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Healthcare Costs and Insurance

Australia's health system gives residents access to quality healthcare, at an affordable cost. The system consists of Government-funded public health cover and private health insurance. Victoria strives to achieve the best health and well-being for all.

Public health cover

Australia has two national programs to reduce medical costs - Medicare, and the Pharmaceutical Benefits Scheme.

Medicare

Medicare is Australia's healthcare system. Through Medicare, eligible Australian residents receive free treatment in a public hospital as well as reduced costs for out-of-hospital care.

Eligibility for Medicare

If you live in Australia you can access the Medicare system if you:

  • hold Australian or New Zealand citizenship
  • have been issued with a permanent visa.

If you are in Australia on a temporary visa, you are not eligible for Medicare, unless you are from a country that has a 'Reciprocal Health Care Agreement' with Australia. These countries are:

  • Finland
  • Ireland
  • Italy
  • Malta
  • Netherlands
  • New Zealand
  • Norway
  • Sweden
  • United Kingdom.

Services partly or fully funded by Medicare include:

  • consultation fees for doctors, including specialists
  • tests and examinations by doctors needed to treat illnesses, including X-rays and pathology tests
  • eye tests performed by optometrists
  • most surgical and other therapeutic procedures performed by doctors
  • some surgical procedures performed by approved dentists.

For more information and enrolment details contact Medicare.

Pharmaceutical Benefits Scheme

The Pharmaceutical Benefits Scheme (PBS) ensures that prescription medicine is provided at affordable prices.

If you are eligible for Medicare and have enrolled, you are eligible for the PBS and the pharmacist will automatically reduce the cost of your medicine.

For more information, visit the Medicare website.

Private health insurance

There are three types of private health insurance in Australia:

  • hospital cover
  • treatment cover (also known as extras cover)
  • ambulance cover.

Most private health insurers offer single polices and combined policies.

Private health insurance in Australia is optional, but many people choose it to have further health coverage and options in addition to Medicare.

It is important to note that some private health insurance will not cover the full cost of the services you receive.

Private hospital cover

Private hospital cover means that you can choose your doctor, surgeon and hospital. Access to private hospitals can reduce the waiting time for elective surgery.

Treatment and extras cover

Private extras cover could include:

  • dental treatment
  • chiropractic treatment
  • home nursing
  • podiatry
  • physiotherapy, occupational, speech and eye therapy
  • glasses and contact lenses
  • prostheses.

For temporary residents and migrants

Migrants on temporary work visas (such as subclass 457 and subclass 485) must provide evidence of adequate health insurance for the duration of their stay in Australia. For more information on the requirements, see the Department of Immigration and Border Protection website.

If your current health fund is a member of the International Federation of Health Plans (IFHP), you may be able to transfer to an Australian fund, without penalty, and with a similar level of cover. To check if your health fund is a member, visit the IFHP website

Choosing private health insurance

Choose from the many private health funds and different insurance policies available. Membership and prices vary between funds and policies.

For more information about private health insurance policy, visit PrivateHealth.gov.au.

Lifetime Health Cover

If you are moving to Australia permanently you need to be aware that the Australian Government has recently introduced Lifetime Health Cover. Lifetime health cover only applies to registered Australian funds.

Under this new health cover, the cost of private health insurance goes up for every year you are uninsured after you turn 31 years old. People who decide not to purchase private health will pay a higher premium of two percent per year for every year that they haven't joined since they turned 30.

However, if you are a new migrant, this rule does not apply to you, as long as you get private health insurance within one year of arriving in Australia, or by the month of July following your 31st birthday (whichever comes first).

Ambulance cover

Ambulance costs for one trip can range from A$900 to more than A$5500, if an air ambulance is necessary. To avoid this, you can become a member of Ambulance Victoria - which will cover all ambulance service costs throughout Australia. Membership is A$40.30 for single cover and A$80.60 for family cover for one year.*

If you have private health insurance it may cover part or all ambulance costs. Private health funds set their own rules and may only provide restricted ambulance cover such as one emergency transport per year or only cover costs up to a certain dollar amount. Please check your policy for coverage details.

*Current at 1 July 2013. Prices are subject to change.

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