Health Insurance and Coverage in Australia
Before leaving for Australia, it is good to find out about how your health system works and what are the basic rules for not having to go through exaggerated payments simply for a cold.
Here, health care is partly public and partly private. The Australian public health system is called Medicare and how our Italian system offers basic health care for all citizens.
It includes hospital treatment, the purchase of loanable medicines and visits to the general practitioner. For other services, on the other hand, a portion of the costs is paid as in Italy.
There are agreements between the Italian and Australian governments called ‘ Reciprocal Health Care Agreements ‘, based on which basic health coverage is provided for any illness or accident that occurs during the stay.
Specifically, these agreements provide for different scenarios depending on the type of visa.
INSURANCE BASED ON THE TYPES OF VISA
- Tourist Visa – Healthcare coverage is included in the tourist visa (up to a maximum of 3 months).
- Working Holiday Visa – Healthcare is guaranteed for the first 6 months. On expiry, a new private insurance must be stipulated – if you do not want to incur any medical expenses – by paying this time from your own pocket. Alternatively, it is necessary to leave the country and then return later. To be able to activate the free health insurance for the first six months you must go directly to the Medicare offices in possession of:
- Italian health card
At the time of signing the cover, a health card is issued which certifies the successful subscription: it will be a document to always carry with you, just like in Italy.
- Student Visa – Student Visa holders are obliged to enter into the ‘OSHC (Overseas Student Health Cover) for the duration of their stay in Australia. If the visa is renewed, the insurance must also be extended. There are different types of OSHC insurance, for example Medibank and AHM. The OSHCs cover the costs of medical, hospital, medication and ambulance services. Taking out OSHC private health insurance in Australia is also necessary for those who have exhausted the six months of free Medicare public assistance. The OSHC must cover the student and any other persons included in his visa for the entire duration of the stay in Australia. OSHC private health insurance coverage is similar to that offered by Medicare. OSHC insurances have agreements with some facilities where direct billing can be exercised, or direct reimbursement of expenses. In non-affiliated facilities, on the other hand, it is necessary to anticipate the cost of care and then exercise the claim (reimbursement of health costs incurred).
Standard health insurance (guaranteed by tourist and working holiday visas and by the OSHC) provides free treatment in public hospitals, government subsidized medicines and (limited) reimbursements for private care.
MEDICAL SERVICES NOT COVERED BY MEDICATION
The medical services not covered by Medicare are:
- Medicines not subsidized by the PBS (Pharmaceutical Benefits Scheme)
- Organized treatments before arriving in Australia
- Accommodation and medical care in a private hospital
- Accommodation and medical care as a private patient in a public hospital
- Ambulance services
- Examinations and dental treatments (except for specific cases introduced for combined health services as part of the Chronic Disease Management (CDM) program)
- Physiotherapy, occupational therapy, speech therapy, ocular therapy, chiropractic services, podiatry or psychology (except for specific cases introduced for joint health services as part of the Chronic Disease Management (CDM) program
- Acupuncture (unless it is part of a doctor’s consultation)
- Glasses and contact lenses
- Hearing aids and other appliances
- The cost of prostheses
- Medical expenses for which you are responsible for someone else (for example, an employer or the government)
- Medical services that are not clinically necessary
- Surgery solely for aesthetic reasons
- Exams for life insurance or pension fund
- Eye therapy
- Stay at nursing homes
However, all these services can be included by entering into extra policies.
It is possible to obtain medical treatment in private medical offices and / or medical centers in the area. Doctors in these practices charge for their services in one of the following ways:
- The doctor bills Medicare directly (‘Bulk bill’)
In this case you will be asked to show your mutual health care card and to sign a Medicare form for bulk billing after seeing the doctor, but you will not need to pay.
Not all doctors apply bulk billing.
- The doctor gives the bill to the patient
Doctors who do not take part in the bulk billing system will ask you to pay a certain amount at the time of consultation.
You can immediately pay the amount provided by the service, or you can present your unpaid bill to Medicare.
In the first case it is possible:
- Ask the reception staff if they can present your Medicare request for you
- Request reimbursement in person at a DHS service center
- Send a claim form, including the original doctor’s bill and receipt to the Department of Human Services, GPO Box 9822. They will then send you a check to cover the portion of Medicare.
- Apply online for self service
- Make the request by phone by calling 132 011
Instead, to present Medicare with an unpaid bill is necessary:
- Bring the invoice together with a completed application form to a DHS service center, or send it to the Department of Human Services, GPO Box 9822, in your city. They will send you a check payable to the doctor.
- Bring the check to the doctor and pay the difference between the Medicare coverage and the total cost of the medical service received.
If you receive essential medical treatment as a public patient in a public hospital, you will not be charged for treatment and / or accommodation.
Simply show your passport or health care card to the reference staff when you arrive at the hospital.
If instead you choose to be treated as a private patient in a public hospital or as a private patient in a private hospital, you will have to pay for both medical care and accommodation.
These charges cannot be claimed by Medicare.
Finally, remember that the insurance is valid only on Australian territory : if you want to be protected in case of a visit to New Zealand or in another state, you need to inquire to make travel insurance.
WHAT TO DO AFTER THE 6 MONTHS OF HEALTH COVERAGE?
There are two possibilities:
- Take out private health insurance (as in the case of Student Visa) so that they can be fully covered even during the remaining months;
- Get out of Australia and return: in this case, just go back to the Medicare office with your passport, which stamps your temporary expatriation from the land of kangaroos. In this way, free health insurance will be renewed for another 6 months.
All clear? Remember that the practices to take out insurance are included in the free Study Search Australia consulting services.
We can help you by taking care of the bureaucracy and getting you a health card from the moment you arrive in Australia, to avoid running any risk.
As regards OSHC insurance, we refer to the Medibank company. Discover all the details on this policy visit this page.
For Medicare insurance specifications instead visit Medicare Australia.