Healthcare in Australia
The healthcare system in Australia is exceptional, and it comes as no surprise that the country’s population therefore claims one of the highest life expectancies in the world.
Expats will learn that the governing principle behind healthcare in Australia is that it is a hybrid of both public and private service provision. In a nutshell, it can be regarded as sitting somewhere between the National Health Service (UK) and the fully privatised US system; but unlike the NHS, there is no universal free healthcare for expats.
That means that although most foreigners who come to live and work in Australia on a temporary basis may have access to the best available healthcare in the private and public system, they will have to pay for both. This ‘user-pay’ principle means that expats generally will have to pay for everything – from GP visits to a stay in a public hospital, if they are admitted in an emergency.
The following exceptions apply to citizens of the following ten countries, all of which have Reciprocal Health Care Agreements (RHCA) with Australia: Finland, Italy, Malta, New Zealand, Norway, Republic of Ireland, Sweden, Belgium, The Netherlands and United Kingdom.
Compulsory private health insurance for expats
Expats moving to Australia to live and work on a working visa need to prove to the Australian authorities that they are adequately covered by a minimum level of private health insurance to be granted their visa. For details of the required minimum level of insurance, refer to the Department of Immigration and Citizenship’s (DIAC) website.
Even if an expat is a citizen of a country with a reciprocal health agreement, they are still required to take out health insurance cover in order to qualify for the visa, as they can only enrol in Medicare from within Australia. If someone is on a reciprocal agreement and then enrols in Medicare after they arrive, they can obtain an exemption from DIAC.
It important that one understands the level of access to Australian healthcare services that these reciprocal agreements provide. Generally it is limited to immediate necessary care in the Australian public health system.
Public healthcare in Australia
While the public healthcare system in Australia is quite efficient and is accepted internationally as a world-class operation, expats should realise that there are still occasional queues and waiting lists for non-emergency surgery. What’s more, the standards of rural facilities and urban facilities can differ, and for those living far from a metropolis, it may be necessary to travel some distance to receive the right kind of care for complicated or specialised cases.
For these reasons, and because costs for temporary residents not eligible for the Medicare system are on par with that of private facilities, most expats in Australia without permanent residency opt to use private doctors and hospitals. Public services are only used in the case of emergencies.
That said, if it does become necessary for expats with temporary residence to use the public system, there is no need to worry about the standard of care administered.
Medicare (public health insurance in Australia)
The government supported healthcare system is called Medicare; it is available to all Australian citizens and permanent residents, and is paid for through taxes levied on individual salaries. The Medicare scheme completely covers treatment in public hospitals, and also offers complete or partial coverage of the cost of doctors’ consultations (usually about 85 percent of costs, if not all).
Eligible expats wishing to use Medicare will need to register with their passport, travel documents and permanent visa to have a Medicare card issued to them. This process usually takes between three weeks and a month, and should be done one week after arrival in Australia.
The Medicare information kit, which is available in Braille and 18 other languages, explains the whole system in detail, including benefits and payments.
Though the Medicare scheme doesn’t make it compulsory to visit certain doctors, expats should realise that in order to see a specialist and have the cost of the consultation and procedures covered, it’s necessary to first get a referral from a general practitioner.
When seeing a medical practitioner it is also important to check that they have been issued with a Medicare provider number.
Doctors either bill Medicare directly, or if the patient pays then that individual is able to claim the rebate from Medicare via a claims drop box (there are 239 around the country), by mail or by telephone. The rebate is then paid electronically into the claimant's account.
The government’s Health Insurance Commission monitors fees charged by doctors and issues a government-set fee schedule.
The State also has the Pharmaceutical Benefit Scheme (PBS), which offers subsidies on the cost of prescription medication.
Furthermore, even if someone is eligible for Medicare, the cost of ambulance transport (even if this is for an emergency), dentistry and optometry are not covered.
Therefore, it is highly recommended that expats take out some form of private medical insurance even if it is only the most basic ambulance-only cover.
Private healthcare in Australia
Over half the population in Australia has some form of private health cover, and both locals and expats are actively encouraged (through a carrot and stick approach) to take out such a coverage scheme by the government.
The ‘carrot’ is that the government subsidises private health cover. The ‘stick’ is that higher rate tax payers without private health insurance are penalised through the tax system under the Medicare Levy Surcharge if they do not take out at least Basic Hospital cover for elective surgery.
Private health insurance in Australia is now compulsory for expats, and in many cases can be expensive - in some situations more than AUD 500 per month for comprehensive coverage.
Australia does have a number of private healthcare facilities; however, none of them offer emergency services, so even if choosing to use the private healthcare sector, expats will still have to rely on the public healthcare system during emergencies.
The majority of private healthcare package options specialise in surgery, particularly non-emergency surgeries, such as orthopaedic surgery. As the use of private facilities decreases the demand on public facilities, Medicare does offer certain rebates, of up to 30 percent, to residents who choose to use private facilities.
Reciprocal health agreements
Expats who originate from countries that have reciprocal health agreements with Australia are entitled to:
- Free treatment at a public hospital either as an in-patient or outpatient
- Subsidised medicines
- Medical treatment by doctors at surgeries and community health centres
The Australian government does allow tourists and visitors from Ireland, Italy, Finland, Malta, the Netherlands, New Zealand, Norway, Sweden and the United Kingdom access to Medicare’s health facilities based on a series of reciprocal agreements between their governments and the Australian government. Until a person is granted Permanent Residency they are liable to all medical bills so it may be a good idea to have private insurance as cover for the interim.