What's covered by Medicare

How Medicare works

All Australians can enrol in Medicare. Find out how to enrol on the Services Australia website.

When you enrol in Medicare, some or all of the costs of your necessary health care are paid for by Medicare.

The Medicare Benefits Schedule (MBS) lists the services Medicare will pay for. The Department of Health manages the MBS.

Read more about what's covered on the Services Australia website.

If your doctor bulk bills, Medicare will pay the cost directly to them. This means you won’t have to pay anything.

Medicare can also help make some medicines more affordable through the Pharmaceutical Benefits Scheme (PBS).

Read more about Medicare on the Services Australia website.

Medications

If you're eligible for Medicare, you won't pay for any medications you have while you're in hospital.

You might have to pay for medication you get when you're discharged or as an outpatient. These are usually the same price as the Pharmaceutical Benefits Scheme co-payment for each item.

If you’re not eligible for Medicare, you'll be charged the full price for all medications dispensed through the pharmacy. Health insurance may help to cover some of these costs.

Specialist fees

Fees can vary. They'll depend on whether you see a specialist in a bulk billing public hospital or at a private clinic or hospital.

The fee structure of different specialists may also vary.

When you're thinking about the costs, ask if the specialist:

  • works in the public or private healthcare system
  • bulk bills using the Medical Benefits Scheme (MBS)
  • requires gap payments
  • has a payment plan
  • accepts your private health cover.

Ask your doctor and specialist how much it will cost upfront and if there are going to be any more costs.

Last updated: March 2022