Medicare for Australian Citizens Living Overseas

Australia has a universal health care system called Medicare. Medicare provides free or subsidised health care to all Australian citizens and permanent residents. However, who is eligible for Medicare in Australia and who is not eligible for Medicare in Australia remains a grey area for many.

This article aims to help you understand Australia’s Medicare system, how it works and if it is accessible to Australian expats living overseas.

Who is Eligible for Medicare?

In Australia, Medicare is a universal health insurance scheme that provides access to a range of medical services and subsidises the cost of various healthcare treatments. The eligibility for Medicare in Australia is as follows:

Australian Citizens: Australian citizens are generally eligible for Medicare. They need to apply for a Medicare card and provide the required documentation, such as proof of citizenship or residency.
Permanent Residents: Permanent residents of Australia are also eligible for Medicare. They need to apply for a Medicare card and provide proof of their residency status.
New Zealand Citizens: New Zealand citizens who were residing in Australia on or before February 26, 2001, are eligible for Medicare. They need to apply for a Medicare card and provide proof of their eligibility.

What services are covered by Medicare?

In Australia, Medicare provides coverage for a wide range of medical services. Here are some of the services covered by Medicare:

Doctor’s Visits: Medicare covers a portion of the fees for visits to general practitioners (GPs), medical specialists, and some allied health professionals, such as physiotherapists, psychologists, and optometrists.
Hospital Care: Medicare covers a significant portion of the costs for treatment as a public patient in a public hospital. This includes doctor’s fees, accommodation, and some diagnostic tests and medications.
Pharmaceutical Benefits Scheme (PBS): Medicare subsidises the cost of many prescription medications through the PBS. Patients pay a reduced amount for most prescribed medications, with the government covering the remaining cost.
Pathology and Diagnostic Imaging: Medicare provides benefits for a wide range of diagnostic services, including blood tests, X-rays, CT scans, and ultrasounds. The level of coverage depends on the specific service and the provider.
Allied Health Services: Medicare provides coverage for a certain number of visits per calendar year to allied health professionals, such as physiotherapists, psychologists, dietitians, and occupational therapists. A referral from a GP is usually required.
Emergency Care: Medicare covers the cost of emergency treatment in public hospitals.
Maternity Services: Medicare covers a portion of the costs related to antenatal care, childbirth, and postnatal care, including midwifery services and some specialist consultations.

It’s important to note that while Medicare covers many medical services, there may be out-of-pocket expenses, such as gap fees, depending on the specific healthcare provider and the treatment received. Many Australians also choose to have private health insurance to cover additional services or to have access to private hospitals and extra benefits.

For more detailed information on the specific services covered by Medicare in Australia, it is advisable to visit the official website of the Australian Government Department of Health or consult with Medicare representatives directly.

How to Enrol in Medicare

Enrolling in Medicare in Australia is a relatively straightforward process. Here’s a general guide on how to enrol:

Check your eligibility: Ensure that you meet the eligibility criteria for Medicare in Australia. Generally, Australian citizens, permanent residents, and certain New Zealand citizens are eligible. Temporary visa holders may have limited access to Medicare or need to maintain private health insurance.
Gather necessary documents: Before enrolling, gather the required documents, which typically include proof of identity, citizenship or residency status, and any relevant visa details.
Complete the application form: Obtain the Medicare Enrollment Application form (also known as the Medicare Enrollment and Amendment form) from a Medicare Service Centre, or you can download it from the Australian Government Department of Human Services website.
Submit the application form: Fill out the form with accurate information and provide any required supporting documents. You can submit the completed form in person at a Medicare Service Centre or mail it to the address specified on the form.
Receive your Medicare card: Once your application is processed and approved, you will receive a Medicare card in the mail. The card will have your individual Medicare number, which you will need to present when accessing healthcare services.
Activate your Medicare card: It’s important to activate your Medicare card by visiting a Medicare Service Centre or by calling the Medicare general enquiries line. Activating the card ensures that it is linked to your Medicare record.

It’s worth noting that if you are already enrolled in Medicare but need to update your details or make changes, you can use the same Medicare Enrollment and Amendment form.

Tips for Australian Citizens Living Overseas

If you are an Australian citizen living overseas, there are a few things you can do to ensure that you have access to quality health care:

Purchase private health insurance: Secure insurance coverage to help with medical expenses while living abroad.
Research the local healthcare system: Understand the healthcare services, costs, and accessibility in your country of residence.
Register with the Australian embassy/consulate: Stay connected with consular services and receive necessary updates and assistance.
Obtain a valid passport and visa: Ensure you have proper identification and legal status for easier access to healthcare.
Carry copies of medical documents: Keep essential medical records and prescriptions for reference during healthcare visits.
Stay up to date with vaccinations: Follow recommended immunizations to protect against local health risks.
Know local emergency medical services: Familiarise yourself with emergency contact information and procedures.
Seek travel advice and health recommendations: Consult official travel advisories and healthcare professionals for guidance on your destination.

Tax Benefits of Medicare System in Australia

In Australia, Medicare is primarily funded through the Medicare Levy, which is a tax on taxable income. While there are no specific tax benefits associated with Medicare in Australia, the Medicare Levy may affect your tax obligations and provide access to subsidised healthcare services.

Here’s an overview:

Medicare Levy: The Medicare Levy is a tax imposed on most Australian residents to help fund the Medicare system. The current Medicare Levy rate is set at 2% of taxable income, although there may be exemptions or reductions available for low-income earners or individuals who meet certain criteria.
Medicare Levy Surcharge: In addition to the Medicare Levy, higher-income earners who do not have private hospital insurance may be liable for the Medicare Levy Surcharge. The surcharge is an additional tax, ranging from 1% to 1.5% of taxable income, imposed on those who earn above a certain threshold and do not have appropriate private health insurance.

It’s important to note that while the Medicare Levy helps fund the public healthcare system, it is not directly linked to specific tax benefits. Instead, it ensures that Australian residents have access to subsidised healthcare services through Medicare.

For Australian Expats Living Overseas

For Australian expats living overseas, the tax benefits related to Medicare in Australia may vary. Here are some considerations:

Medicare Levy: If you are an Australian expat and you earn income from Australian sources, such as rental income or certain capital gains, you may still be subject to the Medicare Levy. The Medicare Levy is based on taxable income, so if you meet the income threshold, you may need to pay the levy on your Australian-sourced income.
Medicare Levy Exemption: Some Australian expats may be eligible for an exemption from the Medicare Levy if they meet specific criteria. For example, if you are a resident of a country that has a reciprocal healthcare agreement with Australia (such as the United Kingdom, Ireland, New Zealand, or some other countries), you may be exempt from paying the Medicare Levy.
Private Health Insurance: As an Australian expat, you are not required to maintain private health insurance in Australia. However, it’s important to consider your healthcare needs and the healthcare system in your country of residence. Depending on your circumstances, it may be beneficial to obtain international health insurance or local health coverage in your country of residence.
Medicare Benefits: As an Australian expat living overseas, you generally do not have access to Medicare benefits for medical services received outside Australia. However, if you return to Australia temporarily and meet certain eligibility criteria, you may be eligible for Medicare benefits during that period.

Consult a Professional

Medicare is a valuable resource for Australian citizens and permanent residents. However, it is important to remember that Medicare does not cover you when you are living overseas. If you are planning to live overseas, it is important to purchase private health insurance or to research the healthcare system in the country where you will be living.

For personalised advice or assistance with tax matters related to living overseas, speak with our tax experts at Odin Tax who can provide guidance tailored to your specific situation.