Australia's healthcare system is a blend of public and private sectors. The public health insurance system is known as Medicare. It provides free or subsidized medical services, including doctor visits, hospital care, and some prescription medications.
While Medicare covers essential medical services, private health insurance provides coverage for additional services such as dental, optical, and specialist consultations. It also allows individuals to choose their doctor and receive treatment in private hospitals.
Many healthcare providers offer "bulk billing," which means they accept the Medicare benefit as full payment for their services, and patients do not have to pay out-of-pocket expenses. For anything out-of-pocket, private healthcare can help cover. There are a lot of private health care providers and each of them offer plans with different tiers. The higher your premium, the more services your plan includes.
Who Can Get A Medicare Card
You can apply for Medicare online as soon as you are eligible. In order to apply, you need to know what visa you’ve applied for or the respective visa conditions. To access your visa information, please use the Australian Government’s Online Visa Holder Enquiry Form called VEVO (Visa Entitlement Verification Online).
You are eligible for Medicare if you tick any of the following boxes:
• Permanent Residents
• Skilled Work Regional (subclass 491) Visa
• Skilled Employer Sponsored Regional (subclass 494) Visa
• You live in Australia and have applied for a permanent residency visa with work rights.
• You live in Australia and have applied for a permanent residency visa and you have a parent, spouse or child living in Australia, who is an Australian citizen, permanent resident or New Zealand citizen.
• You live in Australia and have applied for a permanent protection visa.
• You have applied for a combined 309/100 or 820/801 partner visa – for offshore applications, you will be eligible to enrol in Medicare from the date you arrive in Australia.
• Contributory Parent Visas (subclasses 173, 143, 884, 864)
• Witness Protection (Trafficking) Temporary Visa (subclass 787)
• Support for Victims of People Trafficking Program
• Temporary Humanitarian Concern Visa (subclass 786)
• Temporary Protection Visa (subclass 785)
• Removal Pending Bridging Visa (subclass 070)
• Unauthorised maritime arrivals holding a Bridging E (Class WE) Visa
• Humanitarian Stay (temporary) Visa (subclass 449))
• Secondary Movement Offshore Entry Visa XB (subclass 447)
• Safe Haven Enterprise Visa (subclass 790)
• Fulbright Scholars
When Can You Enroll In Medicare
You can enrol in Medicare from either:
• The date you applied for permanent residency, OR,
• The date you arrived to live in Australia if you applied outside Australia.
If you are living overseas after you enrol, you will remain enrolled in Medicare for 12 months from the date you first left Australia. You cannot use Medicare services from outside Australia. You may have some cover under a Reciprocal Health Care Agreement. If so, you will need a Medicare card for this.
Reciprocal Health Care Agreements
If you are a citizen of the following countries that have a reciprocal health care agreement with Australia, you are likely eligible for Medicare while in Australia:
• Belgium
• Finland
• Italy
• Malta or the Maltese Islands
• The Netherlands
• New Zealand
• Norway
• Republic of Ireland
• Slovenia
• Sweden
• United Kingdom
If you live overseas for more than 12 months, you will no longer be enrolled in Medicare. You also won’t be able to use a Reciprocal Health Care Agreement. You will need to re-enrol in Medicare when you move back to Australia.
2. Provide identity documents, such as your current passport or Immicard.
3. If needed, as per the categories listed above, provide proof of your visa status including: a. Visa Grant Notification b. VEVO Print Out c. Proof from the Department of Home affairs that you’ve applied for permanent residency, such as an ‘Acknowledgement Of Application Received’ letter
4. If needed, as per the categories listed above, provide proof of your Australian citizen or Permanent Resident parent, spouse or child, including: a. Birth Certificate b. Marriage Certificate c. Joint Bank, Gas, Water or Electricity Account Statement d. Proof you own a Home Together
5. Email all attachments to Medicare Enrolment Service. In the email subject, type “Enrolment Medicare – Your Full Name”.
How To Apply For Medicare (Via myGov)
To enrol online using myGov, you need to be living in Australia, 15 or older, and enrolling as an individual. You must also have either:
1. Applied for a permanent resident visa,
2. Been granted permanent residency, OR,
3. Hold a returning resident visa.
If you are enrolling as a family, you need to complete a Medicare Enrolment Form and can opt to email or post your documents.
If your application is approved, Services Australia will contact you with next steps. They will also send your Medicare card in the mail to the address you supplied. The card contains a unique identifier that ensures accurate billing through the Medicare system.
3 Types Of Medicare Cards
There are 3 types of Medicare cards that come in the following colours:
1. Green, standard Medicare cards, valid for 5 years.
2. Blue, interim Medicare cards, valid until the expiry date on the card; for applicants who are not Australian permanent residents or citizens and are not covered by a Reciprocal Health Care Agreement.
3. Yellow, if you’re visiting Australia from a country with a Reciprocal Health Care Agreement (RHCA) Medicare card, valid until the expiry date on the card and you need to meet the RHCA criteria for your country to enrol in Medicare.
