About the program
The program provides Government funding for approved Australians who need life-saving medical treatment that’s only available overseas. It covers the costs of:
- medical services related to the approved medical treatment (including hospital accommodation where required)
- travel costs including airfares, passport fees and travel insurance
- non-hospital accommodation costs
- travel and accommodation expenses for one carer
Why it is important
This program ensures Australians with a life-threatening condition may be able to access life-saving treatment they need, even if it is not available in Australia. This can save and significantly extend their life.
Eligibility
To be eligible for the program you must:
- live in Australia
- be eligible for Medicare benefits
- have a life-threatening condition
- be seeking a specific treatment that is intended to cure the disease and is not experimental
- have an application signed, supported and submitted by your Australian treating specialist that provides evidence you meet the 4 medical criteria.
Requirements for applications for proton beam therapy
Photon therapy is available in Australia and may be effective for applicants requiring radiotherapy.
Applications for proton beam therapy must be submitted with comparative proton versus photon plans unless the applicant falls into one of the following patient cohorts:
- Cranio-spinal irradiation in patients aged up to (and including) 25 years
- Brain tumours in patients aged up to (and including) 5 years
- Base of skull chordomas and chondrosarcomas, following maximal safe resection, in patients aged up to (and including) 25 years
- Patients with a diagnosed predisposition syndrome (such as Li Fraumeni syndrome) with increased risk of secondary radiation induced malignancy and aged up to (and including) 25 years
If comparative planning is not available from the applicant’s treating centre, a comparative planning service is available from the Australian Bragg Centre for Proton Therapy and Research (ABCPTR). Further information on the process to request a comparative plan from ACBPTR is available at Referring Clinicians - Australian Bragg Centre for Proton Therapy
Medical criteria
- The proposed overseas treatment or an effective alternative treatment are not available in Australia, and won’t be available in time to benefit you.
- The overseas treatment will either significantly extend your life and potentially cure your condition.
- The overseas treatment has a real prospect of being successful.
- The Australian medical profession accepts the overseas treatment as a standard form of treatment for your condition.
As well as considering the medical criteria, our decision-maker must also consider if the planned spending for the overseas treatment aligns with the Commonwealth’s policies, particularly those relating to whether the use of public money is efficient, effective, economical and ethical.
What’s not eligible
The program does not cover travel overseas to:
- get medical advice or a medical assessment
- receive experimental treatments
- take part in overseas clinical trials
- receive treatments for conditions that are not life threatening
- receive an organ transplant if an organ is not available in Australia
- get palliative care that does not aim to cure the disease.
Medical Treatment Overseas Program – Guidelines for applicants
Apply
An Australian specialist medical practitioner can apply to the MTOP on behalf of their patient (the applicant).
The Australian treating specialist applying to the MTOP must:
- Refer the patient to the overseas treating facility (or provide evidence that another Australian specialist referred the patient to the overseas treating facility).
- Complete the relevant sections of the MTOP application form and provide all required documentation as set out in the application form.
- Sign the MTOP application form.
A panel of medical advisers will assess each application to confirm whether the applicant meets the 4 medical criteria, and then a recommendation will be made to the Delegate to the MTOP as to whether the application is approved or not.
Medical Treatment Overseas Program – Application form
Contact
Medical Treatment Overseas Program contact
Please note that the telephone number goes directly to voicemail. Please leave a message and the MTOP administration team will return your call.