Reciprocal Health Care Agreements - What They Are and How You Can Benefit


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Australia has an excellent health care system that most citizens around the world envy. Some overseas visitors have access to Medicare through an agreement between the Australian government and theirs.   

What is a Reciprocal Health Care Agreement (RHCA)?

A reciprocal health care agreement is an arrangement between two countries to provide publicly funded, medically necessary care to visitors who are residents of the reciprocal country.  

The agreements cover or subsidise some emergency medical costs, usually urgent treatments that can’t be postponed until the visitor returns home. Each country decides what they will cover or subsidise but often, the patient assumes a co-payment. The treating doctor decides if the condition is medically necessary to proceed or not. 

Which Countries Australia Has a Reciprocal Agreement With

Australia has a reciprocal agreement in place with the following 11 nations -  New Zealand, the United Kingdom, Ireland, Italy, Malta, Finland, Sweden, the Netherlands, Belgium, Norway, and Slovenia.

Overseas Visitors Travelling to Australia

Overseas visitors to Australia from a country that has a reciprocal agreement have coverage for medically necessary treatments in a public hospital. Visitors can’t choose their doctor and won’t have coverage for treatment in a private hospital (only public hospitals). Non-emergency doctor appointments aren’t covered under the agreement. Services like ambulance, dental, and optical don't have coverage by Medicare and therefore, can’t be accessed by overseas visitors.  

Visitors from these countries are covered immediately for necessary health care in Australia because these countries cover Australians in the same way when they visit their country. 

If you’re coming to Australia from a country with a reciprocal agreement, there are a few things you should know. 

Medicare Card 

Visitors to Australia who are covered by the Reciprocal Health Care Agreement are issued a yellow Medicare card. The green Medicare card covers Australian citizens and permanent residents. Blue Medicare cards are issued to those people who have temporary residency and are applying for permanent residency.  

Is Private Health Insurance Necessary While in Australia?

While Medicare is good, it’s not a perfect system. The reciprocal agreement offers immediate care for emergencies. For non-emergency surgery, visitors must join the public health waiting list. Unfortunately, waiting lists can be lengthy given the thousands of Australians who require surgery. Their quality of life is often impacted by the wait periods.

If overseas visitors intend to stay in Australia for a lengthy period, they may want to take up private health insurance. This allows access to non-emergency surgery without having to join the public health wait list. Paying the full amount of the surgery with no subsidies from Medicare is cost-prohibitive for most travellers. Even fairly minor surgery costs thousands of dollars to cover the cost of the operating theatre, hospital accommodation, surgeon, anaesthesia, and nursing staff. 

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FAQs for Overseas Visitors Travelling to Australia

Are visitors with student visas in Australia covered under the agreement?

Some student visitors can access a range of subsidised health care services but students from Norway, Finland, Malta, and the Republic of Irement who visit Australia are not covered under the RHCA.

Will I be able to claim for the same services in Australia as I can back home? 

The RHCA provides visitors with access to the Australian medicare system. This means visitors have the same access to medical treatment as Australian residents. Medicare may not be as generous as the healthcare system in reciprocating countries.

What’s not included in the agreement? 

Medicare doesn’t include dental treatment so if you have an accident and lose a tooth, a visit to the dentist isn’t covered. Ambulance is covered by private health insurance in Australia but not Medicare, so an ambulance trip isn’t covered under RHCA. Medicare only covers public hospital treatment, not treatment as a private patient or in a private hospital. Any services provided out of hospital such as a physiotherapist, chiropractor, or optician aren’t covered and need to be paid in full by visitors. 

How much does surgery cost in Australia if I don’t have health cover?

If you required surgery for a routine operation such as removing your appendix, the cost can be as much as $30,000 as none of it would be subsidised. If you needed intensive care, the cost could quickly rise over $100,000 for the specialist care.  

Will I need private health cover in Australia even with RHCA? 

For visitors who don’t have travel insurance or intend to have an extended stay in Australia, there is overseas visitor health cover (OVHC). Private health insurance covers a portion of overseas visitor’s health care expenses while in Australia. The cover means visitors can claim for the items Medicare doesn’t cover under the RHCA such as:

  • Emergency ambulance

  • Some medications

  • Some out of hospital services such as dental and optical

  • Medical fees 

What about visitors from countries that don’t have an RHCA with Australia?

To avoid a hefty hospital bill, if you were to have an accident or illness while in Australia you will need to take out travel insurance or overseas visitors health cover. Whether you’re here on holiday, to visit relatives, or to work, you need insurance as Australia’s healthcare is expensive for people not covered by Medicare. 

How can I apply for Medicare? 

If you’re visiting Australia on a temporary visa, you can’t gain access to Medicare benefits unless you’re visiting from one of the 11 countries with a reciprocal agreement with Australia. People who have temporary residency and are applying for permanency are given a blue Medicare card.    

What if I’m coming to Australia on a working Visa, can I use the RHCA?

If you’re working in Australia on a visa subclass 188, 400, 403, 407, 408, 417, 462, 482, 485, 489, plus others you may need to have health insurance to satisfy the requirements of your visa. More information is available on the Department of Home Affairs website

Information for Australians Travelling Overseas

If you’re Australian and intend to travel to an overseas country that has a reciprocal healthcare agreement, there are a few things you should know.

How You Can Prove Your Eligibility Overseas

To take advantage of the agreement and access medical care while in another country, you will need to show your Australian (or other valid passport) that identifies you as a permanent Australian resident plus your valid Medicare card. If your Medicare card is due to expire while overseas, arrange a new card before you travel. If you’re travelling to the Netherlands, you will need to complete an eligibility form but all other nations only require proof that you’re Australian. 

What’s not included in the agreement? 

Every country has different inclusions, exclusions, and co-payments expected for patients to fund. You can read about the conditions for each of the reciprocal health care countries by following the links on the Services Australia website.     

Cost of Medications

Some countries cover part of the costs of medications prescribed. There may be conditions that apply or only cover a set amount. Italy, for example, doesn’t cover medicine costs and Norway covers up to a set amount. You can read more about the medicine costs here

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FAQs for Australians Travelling Overseas

Does a reciprocal agreement mean I won’t need travel insurance when I leave Australia?

The Australian Government Smart Traveller website advises that a reciprocal healthcare agreement is not a substitute for travel insurance. You or your family may decide that you should be treated in Australia and you need a medical evacuation, which it’s not covered under the agreement and would mean thousands of dollars out of pocket. 

Does it mean overseas visitors are able to travel here for medical care? 

Australian doctors can only provide emergency treatment that can’t wait for a visitor to return home.   

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So medical treatment in a reciprocal country is free for Australians?

No, most countries will require you to make a co-payment or pay a percentage of the cost of treatment. Only medical treatment deemed urgent is usually available while you’re overseas. If the overseas doctor doesn’t believe treatment is necessary, you will need to travel back to Australia or use travel insurance to cover the cost of being treated overseas.  

How can I find out more about the agreement for the country I’m visiting?

The Australian government Services Australia website has information about what is and isn’t covered and how to gain access to health care in each of the 11 countries.  

If you're travelling to a country that does not have a reciprocal health care agreement with Australia, the best way to achieve peace of mind and stay covered overseas is through travel insurance. Take a look at HIF's travel insurance plans and sort your cover before jetting off.

Tammy George

Please note: Tammy's blog is general advice only. For further information on this topic please consult your healthcare professional.

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