Registering for Medicare

What Does This Page Tell You About?

This page provides an overview of Medicare, as well as information about registering for Medicare within Australia.

Factual Information

What is Medicare?

Medicare provides access to medical and hospital services for all Australian residents and certain categories of visitors to Australia.

What Does Medicare Cover?

Medicare covers:

  • Free or subsidised treatment by health professionals such as doctors, specialists, optometrists – and in specific circumstances – dentists, and other allied health practitioners;
  • Free treatment and accommodation for public Medicare patients in a public hospital; and/or
  • 75% of the Medicare Schedule fee for services and procedures if you are a private patient in a public or private hospital – this does not include hospital accommodation and items such as theatre fees and medicines.

What is the Medicare Benefits Schedule?

The Medicare Benefits Schedule (MBS) lists services that are subsidised by the Australian Government under Medicare.

What is the Medicare Safety Net?

Once you reach a relevant threshold, the Medicare Safety Net provides an additional benefit for eligible services on top of the standard Medicare benefit. This may mean that visits to your health professional or having tests could cost you less for the rest of that calendar year.

You need to register to benefit from the Medicare Safety Net. When registering for Medicare as a family, the staff member processing your details should automatically do this for you (if they don’t tell you, ask).

What is the Pharmaceutical Benefits Scheme?

Many types of medicine cost much more than the price you pay. The Pharmaceutical Benefits Scheme (PBS) and the PBS Safety Net can reduce the cost of medicine. If you have an Australian Government concession card, you will pay even less for your PBS medicines when you show your card.

What about Private Health Insurance?

If you or your family pay for private health insurance, you may be eligible for the Australian Government Private Health Insurance Rebate on your premiums.

What about Reciprocal Health Care Agreements?

Medicare benefits are not available for treatment you receive overseas. However, the Australian Government has signed Reciprocal Health Care Agreements with some countries to cover Australians for the cost of essential medical treatment while they are visiting those countries.

These agreements also provide some health services and subsidised medicines to visitors from these countries (such as the UK) when they are in Australia.

Documents Required When Registering for Medicare

  • Passport;
  • Visa;
  • Completed Medicare Enrolment Application Form (3101): Use this form to enrol for Medicare if you hold a relevant visa, have applied for permanent residency or are a visitor from a reciprocal health care agreement country.
  • Forms can be downloaded or obtained from Centrelink.

If you are pregnant when you move to Australia, or become pregnant later on, your newborn will automatically be enrolled in Medicare if you use the Newborn Child Declaration form as proof of birth.

Ideal Time to Apply

Although you can apply for Medicare as soon as you arrive in Australia, ideally wait until you have:

  1. An Australian telephone number (mobile or landline); and
  2. A long-term rental address.

Application Location

Once you have completed your Medicare Enrolment Application Form, take it to a Centrelink for processing. If there are no queries (from either you or Centrelink), the process will take approximately 15-20 minutes.

Medicare Card

Although your Medicare card will take 3-4 weeks to arrive in the post, you will be given a copy of your Medicare number so you can start claiming immediately.

Take your Medicare card with you when you visit a health professional or have a prescription filled.

As a family, you will be issued with one Medicare card which covers all family members.

Getting Medicare Benefits Paid

Since 01 July 2016, you need to have your bank details registered with Medicare to get your benefit.

When you register you will need:

  • Your Medicare card number; and
  • Bank account details (BSB, account number and account name).

Billing and Claiming Options

  • Billing: Your health professional can choose to bulk bill you for the service you receive or issue you with a patient account.
    • Bulk billing is when your health professional accepts the Medicare benefit as full payment for a service. You cannot be charged additional costs such as a booking or administration fee, or be charged for consumables such as bandages.
    • A patient account is when a health professional charges you directly. You can claim benefits for this cost.
  • Claiming: You can submit claims for anyone listed on your Medicare card. You can also submit a claim for someone who is not listed on your Medicare card if you have paid for the service (get a receipt).

myGov Account

Setting up a myGov account is easy. myGov is a way to access Government online services, linking different services via one account, including:

  • Medicare;
  • Australian Taxation Office (ATO), allows online Tax Returns and Business Activity Statements (BAS);
  • Centrelink;
  • Child Support; and
  • National Disability Insurance Scheme.

Medicare Levy

Medicare gives Australian residents (and certain visa holders) access to health care and is partly funded by taxpayers who pay a Medicare levy of 2.0% of their taxable income.

The Medicare levy and any reductions are calculated from information provided in your tax return.

Medicare Levy Surcharge

The Medicare Levy Surcharge (MLS) is designed to reduce the demand on the public Medicare system.

You will be required to pay the MLS if your income for MLS purposes is above the base income threshold and you or your family do not have an appropriate level of private patient hospital cover. This applies unless you are exempt from paying the Medicare Levy and your dependents are also exempt or have an appropriate level of private cover.

The base income threshold is $90,000 for singles and $180,000 for families. However, you do not have to pay the MLS if your family income exceeds the threshold but your own income for MLS purposes was $21,335 or less.

Private patient hospital cover is provided by registered health insurers for hospital treatment provided in an Australian hospital or day hospital. You must arrange and pay for your cover directly with the insurer.

For singles, an appropriate level of cover must have an excess of $500 or less. Couples or families must have an excess of $1,000 or less.

General cover, commonly known as ‘extras’, is not private patient hospital cover. It covers items such as optical, dental, physiotherapy or chiropractic treatment.

The rate of MLS corresponds with your income for MLS purposes (the surcharge is calculated at the rate of 1% to 1.5% of your income for MLS purposes). If you have to pay the surcharge, it will be included with the Medicare levy and shown as one amount on your notice of assessment called Medicare Levy and Surcharge.

My Observations

  • At Centrelink we found the staff polite, friendly and very helpful.
  • As we haven’t used Medicare yet, we have no other observations.

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