Health care and Medicare
How you can get affordable health care and access our services.
Medicare is Australia's universal health care system. We help all Australians access a wide range of health services. Learn more about Medicare and how it works.
You’ll need to enrol in Medicare to access our services. Find out if you’re eligible to enrol. When you enrol, you’ll get a Medicare card.
It’s best to bring your valid Medicare card or number with you when you visit a health professional.
You’ll also have a My Health Record that helps securely store all your health data in one place. Read more on the My Health Record website.
We help to cover the costs for part or all of the following services:
- seeing a GP or specialist
- tests and scans, like x-rays
- most surgery and procedures performed by doctors
- eye tests by optometrists.
Medicare doesn’t cover
We don’t pay for things like:
- ambulance services
- most dental services
- glasses, contact lenses and hearing aids
- cosmetic surgery.
When you’re enrolled in Medicare, we can help pay some or all of the costs of seeing a doctor. If your doctor chooses to bulk bill, we’ll 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.
If you pay the full cost, you can make a claim for the amount we cover. Your doctor can also make a claim on your behalf.
When you make your appointment, you should ask if they bulk bill. If they don’t, you should ask:
- what they charge
- what you may get back from us.
To find a doctor who bulk bills, use the find a health service tool on the healthdirect website.
It’s best to bring your valid Medicare card or number with you when you see your doctor.
If you download the Express Plus Medicare mobile app, you’ll always have a digital copy of your card with you.
You can see a health professional by videoconference or telephone if you can’t go to their office.
This includes appointments with 1 of the following health professionals:
- Allied health professional
- Nurse Practitioner
- Registered Midwife.
Your appointment may be bulk billed. Contact your health professional to check if they’ll bulk bill and organise an appointment.
Read more about telehealth and attendance services on the Department of Health website.
You may need to go to a hospital emergency department if you’re badly hurt or sick. Hospital emergency departments are open 24 hours a day.
You may also need to go when your GP refers you to a specialist and they suggest you go to hospital. When this happens, you usually have to wait to go into hospital. This is a booked admission.
Your costs are covered if you’re a public patient in a public hospital.
You’ll need to take your valid Medicare card or number with you when you go to hospital.
To find a hospital near you, you can use the find a health service tool on the healthdirect website.
You can choose to be a public or private patient when you go to hospital. As a public patient at a public hospital, your costs will be covered. This includes the costs of going to an emergency department.
Private health insurance can help you cover costs as a private patient in hospital. We can cover some of your costs for services and procedures in a hospital. We don’t cover accommodation costs, medicines, and theatre fees if you’re a private patient.
Learn more about private health insurance and Medicare.
We don’t cover the cost of emergency transport or ambulance services to hospital. Ambulance costs are different in each state and territory. Private health insurance can help you with ambulance costs.
Read more about ambulance cover on the PrivateHealth.gov.au website.
We can help if you and your family have high health care costs. There are also things you can do to keep your costs down. Find out how to get help with medical costs.
Medicare Safety Net
If you have a lot of out of hospital costs, the Medicare Safety Net can help keep them under control. If your costs for the year reach a threshold amount, we’ll pay more of your costs. If you’re enrolled in Medicare, you’re automatically registered for the safety net.
You can combine your out of hospital costs with your partner and children to reach the threshold sooner. To combine your out of hospital costs, you need to register as a family.
Medicines and Medicare
The Pharmaceutical Benefits Scheme (PBS) helps you get PBS medicines at a cheaper price. You may get further discounts if you have a concession or health care card.
If you spend a lot on PBS medicines, you can apply to the PBS Safety Net to get them even cheaper. Read about the PBS Safety Net thresholds.
Depending on your needs, we have a range of other programs and schemes to support your health care:
- Medicare services for Indigenous Australians
- Medicare services for conceiving, pregnancy, and birth
- Children’s health care
- Health care and ageing
- Medicare services for rural and remote Australians
- Other Medicare support.
You can keep track of your health information in 1 place with My Health Record. It’s an online summary of your key health information. It brings together information from you, your health care providers, and Medicare.
It records details of your:
- medical conditions
- medical treatments
- test or scan results.
Find out more about My Health Record on their website.
Page last updated: 15 April 2020
This information was printed 22 September 2020 from https://www.servicesaustralia.gov.au/individuals/subjects/whats-covered-medicare/health-care-and-medicare. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/individuals/site-notices when using this material.