Australia has two health insurance regimes: Medicare, and private health insurance.
Medicare is a taxpayer-funded health cover scheme that gives all permanent residents a basic level of health insurance. It provides:
- access to free treatment as a public patient in a public hospital
- a rebate on the medical costs of being a private patient in a public or private hospital (75% of the recommended schedule fee)
- a rebate on fees charged by GPs, specialists and optometrists (85% of the schedule fee)
- subsidised prescription medications purchased from pharmacies.
If a doctor bulk-bills the government, there is no charge to the patient. If the doctor does not bulk-bill, the patient is responsible for the shortfall between what the doctor charges and what Medicare pays (this is often referred to as ‘the gap’).
The content of the Law Handbook is made available as a public service for information purposes only and should not be relied upon as a substitute for legal advice. See Disclaimer for details. For free and confidential legal advice in South Australia call 1300 366 424.