Private Healthcare – EXTREMELY IMPORTANT
Did we mention how important this section is? You better believe it. If you haven’t had the chance to see the Medicare Enrollment Form, let us share the section on the form, known as “Lifetime Health Cover”.
Lifetime Health Cover (LHC) is a financial initiative introduced by the Australian government to encourage individuals to take out and maintain private health insurance before they turn 31.
Loading On Private Health Care Premiums
If an individual takes out private hospital cover later in life (after the age of 30), a loading on the base premium is applied at 2% for each year over the age of 30 that a person delays taking out private hospital cover. The maximum loading is capped at 70%, meaning that the highest loading a person can have is 70% of the base premium. The LHC loading is applied for 10 continuous years once an individual takes out private hospital cover. After 10 years of continuous cover, the loading is removed.
Exemptions on LHC Loading
You are exempted from the LHC loading if, as an immigrant, aged 31 or over, you purchase private hospital cover within the 12 months of being enrolled in Medicare OR if under 31, purchase private hospital cover before turning 31. Other exemptions are if you have served in the Australian Defence Force, or low-income earners who are eligible for a Medicare Levy Exemption.
Medicare Levy
Medicare Levy is a tax in Australia that helps fund the country's public health care system, Medicare. The levy is applied to the taxable income of most taxpayers, with the revenue generated contributing to the cost of providing essential health services to Australian residents. The standard rate for Medicare Levy is 2% of an individual's taxable income.
Low-income earners can be exempted from Medicare Levy and the LHC Loading. If their income increases however, and they are over the age of 31, the same principles apply as stated under Loading on Private Health Care Premiums.
Medicare Levy Surcharge (MLS)
In addition to the standard Medicare Levy, individuals who earn above a certain threshold and do NOT have private hospital cover (insurance), will be subject to a Medicare Levy Surcharge when they file their taxes. This is an additional tax aimed at encouraging individuals to take out and maintain private health cover.
For Medicare Levy and the Medicare Levy Surcharge Calculators, as well as more information on private health care providers, please see our detailed research on Private Health Care.
Higher Loading Example
Older = Higher Loading
If you enroll in Medicare and decide NOT to purchase private health care within the 12 months of enrolling in Medicare, this is how the loading works:
Age 42 at time of enrollment.
Base premium (incl. GST) for annual private hospital cover is AUD $1,000.
Loading = 2% per year, 42-31 = 11 years of loading multiplied by 2% = 22% loading
Total Annual Premium = AUD $1,220
Medicare Levy Surcharge Example
Above 31, Income Above MLS Income Threshold
If you enroll in Medicare and decide NOT to purchase private health care within the 12 months of enrolling in Medicare, this is how the Medicare Levy Surcharge works:
Age 42 at time of enrollment. Gross Annual Income = AUD $100,000, Above threshold of $93,000.
Medicare Levy Surcharge = 1%, 100,000*0.01 = AUD $1,000.
For Medicare Levy and the Medicare Levy Surcharge Calculators, as well as more information on private health care providers, please see our detailed research on Private Health Care.
Medicare Entitlement Statement (MES)
The Medicare Entitlement Statement is a document that provides information about an individual's Medicare enrollment and entitlement status. It is an official statement issued by the Australian Government Department of Human Services (Medicare) and is designed to inform individuals about their eligibility for Medicare benefits.
The statement serves to confirm an individual's current enrollment status with Medicare, with the effective dates of their enrollment, and outlines the basis of their entitlement to Medicare benefits. For individuals on certain visas or with temporary residency status, the statement may specify the conditions under which they are entitled to Medicare benefits.
It may also indicate if an individual is exempt from Medicare Levy, a tax that helps fund the public health system. Exemptions may be based on factors such as income level, residency status, or specific circumstances.
Individuals may use the Medicare Entitlement Statement for various purposes, such as providing proof of Medicare entitlement when dealing with healthcare providers, applying for certain government benefits, or fulfilling other documentation requirements. You can apply for a Medicare Entitlement Statement online using myGov or by filling in a form, attaching the required documents, and emailing Medicare.
Your tax agent can also complete the form, but you will need to complete the declaration.
More information on obtaining an MES is available here.
How Long Till You Receive Your Medicare Card In The Mail
Once you submit your email, you can call in a few days to confirm it was received and if all the attachments are correct or if any other information needs to be supplied. If a Medicare associate finds something missing, they will NOT call you. The onus is on you to follow up. Medicare services are hands down, the slowest, in the country. It is faster to renew one’s passport than it is to get Medicare. Phone wait times average 30-40 minutes, and being put on hold for 1 hour+ is common.
As of January 2024, the average application processing time is 28 working days (take note to exclude public holidays). Even then, you should call and follow up within the 28 days to ensure your application is in the queue and on track. Be polite please. If you do not hear back after 6 weeks, call back. Eventually, they will send your card in the mail. Sorry, there isn’t a faster route to this.
