The Australian Health Care System
                     The Australian Health 
Care System
Best Australian Health System
Australia’s health system is best in the world, providing safe and 
reasonable health care for all Australians. It is jointly run by all 
levels of Australian government – federal, state and territory, 
and local.
It provides excellence, safe and inexpensive health care for you 
and your family. It’s a key reason why they enjoy one of the 
longest life expectancies in the world.
Australia Health Care Providers
There are many providers of health care in Australia, including:
• primary care services delivered by general practitioners (GPs)
• medical specialists
• allied health workers
• nurses
Medicare and the public hospital system provide free or low-cost 
access for all Australians to most of these health care services.
Foundation of Health System
Medicare — the foundation of Australia’s health system
Medicare has been Australia’s universal health care scheme since 
1984. It helps Australians with the cost of their health care. 
Australians make more than 150 million visits to a GP every year. 
Medicare- public health insurance system- helps pay for these visits. 
Its 3 major parts are:
•medical services
•public hospitals
•medicines
Medicare for Australian Citizens
Medicare is available to Australian 
Citizens, Permanent Residents in 
Australia
• It also covers some or all of the costs of 
other health services.
• They can also include physiotherapy, 
community nurses and basic dental 
services for children
Free Health Care Services
If you have a Medicare card, you can access a range of health 
care services for free or at a lower cost, including:
• medical services by doctors, specialists and other health 
professionals
• hospital treatment
• prescription medicine
The other important part of Medicare is the Pharmaceutical 
Benefits Scheme (PBS). The PBS makes some prescription 
medicines cheaper as Australians get medicines at a subsidized 
rates.
Pharmaceutical Benefits Scheme
The Pharmaceutical Benefits Scheme
• The PBS helps make medicines cheaper.
• Without the PBS, medicines would be 
more expensive.
You only pay some of the cost of most PBS 
medicines if you are enrolled in Medicare. 
The Australian Government pays the rest.
How Medicare Works
• When you enroll in Medicare, they pay some or all of the 
costs of your necessary health care.
• Keep in mind, Medicare doesn’t pay for all medical services.
• If your doctor bulk bills, Medicare pays the cost directly to the 
doctor. This means you won’t have to pay anything. (Not all 
health professionals do bulk bill). 
• They also help to make some medicines more affordable for 
you through the Pharmaceutical Benefits Scheme.
Australia Medicare Duties
Medicare Levy
The Australian government pays for Medicare through the Medicare 
levy. Working Australians pay the Medicare duty as part of their 
income tax.
Medicare is partially funded by an income tax surcharge - all 
Australian taxpayers earning over a certain threshold pay a Medicare 
levy (currently 2 per cent of their taxable income or 2.5 per cent for 
those on high incomes who don’t have private health insurance.
The Medicare duty is collected from you in the same way as income 
tax. Generally, the pay as you go amount your employer withholds 
from your salary or wages includes an amount to cover the Medicare 
charge.
Medicare Enrollment under PR
Documents to enroll in Medicare if you're a Permanent Resident
You can enroll in Medicare if you have a 
Australia Permanent Resident Visa. You’ll need to give both:
• A current passport or Immi card
• Proof of permanent residency from the Department of Home 
Affairs.
• They need these for each person you want to enroll.
• Documents must be original or certified copies. A certified cop is 
a document an authorized witness has signed as a correct copy.
• You’ll need to complete a Medicare enrolment form and submit it 
with your documents at a service centre.
• Medicare cards are allotted to people registered in Medicare.
Usage of Medicare Card
When to use the Medicare Card
You use your Medicare card when:
• making a Medicare claim for a paid 
or unpaid doctor's account
• visiting a doctor who bulk bills
• receiving treatment as a public 
patient in a public hospital
• filling a Pharmaceutical Benefits 
Scheme (PBS) prescription at a 
pharmacy
Medicare Reimbursement
Medicare usually Pays
• the full schedule fee for general practitioner services
• 85% of the schedule fee for a specialist
• 75% of the schedule fee for in-hospital services
For an example of how this works in practice, a GP might charge 
$50 for a standard consultation. The Medicare rebate for this is 
$36.30, leaving a gap of $13.70 for you to pay.
General Practitioner’s Fees
Medicare Coverage Umbrella
Medicare Coverage and Places Where We Can Use It
We help to cover the costs for part or all of the following services:
• seeing a GP (General Practitioner) or specialist
• tests and scans, like x-rays
• most surgery and procedures performed by doctors
• eye tests by optometrists
It’s best to bring your valid Medicare card or number with you when 
you visit a GP or specialist.
Out of Reach of Medical Medicare
Medicare Doesn’t Cover
They don’t pay for things like:
• ambulance services
• most dental services
• glasses, contact lenses and 
hearing aids
• Cosmetic surgery.
How to use Medicare
Seeing a doctor
When you’re enrolled in Medicare, it can help pay some or all of the 
costs of seeing a doctor. If your doctor chooses to bulk bill, it cover 
the costs and you won’t need to pay at all.
If your doctor doesn’t bulk bill, you’ll need to pay either:
• the full cost
• the difference between what they charge and what we cover.
Medicare Eligibility
When You Live Overseas Again After You Enroll
If you live overseas again for more than 12 months, you’ll no longer 
be in Medicare. You’ll need to enroll again when you back Move to 
Australia.
Check your Eligibility for Australian PR
Avail Medicare Benefits
Claim Medicare Benefits at Your 
Doctor’s Office
The quickest and easiest way to claim 
is at your doctor’s office straight after 
you pay.
To do this you need to both:
• be enrolled in Medicare
• Show your Medicare card
Medicare Claim Settlement
When you pay at the doctor’s office, ask if they can make an 
electronic claim for you. If they can, they’ll do it on the spot.
They will pay your Medicare benefit into either:
• the account for the EFTPOS card you used to pay
• The bank account you’ve registered with us.