What kind of health insurance do I need in Australia?
In Plain English
The type of health insurance you need in Australia depends on your residency status and visa, if applicable.
- Australian citizens and permanent residents are generally eligible for Medicare, which is Australia's public health insurance scheme.
- Temporary visa holders may or may not be eligible for Medicare, depending on their visa type and country of origin. Some temporary visa holders are required to have private health insurance as a condition of their visa.
- Overseas visitors who aren't eligible for Medicare usually need to have private health insurance to cover any medical costs they might incur while in Australia.
Some specific visa holders are considered eligible for Medicare due to Ministerial orders under subsection 6(1) of the Health Insurance Act 1973. These include, but are not limited to:
- Holders of a Safe Haven Enterprise Visa (subclass 790) (Health Insurance (Eligible persons and holders of Safe Haven Enterprise visa) Order 2017 and Order under Subsection 6(1) of the Health Insurance Act 1973 - Health Ref No. 794)
- Holders of certain Contributory Parent visas (subclasses 173 and 884) (Health Insurance (Eligible persons and holders of a Contributory Parent visa) Order 2017)
- Holders of Skilled Work visas (subclasses 491 and 494) (Health Insurance (Eligible persons and Holders of Skilled Work Visa (subclass 491 and 494)) Order 2019)
- Ukrainian nationals (and their immediate family) holding Bridging Visa E (subclasses 050 and 051) (Health Insurance (Eligible persons – Ukrainian nationals including their non-Ukrainian immediate family members) who are holders of Bridging Visa E (Subclass 050 and Subclass 051) Order 2022)
- Holders of a Humanitarian Stay (Temporary) Visa (Subclass 449) who meet specific criteria related to the security situation in Afghanistan (Health Insurance (Eligible persons - holders of Humanitarian Stay (Temporary) Visa (Subclass 449)) Order 2021)
- Citizens of Italy for a period of six months after their last entry to Australia, provided they are eligible for services under the national health legislation of Italy (Health Insurance (Eligible persons and citizens of Italy) Order (No.2) 2022)
- De facto partners of Australian citizens or permanent residents who meet certain criteria (Health Insurance (Eligible persons holders of temporary visas and de facto partners of Australian citizens) Order 2017)
Detailed Explanation
The Health Insurance Act 1973 establishes the framework for Medicare, Australia's universal health insurance scheme. Section 6(1) of this Act grants the Minister for Health the power to declare certain individuals or classes of individuals eligible for Medicare, even if they would not otherwise qualify. This power is frequently used to extend Medicare coverage to specific groups of temporary visa holders.
Medicare Eligibility:
Generally, Australian citizens and permanent residents are eligible for Medicare. However, the legislation clarifies the eligibility of certain groups who may not automatically qualify.
Temporary Visa Holders and Medicare:
Several Ministerial orders address the Medicare eligibility of specific temporary visa holders:
- Safe Haven Enterprise Visa (SHEV) holders (subclass 790): The Health Insurance (Eligible persons and holders of Safe Haven Enterprise visa) Order 2017 declares that holders of this visa who reside in Australia are eligible for Medicare. This order was created because the SHEV is a temporary protection visa, and without the order, holders would not be eligible for Medicare.
- Contributory Parent Visa holders (subclasses 173 and 884): The Health Insurance (Eligible persons and holders of a Contributory Parent visa) Order 2017 extends Medicare eligibility to holders of the temporary Contributory Parent visas (subclasses 173 and 884). This is in recognition of the significant financial contribution these visa holders make towards their healthcare costs in Australia.
- Skilled Work Visa holders (subclasses 491 and 494): The Health Insurance (Eligible persons and Holders of Skilled Work Visa (subclass 491 and 494)) Order 2019 makes holders of these visas eligible for Medicare.
- Ukrainian nationals holding Bridging Visa E (subclasses 050 and 051): The Health Insurance (Eligible persons – Ukrainian nationals including their non-Ukrainian immediate family members) who are holders of Bridging Visa E (Subclass 050 and Subclass 051) Order 2022 provides Medicare access to Ukrainian nationals (and their immediate family) holding these visas, granted as part of Australia's response to the situation in Ukraine.
- Humanitarian Stay (Temporary) Visa (Subclass 449) holders: The Health Insurance (Eligible persons - holders of Humanitarian Stay (Temporary) Visa (Subclass 449)) Order 2021 grants Medicare eligibility to holders of this visa who meet specific criteria related to the security situation in Afghanistan.
- Citizens of Italy: The Health Insurance (Eligible persons and citizens of Italy) Order (No.2) 2022 ensures that Italian citizens eligible for services under Italian national health legislation are eligible for Medicare for a period of six months after their arrival in Australia.
- De facto partners of Australian citizens or permanent residents: The Health Insurance (Eligible persons holders of temporary visas and de facto partners of Australian citizens) Order 2017 addresses an issue created by amendments to the definition of "Australian resident" in the Health Insurance Act 1973, restoring Medicare eligibility to de facto partners of Australian citizens or permanent residents who meet certain conditions.
Private Health Insurance:
Even with Medicare, some individuals may choose to purchase private health insurance to cover services not covered by Medicare, such as dental, optical, and some physiotherapy services. Additionally, certain temporary visa holders may be required to have private health insurance as a condition of their visa. Rules 17 and 18 of the Private Health Insurance (Health Insurance Business) Rules 2018 outline specific circumstances where insurance for overseas visitors and students is not considered "health insurance business" under the Act. This relates to the regulatory framework for private health insurers.
Recommendation:
To determine the specific type of health insurance you need, it is essential to consider your individual circumstances, including your residency status, visa type (if applicable), and any specific health needs you may have. You should consult the Department of Health website or contact Medicare directly for the most up-to-date information and guidance.