Understanding Healthcare in Australia
Australia has excellent public healthcare. The World Health Organization ranks Australia’s healthcare system as the 32nd most efficient in the world. The country boasts world-class hospitals, clinics, research facilities, and state of the art diagnostic and testing facilities. Australia also has an impressive ratio of one physician per every 322 people. However, healthcare in Australia has many challenges thanks to the country’s vast size. As such, patients in rural and remote areas often have limited healthcare options compared to those living in urban areas.
Overview of Australia’s Healthcare System
Public healthcare in Australia is provided through Medicare. Since 1984, this single-payer, universal healthcare program covers all Australian citizens and permanent residents. Additionally, it also includes special programs to cover specific groups, including veterans, Indigenous Australians, and workplace safety programs. The system is designed to cover the cost of medical appointments, public hospitals, and medications. As well, Medicare covers some costs related to physiotherapy, community nursing programs, and basic dental care for children.
Healthcare in Australia is greatly enhanced through Primary Health Networks or PHNs. There are 31 PHNs across the country. They are responsible for supporting community health centers, hospitals, doctors, and nurses. PHNs also coordinate activities between different components of the healthcare system. Additionally, they provided extra service as needed in different regions. Depending on the need, this could include after-hours services, mental health services, health promotion programs, and continuing education and support for GPs.
How Does Australia Pay for Healthcare
The costs of healthcare in Australia are covered through taxation. Residents pay 2% of their income to the Medicare Levy, which funds the public system. As a result, most patients never pay medical fees at their appointments and they can claim reimbursements if they do. Medicare covers the cost of GP visits, hospital visits, and 85% of specialist costs. Additionally, it also offers heavy discounts on prescription drug prices.
People with certain medical conditions, some low-income earners, and those not eligible for Medicare benefits can apply for an exemption from paying the Medicare levy or for a reduction in the overall amount paid.
Understanding Australia’s Pharmaceutical Benefits Scheme
The Pharmaceutical Benefits Scheme or PBS is a crucial component of the Medicare program. It’s designed to make medications cheaper for patients. In some cases, patients save tens of thousands of dollars a year. The PBS program includes over 5,200 brand name, generic, biologic, and biosimilar medications.
Patients enrolled in Medicare only pay a portion of the cost of their PBS medication. The Australian government pays the balance. As well, there are additional savings for low-income residents who have a concession card. Furthermore, the PBS Safety Net program is designed to keep costs down for people with extensive prescription needs. A yearly cap ensures that patients never pay more than a certain amount for their medication.
Pros and Cons of Public Healthcare in Australia
100% of permanent residents in Australia have Medicare and an additional 50% have private insurance.
The government actively tries to encourage anyone who earns above a certain threshold to take out a private health insurance policy. This threshold is $90,000 per individual or $180,000 per family. This policy is intended to take some of the pressure off the public system. However, if these high earners choose not to take out a private insurance policy, they’ll pay the Medicare Levy Surcharge. This is an additional 1% to 1.5% amount of taxation on top of the usual Medicare Levy.
There is an additional incentive for people to sign up for private health insurance. The Lifetime Health Cover policy is designed to entice people to take private policies. Under the LHC, private hospital insurance gets progressively more expensive as people get older. Therefore, if you’re older than 30 when you first take out a private insurance policy, you have to pay an extra cost or “loading” of 2% a year for the first decade of coverage. Thus, if you’re able to sign up for coverage in your 20s, you will save a lot on surcharges over the years. Furthermore, the government subsidizes private health insurance premiums up to 30%, giving patients an extra incentive to sign up.
In Australia, private health insurance isn’t just about facilities that are modern and comfortable and shorter waiting times. The public system doesn’t cover things like glasses, dental costs, and ambulance care while private insurance often does. As a result, there are a lot of advantages to carrying a private policy.
Who is Eligible for Australian Healthcare
Permanent residents and Australian citizens are eligible for public healthcare. There are three common ways of becoming a permanent resident of Australia. They include a family-stream permanent visa, a work-stream permanent visa, and a business or investor-stream permanent visa.
Australia has reciprocal healthcare arrangements with many other countries. They include Belgium, Finland, Italy, Malta, the Netherlands, New Zealand, Norway, Ireland, Slovenia, Sweden, and the United Kingdom. As such, even if citizens of these countries don’t yet have permanent residency, they are eligible for most kinds of basic public healthcare.
Australian Healthcare Options for Expats and Foreigners
Expats who aren’t permanent residents are responsible for their own healthcare costs. As such, people moving to Australia should carry their own private global medical insurance policy to cover their healthcare costs while they await permanent residency. The Australian Medicare is the place to go to check on your eligibility and begin the application process.
Best Insurance for Expats and Foreigners Living in Australia
Cigna Global Insurance Plan
- The flexibility to tailor a plan to suit your individual needs
- Access to Cigna Global’s network of trusted hospitals, clinics, and doctors
- The convenience and confidence of 24/7/365 customer service
Best Insurance for US Citizens Moving to Australia
Xplorer Worldwide Medical Plan
- Premium Benefits, Coverage and Service
- Define your deductible and prescription benefits
- For Foreigners in the US or US Citizens Abroad
Challenges for the Future
Australia’s healthcare system is facing a set of serious challenges. Three of the most serious concerns are the rising costs within the industry, an aging population, and younger people who are dropping private healthcare coverage.
The country’s aging population base, combined with an increase in chronic diseases and higher medical expectations on behalf of patients, has put Australia’s public hospitals and clinics under stress. The private system is facing a similarly difficult situation. Fewer young people are carrying private health insurance policies. As such, revenue has declined for private facilities, raising concerns about the system’s sustainability.
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