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 and
- whether they hold specialist registration under the Health Practitioner Regulation National Law Act 2009 or
- whether they are enrolled in an approved 3GA training program and actively working towards attaining specialist registration or
- whether they are enrolled in an approved workforce training program to gain general practice experience.
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 hold specialist registration with:
- the Medical Board of Australia.
This is to satisfy section 19AA of the Health Insurance Act 1973 before you can provide Medicare rebateable services to private patients.
If you don’t hold specialist registration, you must be on an approved training program under section 3GA of the Health Insurance Act 1973 and working towards attaining specialist registration.
If you are an International Medical Graduate, 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.
Temporary residents
If you are an International Medical Graduate who is a temporary resident of Australia, you are subject to section 19AB indefinitely. This applies whether you hold specialist registration or not.
As a temporary resident you are not required to satisfy section 19AA of the Health Insurance Act 1973. However, registration as a specialist, satisfies section 19AA and you are eligible to access higher Medicare rebates for your specialty.
Gaining permanent residency before specialist registration
If you become a permanent resident before you gain specialist registration and are not taking part in an approved program under section 3GA of the Health Insurance Act 1973.
- You will no longer be eligible to provide Medicare rebateable services to private patients
You must let Services Australia know of any change in your residency status as soon as it occurs to avoid accruing a Medicare debt.
If you become an Australian permanent resident or citizen:
- you must hold specialist registration recognised by Services Australia before you can provide Medicare rebateable services to private patients.
If you do not hold specialist registration:
- You must join an approved 3GA training program at an eligible location or you will lose access to Medicare benefits.
Specialist International Medical Graduates – Expedited Specialist Pathway
A new expedited pathway to specialist registration for eligible internationally qualified medical specialists commenced in October 2024.
The new Expedited Specialist pathway will allow eligible international medical specialists from similar health systems to see Australian patients sooner. If you gain registration with the Australian Health Practitioner Regulation Agency (Ahpra) under this pathway, you satisfy section 19AA of the Health Insurance Act 1973.
The Medical Board of Australia is responsible for all matters relating to the regulation of the medical profession in Australia. This includes determining the suitability of International Medical Graduates for registration. The Medical Board of Australia is supported in its role by Ahpra.
Australian Health Practitioner Regulation Agency (Ahpra)
Workforce and training programs for those without specialist registration
To provide Medicare rebateable services to private patients as a general practitioner, you must be participating on a college-led training program under section 3GA of the Health Insurance Act 1973 or hold specialist registration. The 3GA training programs are:
- Australian College of Rural and Remote Medicine - Independent Pathway.
- Australian College of Rural and Remote Medicine - Rural Generalist Training Scheme.
- Australian General Practice Training Program.
- Remote Vocational Training Scheme.
- Royal Australian College of General Practitioners - Practice Experience Program Specialist Stream
- Royal Australian College of General Practitioners - Fellowship Support Program
- The workforce training programs are:
- Approved Medical Deputising Services Program.
A workforce training program enabling doctors without specialist registration to access Medicare benefits for providing after-hours services on behalf of other doctors. This helps doctors get general practice experience, before joining a 3GA training program while ensuring people can access health care after hours. - Pre-Fellowship Program.
The Pre-Fellowship Program helps doctors without specialist registration gain valuable general practice experience in Distribution Priority Areas before they join a 3GA training program.
If you are training in a specialty other than general practice, you should speak with your college about specialist registration.
Why gaining specialist registration is important
Having specialist registration ensures:
- you and your patients qualify for full Medicare benefits access
- Australians have access to highly qualified medical practitioners.
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