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What is Medicare?

2-minute read

Medicare is the scheme that gives Australian residents access to healthcare. Most taxpayers pay a Medicare Levy of 2% 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).
Medicare card showing family names under a single Medicare number
Medicare card showing family names and individual reference numbers, under a single Medicare number

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 dependency, 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 an Australian permanent resident
  • have applied for permanent residency (some conditions apply)
  • are covered by a Ministerial Order
  • have a Resident Return visa
  • 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 the Department of Human Services. 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. Babies born in Australia are automatically enrolled in Medicare.

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 a specialist
  • 75% of the schedule fee for in-hospital services

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: January 2018

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