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American migrant with Medicare card in Australia

Medicare for Americans in Australia: Who Is Eligible and What It Covers

Medicare for Americans in Australia can be one of the biggest practical differences between moving to Australia and remaining in the United States. But Medicare eligibility depends on your visa and circumstances — simply being an American living in Australia does not automatically give you access.

For eligible migrants, Medicare provides access to Australia’s public healthcare system and subsidises a wide range of medical services.

That can include GP consultations, specialist services, medical tests and public hospital treatment, as well as access to subsidised prescription medicines through the Pharmaceutical Benefits Scheme.

But Medicare does not mean that every doctor visit is free, and it does not cover every type of healthcare.

The first question is therefore:

“Does my Australian immigration status make me eligible to enrol in Medicare?”

Simon Mander — Registered Migration Agent (MARN 0318058) — more than 23 years’ experience in Australian migration law.

American considering moving to Australia?Find out which visa pathways are realistically available to you and what your visa means for your move to Australia.

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What is Medicare?

Medicare is Australia’s universal public health insurance scheme.

It helps pay for a wide range of medical and hospital services for eligible people living in Australia.

Depending on the service, Medicare may cover all of the cost or subsidise part of the cost.

Medicare can help with:

For an American accustomed to a private-insurance-led healthcare system, this can be a significant change.

Can Americans enrol in Medicare?

Yes, some Americans can — but eligibility is based on immigration status rather than nationality.

Broadly, Medicare enrolment can be available to people living in Australia who are:

The United States does not have a Reciprocal Health Care Agreement with Australia, so an American visitor does not obtain Medicare simply because they are a US citizen.

Permanent visa holders

An American who holds an Australian permanent resident visa and lives in Australia can generally enrol in Medicare.

This can include people granted permanent visas through pathways such as:

Holding permanent residence does not automatically mean your Medicare card arrives without action. You still need to enrol and provide the required identification and visa evidence.

Can you get Medicare while a permanent visa application is being processed?

Sometimes.

A person living in Australia who has applied for permanent residence may be able to enrol in Medicare before the permanent visa is decided.

However, conditions apply.

For many permanent-residence applicants, Medicare eligibility requires that you also have either:

Different rules apply to some visa categories, particularly Parent visas.

This means applicants should check their actual Medicare eligibility rather than assuming that every permanent visa application automatically creates immediate Medicare access.

What about Americans who have applied for an 804 Aged Parent visa?

Americans who lodge an onshore subclass 804 Aged Parent visa do not become eligible for Medicare simply because they have applied for permanent residence.

Parent visa applicants are specifically excluded from the general rule that can allow some people who have applied for Australian permanent residence to enrol in Medicare while their application is being processed.

For a subclass 804 Aged Parent visa applicant, Medicare may be available while the visa is being assessed if the applicant is from a country that has a Reciprocal Health Care Agreement with Australia and they satisfy the conditions of that agreement.

The United States does not have a Reciprocal Health Care Agreement with Australia.

This means an American who has lodged an 804 visa onshore will generally not gain Medicare eligibility merely because the 804 application is pending or because they subsequently hold a bridging visa.

They should therefore plan for appropriate private health insurance and healthcare costs while the 804 application remains undecided, unless some separate basis for Medicare eligibility applies.

Can Americans on a 491 visa access Medicare?

Yes.

The subclass 491 Skilled Work Regional visa is a provisional visa rather than permanent residence, but subclass 491 holders are specifically included in a Ministerial Order that makes them eligible for Medicare while they are in Australia.

This is an important practical feature of the 491.

An eligible 491 holder can therefore enrol in Medicare even though the visa itself is provisional.

For Americans comparing the 491 with other temporary visa pathways, this can make a significant practical difference.

What about the subclass 494 visa?

The subclass 494 Skilled Employer Sponsored Regional visa is also covered by the same Medicare Ministerial Order.

Eligible subclass 494 holders in Australia can therefore enrol in Medicare.

This distinguishes the 494 from some other temporary employer-sponsored visas.

Can Americans on a subclass 482 Skills in Demand visa get Medicare?

Generally, not simply because they hold the 482.

The subclass 482 Skills in Demand visa is a temporary employer-sponsored visa.

The United States does not have a Reciprocal Health Care Agreement with Australia, and the 482 is not one of the temporary visas listed in the current Ministerial Order for Medicare eligibility.

Americans on a 482 therefore generally need appropriate private health insurance and should not assume they will have Medicare access.

Health insurance is also relevant to the visa requirements themselves.

Can Americans on student visas use Medicare?

US citizens studying in Australia generally do not become Medicare-eligible merely because they hold a student visa.

International students are generally required to maintain Overseas Student Health Cover — commonly called OSHC — for the relevant period.

The position may differ for citizens of countries covered by a Reciprocal Health Care Agreement, but the United States is not one of those countries.

Can American visitors use Medicare?

Generally no.

An American visiting Australia does not have Medicare access merely by holding a US passport.

Because there is no US-Australia Reciprocal Health Care Agreement, Americans visiting Australia should arrange appropriate travel or health insurance for their stay.

Does Medicare mean GP appointments are free?

Not necessarily.

This is an important misconception.

Medicare sets a schedule fee for eligible medical services.

For GP services, Medicare generally provides a benefit based on the Medicare Benefits Schedule fee.

If the GP bulk bills, the doctor accepts the Medicare benefit as full payment and you pay nothing for that consultation.

If the doctor does not bulk bill and charges more than the Medicare benefit, you pay the difference.

So Medicare dramatically reduces healthcare costs for many people, but it does not mean every GP appointment is automatically free.

What about specialist appointments?

Medicare can subsidise eligible specialist consultations.

However, specialists may charge more than the Medicare Benefits Schedule fee.

You may therefore receive a Medicare rebate but still have an out-of-pocket cost.

The amount depends on what the specialist charges and the relevant Medicare benefit.

Public hospital treatment

One of Medicare’s most important benefits is access to public hospital treatment.

If you are treated as a public patient in a public hospital and are Medicare-eligible, your eligible public hospital treatment is covered.

This can be a major difference for Americans accustomed to the possibility of substantial hospital bills.

However, as a public patient you generally do not choose your doctor and may face waiting periods for non-urgent elective treatment.

Private hospital treatment

Medicare does not make private hospital treatment free.

If you choose to be treated as a private patient, Medicare may pay part of the relevant medical fees, while private health insurance may contribute to other costs depending on the policy.

Out-of-pocket costs can still arise.

What does Medicare not cover?

Medicare does not cover everything.

Services commonly outside normal Medicare coverage include:

There are exceptions and separate government programs in some circumstances, but Medicare should not be thought of as covering every healthcare expense.

Does Medicare cover dental treatment?

Generally, routine adult dental treatment is not covered by Medicare.

There are limited programs and circumstances where certain dental services may receive government support, particularly for eligible children or through state and territory public dental systems.

Many Australians therefore either pay dental costs themselves or purchase private health insurance with extras cover.

What about ambulance costs?

Medicare does not generally cover ambulance services.

Ambulance arrangements vary between Australian states and territories.

Depending on where you live, ambulance may be funded through state arrangements, separately insured or covered through private health insurance.

An American settling in Australia should check the rules in the state or territory where they live.

The Pharmaceutical Benefits Scheme

Medicare enrolment can also provide access to the Pharmaceutical Benefits Scheme — PBS.

The PBS subsidises many prescription medicines.

For medicines listed on the PBS, the Australian Government pays part of the cost and the patient generally pays up to the applicable co-payment.

For Americans accustomed to US prescription medication pricing, this can be one of the most noticeable differences in the Australian healthcare system.

However, not every medication available in the United States is necessarily listed on the PBS, and Australian prescribing arrangements can differ.

Do you still need private health insurance if you have Medicare?

Possibly.

Many Australians choose to hold private health insurance in addition to Medicare.

