Medicare services

Our payments and services can help you, or someone you care for, use health care services or buy prescription medicines.

About Medicare

We administer Medicare and pay Medicare benefits on behalf of the Department of Health. They develop Medicare policy.

Medicare gives you access to:

  • a range of medical services for free or at a lower cost including:
    • doctors
    • specialists
    • optometrists, and
    • at times, dentists and other allied health professionals
  • lower cost prescriptions, and
  • free care as a public patient in a public hospital

You can also get a 75% rebate of the Medicare Schedule fee for services and procedures you have as a private patient. This can be in a public or private hospital. This doesn’t include hospital accommodation and items such as theatre fees and medicines.

You can access Medicare services if you’re enrolled in Medicare. When you enrol in Medicare, you’ll get your own Medicare card. Read more about enrolling and getting your own Medicare card.

Payments and services

The Medicare Benefits Schedule (MBS) lists the services you may get at a lower cost. See if your service is on the MBS list on the Department of Health MBS Online website.

Medicare Safety Net

The Medicare Safety Net provides a higher Medicare benefit for out of hospital costs. When you reach the Medicare Safety Net threshold, you may get higher Medicare benefits for out of hospital medical costs.

Pharmaceutical Benefits Scheme

Many types of medicines cost much more than the price you pay. The Pharmaceutical Benefits Scheme (PBS) and the PBS Safety Net can reduce the cost of medicine. If we’ve issued you with a concession card, you’ll pay even less for your PBS medicines when you show your card.

Private health insurance

You may be eligible for the Australian Government rebate on Private Health Insurance as a reduced premium.

The rebate reduces the amount you pay for Private Health Insurance. The rebate amount you get depends on the age of the oldest person covered by the policy and their annual earnings.

To receive the rebate:

  • the policy must cover you
  • all people covered by the policy must be eligible for a Medicare card, and
  • you must earn income within the thresholds

Reciprocal Health Care Agreements

You can’t get Medicare benefits for medical treatment overseas. However, you can get help with medically necessary care in countries we have  Reciprocal Health Care Agreements with.

These agreements let visitors between the two countries get help with health care costs.

Medicare Two-way

Medicare Two-way can make submitting health claims easier if you have private health insurance.

Register your bank account details

We pay your Medicare benefit directly into a bank account. You must register your bank account details with us so we can pay you.

How to register

To register your bank account details:

You’ll need your:

  • Medicare card, and
  • bank account details, including your BSB, account number and account name

Billing and claiming

Billing

Your health professional can choose how they bill you for the medical service you get.

Bulk billing

They may choose to bulk bill you for the service you get. This means they accept the Medicare benefit as full payment and you don’t have to pay anything.

They can’t charge you:

  • extra costs such as a booking or administration fee, or
  • for consumables such as bandages

Patient account

They may choose to issue you with a patient account. If they do, you need to pay them for the service you get. You can claim a Medicare benefit from us for this cost.

Claiming

You can claim a Medicare benefit for a medical service for anyone listed on your Medicare card that:

  • you’ve paid for, or
  • your health professional has charged you for

You can also make a claim, if you pay for a medical service for someone not listed on your Medicare card.

Read more about Medicare claiming options.

Page last updated: 27 August 2017