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Medicare

Medicare is the scheme that gives Australian residents access to healthcare. Most taxpayers pay a Medicare Levy of 1.5% of their taxable income to help fund it.

Medicare gives you access to:

  • free or subsidised treatment by health professionals such as doctors, specialists, optometrists, dentists and other allied health practitioners (in special circumstances only)
  • free treatment and accommodation as a public (Medicare) patient in a public hospital
  • 75% of the Medicare Schedule fee for services and procedures if you are a private patient in a public or private hospital (not including hospital accommodation and items such as theatre fees and medicines).

Are you a carer or helping someone out?

Carers are everyday people who provide unpaid and ongoing care and support to someone they know who has a disability, mental illness, drug or alcohol dependancy, chronic condition, terminal illness or who is frail.

Support for carers

Find practical information and useful resources for carers on Carer Gateway. You can also learn more about carers' support and services in your state or territory through Carers Australia.

Who's eligible?

You are eligible for Medicare benefits if you:

  • are an Australian or New Zealand citizen
  • are a permanent resident
  • have applied for permanent residency (excludes an application for a parent visa) and meet certain other criteria
  • are covered by a Reciprocal Health Care Agreement with another country.

Medicare cards are issued to people enrolled in Medicare. You can find registration information at the front of the Medicare enrolment form at www.humanservices.gov.au. If you are aged 15 years or older, you can apply for your own Medicare card, while children under 15 can be listed on their parents' card.

When to use the Medicare card

You use your Medicare card when:

  • making a Medicare claim for a paid or unpaid doctor's account
  • visiting a doctor who bulk bills
  • receiving treatment as a public patient in a public hospital
  • filling a Pharmaceutical Benefits Scheme (PBS) prescription at a pharmacy.

The benefits (refunds) you receive from Medicare are based on a schedule of fees set by the Australian Government, although doctors can choose to charge more than the set schedule fee. Medicare usually pays:

  • the full schedule fee for general practitioner services
  • 85% of the schedule fee for other out-of-hospital services
  • 75% of the schedule fee for in-hospital services.

Sources: Australian Taxation Office (Guide to Medicare levy), Department of Human Services (Medicare service changes, Contact us, Medicare website, Medicare Card)

Last reviewed: September 2015

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