If you have a Medicare Card and are admitted to hospital as a public patient for an emergency or for elective surgery, you are treated for free.
If you are admitted to hospital as a private patient, Medicare pays 75% of the Medicare Benefit Schedule (MBS) fee for treatment, anaesthesia and all diagnostic work.
You must pay the remaining 25% of the cost of treatment, anaesthesia and diagnostic work and any additional fees charged on top of the MBS fee.
You also have to pay 100% of the hospital accommodation fees, additional doctors’ fees and theatre fees.
Many people prefer to be admitted as a private patient for elective surgery because they can avoid lengthy waiting lists and can choose the doctor who will perform the surgery. In most cases, they have private health insurance, which they use to help pay for this.
The cost of using an ambulance varies between states and territories.
In Queensland and Tasmania, it is free for residents of those states.
In other states and territories, you have to pay for an ambulance. If you live in one of these states, you may want to consider taking out Ambulance Cover from a private health insurer.
Medicare does not cover the cost of being transported by ambulance.
If your General Practitioner (GP) bulk bills, Medicare pays for the consultation and you do not have to pay anything for the service.
If your GP does not bulk bill, you have to pay the gap between the Medicare Benefit Schedule (MBS) fee and the amount your GP charges.
If your medical specialist bulk bills, Medicare pays for the consultation and you do not have to pay anything.
If your medical specialist does not bulk bill, Medicare pays 85% of the Medicare Benefit Schedule (MBS) fee. You have to pay the remaining 15% plus any additional amount your specialist charges.
Dentists do not have standard fees, so it is difficult to say how much it costs to visit a dentist.
Medicare does not cover the cost of visiting a dentist, however public dental is available for those holding certain Australian concession cards.
In most cases, you have to pay the full cost of dental treatment. Many people take out Extras Cover to help pay the costs of dental treatments.
The cost of visiting an allied health professional varies widely.
In most cases, Medicare does not pay for the cost of receiving treatment from an allied health professional such as a:
You have to pay the full cost of these treatments. Many people take out Extras Cover to help pay the costs of these treatments.
Medicare does pay the cost of an optometrist giving you an eye test.
Medicare may pay towards the cost of other allied health services such as physiotherapy and psychology in some cases, if the eligibility criteria are met.
The Pharmaceutical Benefits Scheme (PBS) subsidises the cost of medicines if you are an Australian resident and have a Medicare Card.
You may also be able to receive discounted medicines if you are from a country that has a Reciprocal Health Care Agreement with Australia.
If you qualify for the PBS, you will pay a lower price for your medicines at a pharmacy.
If you hold a Concession Card or a Health Care Card, you can receive additional discounts on the cost of many medicines.
However, if a medicine is not listed on the PBS, you have to pay full price for the medicine, unless your health insurance covers it.