What Is Medicare?
Medicare is Australia's universal public health insurance scheme, funded by the federal government. It provides Australian residents and eligible visitors with access to a wide range of medical services either free of charge or at a subsidised cost. The scheme is administered by Services Australia.
Who Is Eligible for Medicare?
You are generally eligible for Medicare if you are:
- An Australian citizen
- A permanent resident of Australia
- A New Zealand citizen living in Australia
- A resident of a country that has a Reciprocal Health Care Agreement (RHCA) with Australia, such as the UK, Italy, or Sweden
- Certain temporary visa holders (check Services Australia for current eligibility)
What Does Medicare Cover?
Medicare covers a broad range of healthcare services. Here's a breakdown of key areas:
GP and Specialist Visits
Medicare subsidises visits to general practitioners (GPs) and medical specialists. If your doctor bulk bills, you pay nothing. If they charge above the Medicare schedule fee, you pay the difference (the "gap").
Hospital Treatment
As a public patient in a public hospital, Medicare covers your accommodation and treatment costs. As a private patient, Medicare covers 75% of the Medicare Benefits Schedule (MBS) fee for in-hospital medical services.
Diagnostic Services
Medicare contributes to the cost of pathology tests, X-rays, CT scans, MRIs, and ultrasounds when ordered by an eligible healthcare provider.
Mental Health Services
Through a Mental Health Treatment Plan from your GP, Medicare subsidises up to 10 individual sessions per calendar year with a registered psychologist or other allied mental health professional.
What Medicare Does NOT Cover
- Dental services (with some limited exceptions)
- Ambulance services (covered by state schemes or private insurance)
- Elective cosmetic surgery
- Glasses and contact lenses
- Most physiotherapy, occupational therapy, and podiatry (unless under a specific care plan)
- Overseas medical costs
Managing Your Medicare Card Online
Through your myGov account linked to Medicare, you can manage many aspects of your Medicare entitlement without visiting a service centre:
- View your Medicare card details — useful if your physical card is lost or expired
- Update personal details — name changes, address updates
- Add or remove dependants — children and other family members
- View claim history — see recent Medicare claims processed on your behalf
- Submit a claim — if your provider didn't bulk bill, you can claim the rebate online
How to Submit a Medicare Claim Online
- Log in to myGov and select Medicare.
- Go to Make a claim.
- Enter the details from your receipt: date of service, provider number, item number, and amount charged.
- Upload a photo or scan of your receipt if required.
- Submit the claim — refunds are typically paid into your nominated bank account within a few business days.
The Medicare Safety Net
The Medicare Safety Net is a threshold system designed to reduce out-of-pocket costs once your total gap payments exceed a set amount within a calendar year. Once you reach the threshold, Medicare increases its rebate for out-of-hospital services for the remainder of the year. You can track your Safety Net progress through your myGov Medicare account.
Replacing a Lost or Stolen Medicare Card
If your card is lost, stolen, or damaged, you can request a replacement through myGov (Medicare > Request a replacement card) or by calling Services Australia. Your Medicare number remains the same, but a new card is issued with an updated reference number.