Australia has one of the best public healthcare systems in the world — and as a Nepali living here, understanding how to use it can save you thousands of dollars and a lot of stress. Medicare is the foundation of Australian healthcare, but knowing who is eligible, what it covers, and how to navigate bulk billing, GPs, specialists, and private health insurance makes all the difference. This guide explains everything clearly.
What is Medicare?
Medicare is Australia's universal public health insurance scheme, funded by the government. It covers the cost of most medical services — GP visits, specialist appointments, public hospital treatment, pathology tests, and more. For eligible residents, many services are free or heavily subsidised.
Are you eligible for Medicare?
Not every visa holder is automatically eligible. Here's a quick breakdown:
- →Australian citizens and permanent residents — fully eligible for Medicare from day one.
- →New Zealand citizens living in Australia — eligible for Medicare.
- →Temporary residents on certain visas (skilled worker visas, some partner visas) — eligible if Australia has a Reciprocal Health Care Agreement (RHCA) with your country. Nepal does NOT currently have an RHCA with Australia, so most Nepali temporary visa holders are NOT eligible for Medicare.
- →International students — NOT eligible for Medicare. You must have Overseas Student Health Cover (OSHC) — this is a visa requirement.
- →Working Holiday visa holders — NOT eligible for Medicare unless from a RHCA country.
- →Bridging visa holders — eligibility depends on the specific bridging visa type. Check with Services Australia.
Tip: If you are unsure about your eligibility, visit a Medicare service centre at any Services Australia office with your passport and visa details. They will confirm on the spot.
How to enrol in Medicare
- →Visit a Services Australia (Medicare) service centre in person — bring your passport, visa grant notice, and proof of Australian address.
- →Alternatively, enrol online at my.gov.au if you already have a myGov account linked to your visa details.
- →You will receive a Medicare card in the mail within 2–3 weeks. Keep this card — you need it for GP visits, hospitals, and claiming rebates.
- →Set up a myGov account and link Medicare to it — this lets you view your claims history, update details, and access your Medicare Safety Net online.
What Medicare covers
- →GP (General Practitioner) visits — Medicare covers all or most of the cost. If the GP bulk bills, you pay nothing at all.
- →Specialist appointments — Medicare covers a set rebate (usually 85% of the Schedule Fee). You may pay a gap depending on the specialist.
- →Public hospital treatment — as a public patient, your treatment, surgery, and overnight stays are covered at no cost.
- →Pathology (blood tests, urine tests) — most pathology is bulk billed and costs nothing.
- →Diagnostic imaging (X-rays, ultrasounds, MRIs) — partially covered by Medicare. Some providers bulk bill, others charge a gap.
- →Mental health — the Better Access scheme provides Medicare rebates for up to 10 psychology sessions per year with a GP Mental Health Plan referral.
What Medicare does NOT cover
- →Dental treatment — not covered by Medicare for adults. You pay privately or need private health insurance with extras cover.
- →Optical (glasses and contact lenses) — not covered. Some private health extras cover helps here.
- →Physiotherapy, chiropractic, and allied health — not covered by standard Medicare (some sessions covered under specific care plans).
- →Ambulance — not covered in most states. Queensland and Tasmania have free ambulance for residents. In other states (including WA, VIC, NSW) you need ambulance cover — either through private health insurance or a state ambulance subscription.
- →Cosmetic procedures — not covered unless medically necessary.
- →Overseas medical treatment — not covered.
Important for WA residents: Ambulance call-outs in Western Australia can cost over $1,000 if you are not covered. Get ambulance cover — it costs around $60–$80/year through St John Ambulance WA as a subscription.
What is bulk billing?
Bulk billing is when a doctor or medical service agrees to accept the Medicare rebate as full payment — meaning you pay nothing out of pocket. Not all GPs bulk bill, and bulk billing availability has reduced in recent years. To find a bulk billing GP near you, search 'bulk billing GP [your suburb]' on Google or use the Healthengine or HotDoc apps.
Tip: Even if a GP clinic does not bulk bill in general, they may bulk bill for concession card holders, children under 16, and pensioners. Always ask at reception when booking.
Prescription medicines — the PBS
The Pharmaceutical Benefits Scheme (PBS) is a government program that subsidises the cost of most prescription medicines in Australia. Instead of paying full price (which can be hundreds of dollars), PBS patients pay a capped co-payment — currently around AUD $31 per prescription for standard patients, and around AUD $7.30 for concession card holders.
- →To access PBS pricing, you need a valid Medicare card.
- →Take your prescription to any pharmacy (chemist) and present your Medicare card.
- →Common medications for blood pressure, diabetes, mental health, and infections are all on the PBS.
- →Once you reach the PBS Safety Net threshold in a calendar year (around AUD $1,500 for standard patients), further prescriptions are free or heavily discounted for the rest of the year.
Private health insurance — do you need it?
Private health insurance in Australia comes in two types: Hospital cover and Extras cover. It is not mandatory for Medicare card holders, but there are financial incentives to have it:
- →Hospital cover — lets you be treated as a private patient in hospital, choose your own doctor, and avoid public hospital waiting lists for elective surgery.
- →Extras cover — covers dental, optical, physiotherapy, chiropractic, and other allied health services that Medicare doesn't cover.
- →Medicare Levy Surcharge — if you earn over AUD $93,000/year and don't have private hospital cover, you pay an extra 1–1.5% tax levy. Private insurance is often cheaper than this surcharge.
- →Lifetime Health Cover loading — if you don't take out private hospital cover before you turn 31, you pay a 2% loading on premiums for every year you delay. Take it out early if you plan to stay long-term.
- →Popular affordable insurers: HCF, Medibank, Bupa, nib, and HBF (WA-based, good value for Perth residents).
Mental health — how to access support
Moving countries is hard. Many Nepalis experience loneliness, stress, and anxiety — especially in the first year. Australia has good mental health support and much of it is subsidised:
- →See your GP first — they can create a Mental Health Treatment Plan, which gives you Medicare rebates for up to 10 psychology sessions per year.
- →Beyond Blue (1300 22 4636) — free 24/7 phone and online support for anxiety and depression.
- →Lifeline (13 11 14) — free 24/7 crisis support and suicide prevention.
- →headspace — free or low-cost mental health services for people aged 12–25.
- →Many universities offer free counselling to enrolled students — check your university's wellbeing service.
Remember: Seeking mental health support is normal and common in Australia. There is no stigma in using these services — it is the smart thing to do.
International students — OSHC explained
If you are in Australia on a student visa, you are required to hold Overseas Student Health Cover (OSHC) for the duration of your visa. OSHC is similar to Medicare — it covers GP visits, specialist appointments, hospital treatment, and some prescription medicines. It does not cover dental or optical. Your university may have an OSHC provider it recommends (commonly Medibank, Bupa, or nib). You can also choose your own OSHC provider.
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