About Healthcare in Australia

– – – – X Commonwealth Fund. “How does universal health coverage work?” MoveHub. “Healthcare in Australia.”

Australia uses a universal, publicly funded healthcare system known as Australian Medicare. It’s funded by a 2% income tax and government levy, with higher income households paying more money to the system. The public healthcare system serves all Australian citizens and permanent residents, along with expats on a work permit. Over half of residents purchase private health insurance to supplement the public health plan.

Enrollment in Australian Medicare is automatic for citizens. It also extends to New Zealand, Ireland and UK citizens as part of a reciprocal agreement, though it excludes the US. Visitors and undocumented people are treated as private-pay patients under Australian Medicare, including for emergency services.

Australia’s public healthcare system factors in a range of fees that can be complicated to track. Service is free at public hospitals, while GP and specialist visits are subsidized. Dental care, ambulance services, and therapies are not covered by Australian Medicare. The Medicare Benefits Schedule (MBS) can explain further.

For permanent residents, private health insurance fills in the gaps left by the public plan. Private plans usually cover needs like dental  vision, rehabilitation, and outpatient drugs. As with many countries, private coverage pays for private clinics and hospitals, which may offer faster service or more individualized care. Note that private insurance supplements Australian Medicare; it doesn’t cover services already paid for by public insurance, like public hospitalization.

Pharmacies, or chemists, are plentiful, much like in the United States. Prescriptions must come from an Australian physician in order to get filled, but you can bring up to a 90-day supply of your medications over the border. Expats taking ADHD medication or other controlled substances may require a new diagnosis in Australia; try to coordinate this issue before you move here, if possible.

Finding a Physician

– – – – X Melbourne Hip Surgeon. “Do I need a referral to see a specialist?”

Finding your new general physician (GP) in Australia is fairly direct, as you can be seen by any GP who’s taking new patients. Once you register for Australian Medicare, ask your neighbors or pharmacist for recommendations. Local expat Facebook groups can also prove helpful.

Legally, you can see a specialist without a GP’s referral, though it goes against the country’s primary care model. You’ll want a referral from your GP or walk-in clinic to see a specialist under both public and private health systems. Walk-in clinics are common choices for non-urgent care or if you don’t currently have a GP.

Public Healthcare

– – – – X Commonwealth Fund. “Cost-sharing and out-of-pocket spending.” Services Australia. “Medicare card.”

Public healthcare is available to all permanent residents and citizens in Australia. There’s no out-of-pocket fee for public hospital stays under the Australian Medicare scheme, though fees may apply for specialists, prescription drugs, and some GP visits. These costs are capped by the Australian government.

Expats can register for Australian Medicare after getting your permanent residency visa. The median turnaround time on this visa is seven months. Once you’ve applied for permanent residency as well as Medicare, expect to receive your card in 3-4 weeks.

After you receive your Medicare card (either physical or digital), you’ll need to present it when seeking treatment. Australian Medicare covers 100% of the national MBS fee for GPs and 85% of the MBS fee for specialists. Meds on the Pharmaceutical Benefits Scheme (PBS) are capped at $28 USD each. Additional safety nets may keep costs down. Medicare excludes dental, optical, and some other medical services.

Private Healthcare

– – – – X Commonwealth Fund. “Role of private health insurance.”

Private health insurance offers many benefits: cover out-of-pocket fees; access to private providers; no-cost ambulance service; coverage for medical care outside the public health system like dental or podiatry. Over half of Australian residents carried either private hospital or general treatment coverage in 2016.

Private health insurance comes with the usual perks these plans have in countries with universal healthcare. You can use private clinics and hospitals, have shorter wait times, and offset out-of-pocket costs. Private plans also fill in the coverage gaps that expats face with Australian Medicare. When shopping for a private plan, confirm that pre-existing conditions are covered in any new policy, especially if you aren’t covered by the public health plan.

We recommend that you purchase private health insurance when applying for your permanent visa; it shows immigration officials that you’ll be less of a burden on the public healthcare system. Cigna Global is a popular private insurer in this space and may offer extended coverage for other countries you may visit.

Out-of-pocket Options

– – – – X Commonwealth Fund. “How does universal health coverage work?”

Paying out of pocket for medical treatment is certainly an option in Australia, though not recommended. Expats paying out of pocket may use both the public and private health systems. Walk-in clinics may provide a cost-effective solution for out-of-pocket care. Uninsured expats are treated as private-pay patients under Australian Medicare, including for emergency services.

Healthcare Checklist

– – – – X

• Schedule final appointments with your primary care physician and any specialists you see.
• Research your medications for availability in Australia and find alternatives where needed.
• Stock up on prescription refills until you can get to the pharmacy in Australia. It’s a dance because you’ll save money by filling your prescriptions in country, but it may take time for you to learn your way around. 
• Print out and keep photographic records of all prescriptions. Bring meds in original packaging with a letter from your doctor detailing your condition, the drug, and its generic name.
• Request your medical records and, ideally, upload them to a cloud server where you can access them anywhere. Alternatively, printouts, desktop files, and thumb drives also work.
• Ask your providers for referrals abroad. You never know!
• People often find physicians by word of mouth. Ask for recommendations from your local pharmacist, neighbors, or expat Facebook group.
• For public healthcare, apply for permanent residency and Medicare quickly. The process can take several months to complete.
• For private healthcare, apply for private insurance directly. Visit your expat Facebook group to get recommendations.
• See your family doctor and get prescriptions and referrals.

For more information on finding a physician, enrolling in the public option and more, click the Get Started button below to download our free healthcare reports for a growing list of countries: