Section 19AB restricted doctors and access to Medicare
Overseas trained doctors and foreign graduates of an accredited medical school can access Medicare benefits if they work in certain locations and meet eligibility requirements under section 19AB of the Health Insurance Act 1973. Find out about these requirements.
Peak period processing timeframes
November 2021 to April 2022 is our peak processing period. During this time the department and Services Australia have longer than usual processing timeframes. You should allow a minimum of 6 weeks for your application to be processed and a Medicare provider number issued.
We process all Medicare provider number, section 19AB, and approved program placement applications in strict order of receipt to ensure procedural fairness to all applicants. We do not provide status updates. Both departments are working hard to process all applications as soon as practicable, and appreciate your patience. See Services Australia's current processing times.
About the location restrictions
To access Medicare benefits when working in Australia, overseas trained doctors and foreign graduates of an accredited medical school must work in areas that most need them. This helps make sure people have access to the health care they need, regardless of where they live.
This means that from the time you get your medical registration in Australia, you must work for at least 10 years in a:
- Distribution Priority Area (DPA) if you're a general practitioner (GP)
- District of Workforce Shortag (DWS) if you're a non-GP specialist.
This requirement, under section 19AB of the Health Insurance Act 1973, is called the ’10-year moratorium’. You can reduce that timeframe through scaling. Read about the 10-year moratorium and scaling.
There is no restriction if you work in a salaried position that doesn’t attract Medicare benefits, like in a public hospital.
DoctorConnect provides detailed information about working as a doctor in Australia.
Who the restrictions apply to
The restrictions that prevent a doctor from receiving a Medicare provider number apply to you if you:
- got your medical degree outside of Australia or New Zealand (overseas trained doctor)
- enrolled in a medical degree in Australia or New Zealand as a temporary resident (foreign graduates of an accredited medical school).
You can get an exemption that allows you to access Medicare benefits before the end of your 10-year moratorium.
The best way to get an indefinite exemption is to work in a DPA or DWS location. Exemptions to work outside of a DPA or DWS locations are limited.
Read about the different types of exemptions available, depending on your circumstances.
Apply for an exemption
Before applying for an exemption, read more about requirements, including who is eligible and what evidence to submit.
For all exemptions except the spousal and discretionary exemptions, you can apply by including your supporting documentation when you submit your Medicare provider number application. Services Australia will then apply to us on your behalf.
We will assess your exemption application within 28 working days of receiving it. We process applications in the order in which we receive them, and do not provide a status report.
Services Australia will let you know whether your application has been successful.
Spousal and discretionary exemptions
For the spousal and discretionary exemptions, we do an initial assessment before you can apply for a Medicare provider number.
- for the spousal exemption, complete and submit our application form
- for the discretionary exemption, send us details of your circumstances, as outlined in our fact sheet.
Processing timeframes in peak periods
December to March is the peak period for Medicare provider number applications. During that period, please allow a minimum of 6 weeks for us to process your exemption application and issue a Medicare provider number.
You must hold a valid Medicare provider number and 19AB exemption before you can provide medical services that attract a Medicare rebate. If you do not have a provider number, you will gather a debt for the services you provide. Under the legislation, we cannot backdate exemptions.
If an exemption application is declined, you have 90 days from the decision date to contact us to request a review.
Include in your email:
- the reasons you think our decision was incorrect
- any new information or documents that might further demonstrate your eligibility.
Please don’t resubmit the same information as your original application, as this is unlikely to result in a different decision.
If we decline your application again and you disagree, you can seek a review by the Administrative Appeals Tribunal.
Becoming a permanent resident
If you become a permanent resident, you must tell Medicare immediately to avoid gathering a debt, as your current exemption may no longer be valid.
With fellowship qualifications or already on a 3GA program
If you already have a fellowship qualification, or are on a 3GA program, when you become a permanent resident, the terms of your existing exemption remain in place.
Without fellowship qualifications and not on a 3GA program
If you don’t have a fellowship qualification when you become a permanent resident, to continue accessing Medicare benefits, you:
- must join a 3GA program under section 19AA
- will need a new exemption under section 19AB – the organisation that manages your 3GA program will assist in organising this for you.
For more information read our overview information sheet about exemptions.