Who can get Reciprocal Health Care ?

Australia’s Medicare system is a publicly funded universal health care system. It provides essential medical treatment to Australian Citizens and permanent residents. They are entitled to subsidised treatment from medical practitioners, eligible midwives, nurse practitioners and allied health professionals who have been issued a Medicare provider number, and can also obtain free treatment in public hospitals.

If you come to Australia on certain temporary visas (including on a student visa), you will be required to have private health insurance to cover you for the duration of your stay, unless you are covered under a Reciprocal Health Care Agreement (RHCA).

The Australian Government has signed Reciprocal Health Care Agreements with a number of countries. These agreements entitle you to some subsidised health services for essential medical treatment while visiting Australia. The extent and timing of the cover differs, depending on where you are from.

Reciprocal Health Care Agreements for Student visa holders work slightly differently to the arrangements described below, so please read our other blog on Students and Reciprocal Health Care.

Period of Reciprocal Health Care Cover

You are covered for the length of your stay in Australia, as long as you have a current and valid visa and you’re a resident of:

  • Republic of Ireland
  • Finland
  • New Zealand
  • Norway
  • Sweden, or
  • United Kingdom

If you are a citizen of one of the following countries, then you need your European Health Insurance card and a current and valid eligible visa to enrol in Medicare. You’re eligible until the expiry date shown on the card, or your visa expiry date, whichever is earlier:

  • Belgium
  • Netherlands, or
  • Slovenia

If you’re a resident or citizen of one of the following countries and you have a current and valid visa, you are covered by Medicare for a period of 6 months from the date of your arrival in Australia:

  • Italy, or
  • Malta

NOTE: If you applied for or received a Subclass Visa 410, or Retiree Visa, before 1 December 1998, you may access Medicare under the RHCA of your home country. If you applied for Subclass Visa 410 after 1 December 1998, you are not eligible for Medicare and are not covered under the RHCA.

What you are covered for under a RHCA

Reciprocal Health Care Agreements cover essential medical treatment. This means any ill health or injury, which occurs while you’re in Australia and requires treatment before you return home.

Residents of the UK, Sweden, the Netherlands, Finland, Belgium, Norway, Slovenia, Malta or Italy while in Australia are entitled to:

  • free treatment as a public in-patient or out-patient in a public hospital
  • subsidised medicine under the Pharmaceutical Benefits Scheme (PBS), and
  • Medicare benefits for out of hospital treatment provided by a doctor

Residents of the Republic of Ireland and New Zealand have more limited coverage. They are only entitled to services as a public patient in a public hospital. This includes medically necessary medicines available on prescription, which are subsidised under the PBS at the general rate, for outpatients.

Treatment outside a hospital

If you are covered for treatment outside a hospital, you can get medical treatment in private doctors’ practices and community health centres. Doctors in these practices charge for their services in one of the following ways:

  1. The doctor bills Medicare directly – This is known as “Bulk Billing” You’ll be asked to show your reciprocal health care card and sign a completed Medicare bulk bill form after seeing the doctor but you won’t need to pay. It is a good idea to ask the doctor before you receive treatment if they bulk bill as not all doctors do.
  2. The doctor gives you a bill – Doctors who don’t bulk bill will ask you to pay a fee. You may be able to claim part of this fee back from Medicare. Details of how to do this are given on the Department of Human Services

Treatment in a hospital

If you are covered by an RHCA for essential medical treatment in a public hospital, then you are known as a “public patient”. You need to show your passport or reciprocal health care card to staff when you arrive at the hospital and you won’t be charged for any treatment or accommodation.

NOTE: If you choose to be treated as a private patient in a public or private hospital, you will be charged for both medical treatment and accommodation. These fees can’t be claimed from Medicare. You can choose to be a private patient if you wish to pay privately, or if you have private health insurance and/or if you choose to have treatment which is not regarded as “essential” under Medicare.

Examples of medical services NOT covered by Medicare are:

  • medicine not subsidised under the PBS
  • treatment arranged before your visit to Australia
  • ambulance services
  • dental examinations and treatment – except specified items introduced for allied health services as part of the Chronic Disease Management (CDM) program
  • physiotherapy, occupational therapy, speech therapy, eye therapy, chiropractic services, podiatry or psychology – except specified items introduced for allied health services as part of the CDM program
  • acupuncture, unless part of a doctor’s consultation
  • glasses and contact lenses
  • hearing aids and other appliances
  • the cost of prostheses
  • medical costs for which someone else is responsible, for example a compensation insurer, an employer, a government or government authority
  • medical services which are not clinically necessary
  • surgery solely for cosmetic reasons
  • examinations for life insurance, superannuation or membership of a friendly society
  • home nursing
  • repatriation to your home country if you are seriously ill or die (this can cost between $20,000 and $30,000)

You can take out private health insurance to cover many of these services and we strongly recommend that you do so, even if you are covered by an RHCA. There are many providers of private health insurance, including BUPA and MediBank.

Contact Us now to find out more.

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