Accessing Medicare benefits
The conditions that allow doctors to access Medicare benefits under section 19AA of the Health Insurance Act 1973 depend on:
- their residency status
- whether they are vocationally recognised (that is, hold fellowship qualifications from a recognised Australian specialist college).
Section 19AA applies to every doctor who registered to practise medicine in Australia on or after 1 November 1996. No exemption is available for any reason.
Permanent residents or citizens
If you are a permanent resident or citizen of Australia, you must have a fellowship with:
- the Royal Australian College of General Practitioners
- the Australian College of Rural and Remote Medicine
- an Australian specialist college.
If you don’t, you must be on an approved training program and working towards attaining fellowship.
If you are an overseas trained doctor or foreign graduate of an accredited medical school, you will be subject to a 10-year moratorium. This means that for 10 years, you can access Medicare benefits only if you work in certain locations and meet eligibility requirements under section 19AB of the Health Insurance Act 1973.
If you are an overseas trained doctor or foreign graduate of an accredited medical school who is a temporary resident of Australia, you must satisfy section 19AB. This applies whether you are vocationally recognised or not.
Gaining permanent residency before vocational recognition
Your Medicare access will cease if you become a permanent resident before you gain vocational recognition and are not taking part in an approved program.
Let Services Australia know of any change in your residency as soon as it occurs to avoid accruing a debt.
To regain Medicare access, you will need to join an approved program at an eligible location.
Workforce and training programs for those without fellowship
From January 2022, if you are a general practitioner and wish to sit your fellowship examination, you must be participating on a college-led training program. These programs are:
- Australian College of Rural and Remote Medicine Independent Pathway
- Australian General Practice Training Program
- Remote Vocational Training Scheme
- Royal Australian College of General Practitioners Practice Experience Program:
- Royal Australian College of General Practitioners Fellowship Support Program
- Australian College of Rural and Remote Medicine Rural Generalist Training Scheme
If you are training in a specialty other than general practice, you should speak to your college about approved fellowship pathways.
If you do not have fellowship, you can access Medicare benefits only if you are on an approved training or workforce program at an eligible location. These programs are available for a defined period, and you will not be able to sit your fellowship exams while you remain on these programs:
The following programs are closed to new applicants. Current participants on these programs can access Medicare benefits for the remainder of their placement, but will be unable to sit their fellowship exams while they remain on these programs:
- Rural Locum Relief Program
- Special Approved Placements Program
- Temporary Residents Other Medical Practitioners Program.
Why gaining fellowship is important
Having a fellowship ensures:
- you qualify for full Medicare benefits access
- Australians have access to highly qualified medical practitioners.
December to March is our peak processing period for Medicare provider number applications. During this time, allow a minimum of 6 weeks for your application to be processed and a Medicare provider number issued.