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Health Insurance for Overseas Visitors
Medicare and Overseas Visitors
Medicare is the Australian National Health Scheme which provides eligible Australians and specific visitors with free or low cost medical treatment. This scheme works in conjunction with the Pharmaceutical Benefits Scheme that provides subsidisied medication.
Eligibility to Medicare by overseas visitors is dependent on the person’s county of origin, their Visa and in some cases their last country of residence.
Australia's Medicare system has three parts:
If you elect to be treated as a patient in a public hospital by a doctor appointed by the hospital, Medicare will pay for the total cost of the treatment with no charge to you. You cannot choose your doctor and treatment may not be available immediately for non-emergency conditions.
In a public hospital you will be treated at no charge by a hospital appointed doctor. If you elect to be treated as a private patient Medicare will cover you for 75% of the Medicare Schedule fee (MBS) Fee for services provided by your medical practitioner whilst you are being treated as a private patient in a public hospital. In this instance you may have to pay a “Gap” payment being the difference between the MBS scheduled fee and the fee charged by your medical practitioner
Out of hospital
Medicare will reimburse 85% of the MBS fee for your treatment. If your doctor bulk bills Medicare, you will not have to pay any “gap” or additional costs.
The MBS fee is the schedule fee for a particular service set by the Australian Government and the percent you received is based on this set fee, not the fee charged by your Doctor.
Under the Australian Governments Pharmaceutical Benefits Scheme (PBS) you pay only part of the cost for prescription medicines purchased at pharmacies provided the medication is on the PBS medication schedule. The balance of the cost is covered by the Australian Government.
The Government reviews the scheme on an annual basis to determine the proportion to be paid by the public. From 1 January 2011, the maximum payment was $34.20 for PBS medicines or $5.60 if you have a concession card.
Access to Medicare
Medicare eligibility is generally restricted to people living permanently in Australia who are:
• Australian citizens excluding Norfolk Islanders;
• permanent residents who have obtained a permanent visa;
• New Zealand citizens; or
• Persons with applications for permanent residency under consideration (excluding applicants for parent visas) or other types of visas.
• Visitors from countries with whom Australia has Reciprocal Health Care Agreements