Medicare

Medicare is Australia’s universal health insurance scheme. It guarantees all Australians (and some overseas visitors) access to a wide range of health and hospital services at low or no cost. Find out what we’re doing to improve Medicare for all Australians.

About Medicare

What Medicare is, how it works, who’s eligible and who manages it.

What's covered

What Medicare does and doesn’t cover, and other support programs. 

Safety nets

Safety nets provide extra support to people with high medical costs.

Compliance

How we protect our health payment system from incorrect billing.

As a health practitioner you must meet certain requirements to bill for Medicare Benefits Schedule (MBS) items under Medicare or prescribe subsidised medicines. Pathology and diagnostic imaging services must also meet accreditation standards to access Medicare.

Information for health practitioners

Health Products Portal

The Health Products Portal helps us work with the medicines and technology sector more efficiently. Industry can make, track, pay for, and manage submissions to list products and services on the Medicare Benefits Schedule (MBS) or Pharmaceutical Benefits Scheme (PBS) Schedule.

Learn more about the portal

Latest news

Latest news

Victorian woman found guilty of defrauding Medicare

A Victorian medical receptionist has been sentenced today to 2 years imprisonment, with a minimum term of 12 months by the Melbourne County Court after pleading guilty to charging more than $181,000 in fraudulent Medicare payments.

Ashgrove pharmacist found guilty for more than $1.9m in Medicare fraud

A pharmacist has been convicted and sentenced to five years imprisonment today, after pleading guilty to fraudulently claiming more than $1.9 million in payments under the Pharmaceutical Benefits Scheme (PBS).

Jail time for Pharmacist and Practice Manager

A Pharmacist and Practice Manager from across Australia were sentenced last week after fraudulently claiming more than $470,000 in payments under the Medicare Benefits Scheme (MBS) and the Pharmaceutical Benefits Scheme (PBS).

Latest resources

Latest resources

Medicare billing in public hospitals – overview

Public patients in a public hospital receive services free of charge. However, patients may elect to be a private patient and claim Medicare benefits instead. To ensure appropriate billing, you need to know when patients can claim Medicare benefits when they attend a public hospital.

Case study – Hospital in the home care

This case study about hospital in the home care will help you improve your Medicare billing practices.

About the Dental Benefits Schedule (DBS) audit process

Fact sheet describing the Dental Benefits Scheme (DBS) audit process.

Medicare quarterly statistics – State and territory (December quarter 2022-23)

This document contains statistics about the use of Medicare by state and territory from September quarter 2009–10 to December quarter 2022-23.