Medicare

Medicare in Australia

Australians make more than 150 million visits to a GP every year. Medicare – our public health insurance system – helps pay for these visits.

If you have a Medicare card, you can access a range of health care services for free or at a lower cost, including:

• medical services by doctors, specialists and other health professionals
• hospital treatment
• prescription medicines.

The Medical Benefits Schedule (MBS) lists the medical services covered by Medicare.

The schedule includes an MBS fee for each service. This is the amount (or benefit) the Australian Government thinks the service should cost. The schedule also includes how much benefit you can claim for each service.

If you spend a lot of money on out-of-hospital medical costs over a year, you may be able to access higher benefits through the Medicare Safety Net.

A Medicare card also gives you access to the Pharmaceutical Benefits Scheme (PBS). This means you only pay part of the cost of many prescription medicines listed on the PBS. The PBS covers the rest of the cost. If you have a concession card, you pay an even lower price.

If you pay a lot for medications in a year, you may be able to get a further discount through the PBS Safety Net.

Medicare also covers diagnostic imaging services such as ultrasound, CT scans, X-rays, MRI scans. Find out more about diagnostic imaging under Medicare.

What we’re doing about Medicare

We advise the Australian Government on Medicare policy and manage things like:

• which health services to include on the MBS
• the benefit amount for each MBS service
• the threshold for the MBS Safety Net.

Our Medical Treatment Overseas Program provides financial help for people who need life-saving medical treatment that’s only available overseas.

We also help health professionals comply with Medicare requirements by providing information, guidelines and training.