Payments & services
- Australian Childhood Immunisation Register
- Australian Government rebate on Private Health Insurance
- Australian Organ Donor Register
- Centrelink Compensation Recovery
- Child Dental Benefits Schedule
- Chronic Disease Management Plan
- Cleft Lip and Cleft Palate Scheme
- Early Release of Superannuation
- External Breast Prostheses Reimbursement Program
- Healthcare Identifiers Service
- Medicare Benefit Tax Statement
- Medicare Bulk Billing
- Medicare Card
- Medicare Chronic Disease Dental Scheme
- Medicare Compensation Recovery Program
- Medicare Safety Net
- National Bowel Cancer Screening Register
- Pharmaceutical Benefits Scheme
- Pharmaceutical Benefits Scheme Safety Net
- Reciprocal Health Care Agreements
- Supporting Leave for Living Organ Donors scheme
We provide payments and services that can help when you, or someone you provide care for, use health care services or buy medicines.
We administer Medicare on behalf of the Department of Health, who is responsible for developing Medicare policy.
Medicare usually covers:
- free or subsidised treatment by health professionals such as doctors, specialists, optometrists and in specific circumstances dentists and other allied health practitioners
- free treatment and accommodation as a public Medicare patient in a public hospital
- 75% of the Medicare Schedule fee for services and procedures if you are a private patient in a public or private hospital. This does not include hospital accommodation and items such as theatre fees and medicines
- some health care services in certain countries
We pay Medicare benefits in accordance with legislation governing Medicare and we have no discretion to pay benefits outside of this legislation.
The Medicare Benefits Schedule (MBS) is a Department of Health publication that lists services that are subsidised by the Australian Government under Medicare. You can use MBS Online to check if a service is listed under Medicare.
Once you reach the relevant threshold, the Medicare Safety Net provides an additional benefit for eligible services, in addition to the standard Medicare benefit. This may mean that visits to your doctor or having tests could cost you less for the rest of the calendar year.
If you or your family pay for private health insurance, you may be eligible for the Australian Government Private Health Insurance Rebate on your premiums.
If you aren’t already enrolled, you can complete a Medicare enrolment application form. When you take the form to a service centre, you need to bring your identification and proof of residency documents.
Billing and claiming options
Your doctor can choose to bulk bill you for the service or issue you with a patient account.
Bulk billing is when your doctor bills us directly for the full payment for their service. You cannot be charged any additional costs such as a booking or administration fee, or a charge for bandages.
A patient account is when your doctor charges you directly. You can claim benefits from us for this cost.
Before you start your claim, check if you are eligible for this payment.
The most convenient way to claim your Medicare benefit is at your doctor’s surgery. If your doctor offers electronic claiming, practice staff will submit your claim with us, either through the practice's EFTPOS terminal using your EFTPOS card, or through a secure internet connection. Your Medicare benefit will usually be paid into your nominated bank account the next working day, sometimes even sooner.
If your doctor does not offer electronic claiming, you can claim your Medicare benefit:
- online using your Medicare online account
- using the Express Plus Medicare app
- at a service centre
- by submitting a Medicare claim form, by mail or in a drop box at a service centre
- by calling us
- at participating private health funds if they use Medicare two way
You can submit claims for anyone listed on your Medicare card. If you’ve registered your bank account details with us, your benefit will usually be paid into your account the next working day.
You need to register your bank account details with us before you take advantage of the range of claiming options available.
You can register your bank account details:
- through Medicare online accounts
- through the Express Plus Medicare app
- by completing a bank account details collection form
- by calling us
- in person at your local service centre
You will need to:
- have your Medicare card and bank account details (BSB, account number and account name) with you when you register
- let us know if your details change in the future
Register for the Medicare Safety Net
If you are an individual, you don’t need to register for the Medicare Safety Net. Couples and families need to register.
Read more about registering for the Medicare Safety Net.
Pharmaceutical Benefits Scheme
If you have an Australian Government concession card, you will pay even less for your PBS medicines when you show your card.
If your doctor has written a non-PBS or private prescription, you will have to pay the full price for this medicine. These medicines don’t count towards the PBS Safety Net. Also, if you choose a higher priced brand of medicine, or your doctor prescribes one, you may pay more.
Reciprocal Health Care Agreements
Medicare benefits are not available for treatment you receive overseas. However, the Australian Government has signed Reciprocal Health Care Agreements with some countries to cover Australians for the cost of essential medical treatment while they are overseas.
These agreements also provide some health services and subsidised medicines to visitors from these countries when they are in Australia.
Agreements have been signed with:
- New Zealand
- the United Kingdom
- the Republic of Ireland
- the Netherlands
Useful Medicare tips
- Register your bank account details for a great range of claiming options
- Register your family for the Medicare Safety Net
- Let us know if you change your address
- Destroy your old Medicare card if you receive a new one
- Take your Medicare card with you when you visit a doctor or have a prescription filled