What is Medicare Australia?
Medicare is Australia's publicly-funded universal health scheme, operated by the government authority Medicare Australia. Medicare is intended to provide affordable treatment by doctors and in public hospitals for all citizens and permanent residents.
As soon as you land in Australia I recommend that you apply for a Medicare card, you can find it quite handy just in case you ever need medical assistance, your Medicare card can also be considered as a proof of identity sometimes.
Components of Medicare Australia
Medicare funds (or reimburses) expenses related to services provided by medical practitioners. Eye examinations by optometrists are also covered. Dental treatment is excluded except for certain surgical procedures that can only be performed in hospital by specially trained maxillo-facial surgeons.
Medicare benefits are available on a restricted basis for allied health services (such as physiotherapy or speech therapy) under the Enhanced Primary Care program, however most allied health and alternative medicine services are excluded from Medicare.
Each Medicare procedure has an MBS Fee (Medicare Benefits Schedule fee).
• For in-hospital Medicare treatment
i.e. medical treatment provided to an admitted patient of a hospital (which usually excludes treatment provided in an outpatient or accident/emergency department of a hospital), Medicare pays 75% of the MBS Fee. If the patient has private patient hospital insurance, that must cover them for the remaining 25% of the MBS Fee (subject to rules such as waiting periods). If the doctor charges above the MBS Fee, some or all of the remaining charge may be covered by the private health insurance depending on the fund's gap-cover arrangements.
• For out-of-hospital Medicare treatment
i.e. treatment provided to a person who is not an admitted patient of a hospital, Medicare pays 100% of the MBS fee for general practitioner consultations and 85% of the MBS fee for specialist consultations. A practitioner may choose bulk billing, and charge only the relevant percentage of the MBS fee and thus making the service free to the patient. Doctors are not forced to bulk-bill and have discretion in charging their patients. The law prevents private health insurance funds from providing any coverage for the remainder of the charge after the Medicare benefit has been paid.
Treatment in Australian public hospitals
Treatment in a public hospital as a public patient is fully subsidised by Medicare. Regardless of means, every Australian is entitled to attend a public hospital and receive medical treatment free of charge. However, there may be a considerable waiting list for elective surgery. Treatment and hospital accommodation is free to the patient. This is funded through the Commonwealth-State Health Care Agreements.
For private patients in public or private hospitals, Medicare will cover 75 per cent of the Medicare Schedule fee for medical procedures. Private patients still need private hospital coverage to help with accommodation costs and other hospital charges.
The major issues with this part of Medicare are:
- To medical professionals – the rate at which the scheduled fees are set and how accurately they reflect running costs/support profit margins
- To patients – the availability of a bulk-billing doctor (free doctor), particularly in rural and regional areas.
Life in Australia 