Private insurance can provide cover for areas such as:

Whether private insurance is worthwhile depends on your health needs, income, age, location and personal preferences.

What is the Medicare levy?

The Medicare levy is part of Australia’s tax system and helps fund Medicare.

Many Australian taxpayers pay a Medicare levy calculated as part of their annual income tax assessment.

The rate and exemptions depend on individual circumstances.

Medicare enrolment and liability for the Medicare levy are related concepts, but they are not exactly the same thing.

Tax advice should be obtained where your position is uncertain.

What is the Medicare Levy Surcharge?

The Medicare Levy Surcharge is a separate additional tax that can apply to some higher-income taxpayers who do not hold an appropriate level of private patient hospital cover.

The applicable income thresholds and surcharge rates can change over time.

This is one reason higher-income Medicare-eligible migrants sometimes choose to take out private hospital insurance even though they already have Medicare.

Why Medicare can matter when comparing visa pathways

Healthcare access is not usually the primary legal criterion for choosing an Australian visa.

But it can have a significant practical impact.

For example, an American comparing:

may face very different healthcare arrangements after arrival.

That does not mean Medicare should dictate your visa choice.

It means healthcare should form part of the overall practical assessment of a migration pathway.

How different is Australian healthcare from the US?

For many Americans, the biggest difference is that Medicare creates a public healthcare baseline.

You can still face:

But eligible residents have access to subsidised medical treatment and public hospital care through a system that is fundamentally structured differently from the US model.

For many Americans, that becomes one of the most noticeable practical changes after migration.

How do you enrol in Medicare?

If you are eligible, you need to enrol.

Depending on your circumstances, enrolment can usually be completed through myGov or by submitting a Medicare enrolment form with the required supporting documents.

You may need evidence including:

Services Australia determines Medicare enrolment eligibility.

How Simon Mander Consulting can help

My role is Australian migration advice rather than healthcare or insurance advice.

But healthcare access is an important practical consequence of the visa pathway you choose.

When assessing an American client’s migration options, I consider the visa strategy as a whole, including pathways such as:

The objective is to establish which pathway is legally available and realistically achievable.

American considering a move to Australia?Find out which migration pathways are realistically available before planning the practical details of your move.

Book a Paid Consultation |
Submit an Eligibility Assessment

Related guides for Americans

Frequently asked questions

Can Americans access Medicare in Australia?

Yes, if they meet Medicare eligibility requirements. Australian permanent residents can generally enrol, some permanent-residence applicants can enrol subject to conditions, and certain temporary visa holders — including subclass 491 and 494 holders — are covered by Ministerial Orders.

Can Americans on a 491 visa get Medicare?

Yes. Subclass 491 holders are specifically covered by a Ministerial Order that makes them eligible for Medicare while they are in Australia.

Can Americans on a 494 visa get Medicare?

Yes. Subclass 494 holders are also specifically covered by the Medicare Ministerial Order.

Can Americans on a 482 visa get Medicare?

Generally not simply because they hold a subclass 482 Skills in Demand visa. The United States does not have a Reciprocal Health Care Agreement with Australia, so Americans on a 482 generally need appropriate private health insurance.

Does Medicare make every doctor visit free?

No. If a doctor bulk bills, Medicare is accepted as full payment for the eligible service and the patient pays nothing. If the provider charges more than the Medicare benefit, the patient may have an out-of-pocket cost.

Does Medicare cover hospital treatment?

Eligible treatment as a public patient in a public hospital is covered. Different rules and possible out-of-pocket costs apply if you choose to be treated as a private patient.

Does Medicare cover dental treatment?

Most routine adult dental treatment is not covered by Medicare. Some limited programs and other public dental arrangements may apply depending on circumstances.

Does Medicare cover ambulance services?

Generally no. Ambulance arrangements differ between Australian states and territories, so separate ambulance cover may be needed.

Do I need private health insurance if I have Medicare?

Not necessarily, but many people choose private cover for private hospital treatment, dental, optical and other extras. Higher-income taxpayers may also need to consider the Medicare Levy Surcharge.