Going to the Doctor in Australia — How the System Actually Works

How to Find a GP (General Practitioner)

In Australia, a GP (General Practitioner) is your primary doctor — the first point of contact for almost all health issues. Unlike some countries where you might go straight to a specialist, in Australia the GP is the gatekeeper to the entire system.

The best ways to find a GP:

• HotDoc — Australia's most popular appointment booking platform. Search by location, filter for bulk billing, and book online. You can see available appointment times instantly.
• HealthEngine — similar to HotDoc, widely used especially in Western Australia
• Health Direct Service Finder — government directory of all health services
• Google Maps — search "GP near me" or "bulk billing doctor near me"
• Ask neighbours or colleagues — personal recommendations are valuable

Bulk Billing vs Private Billing

This is one of the biggest things to understand about Australian healthcare:

Bulk Billing (You Pay $0)

When a doctor bulk bills, they bill Medicare directly and accept the Medicare rebate as full payment. You pay nothing out of pocket. The doctor receives a set fee from Medicare (around $41 for a standard consultation in 2025-26).

Bulk billing is becoming less common for general adults because the Medicare rebate hasn't kept up with costs. However, many clinics still bulk bill:

• Children under 16 — most clinics bulk bill children
• Concession card holders — pensioners, Health Care Card holders
• After-hours clinics — many large after-hours centres bulk bill
• Some suburban/regional clinics — particularly in less affluent areas

Private Billing (You Pay a Gap)

When a doctor privately bills, they charge more than the Medicare rebate. You pay the full fee upfront, then claim the Medicare rebate back. The difference is called the "gap".

Example: The doctor charges $85 for a consultation. Medicare rebates $41. Your out-of-pocket cost (gap) is $44.

Some clinics offer a hybrid model where they bulk bill children and concession card holders but privately bill working-age adults.

What Medicare Covers (And What It Doesn't)

Medicare is Australia's public health insurance scheme. It covers:

Covered by Medicare

• GP visits — 100% of the schedule fee (if bulk billed, you pay nothing)
• Specialist consultations — 85% of the schedule fee (with a GP referral)
• Public hospital treatment — 100% covered as a public patient
• Blood tests and pathology — most are fully covered
• X-rays, ultrasounds, CT scans, MRIs — partially covered (often a gap)
• Eye tests — one per year fully covered
• Some mental health services — with a Mental Health Care Plan

NOT Covered by Medicare

• Dental — the biggest gap in Medicare coverage. See our dental care guide
• Optical — glasses and contact lenses
• Physiotherapy — unless part of a chronic disease plan
• Ambulance — not covered in most states (take out ambulance cover!)
• Private hospital rooms — you need private health insurance
• Cosmetic procedures
• Most alternative therapies — chiropractic, naturopathy, etc.

The Referral System — GP to Specialist

In Australia, you generally cannot see a specialist without a GP referral. This is different from many countries where you can book directly with a specialist.

How it works:

1. You see your GP about a health concern
2. The GP assesses you and decides if specialist input is needed
3. The GP writes a referral letter to a specific specialist or to any specialist in a field
4. You book an appointment with the specialist (often a 2-12 week wait)
5. The specialist sees you, reports back to your GP

Referrals from a GP are valid for 12 months. Referrals from a specialist to another specialist are valid for 3 months. Without a valid referral, you won't receive a Medicare rebate for the specialist visit — meaning you pay the full fee out of pocket.

Emergency Department vs GP vs After-Hours Clinic

Prescriptions and the PBS

When your doctor prescribes medication, you take the prescription to a pharmacy (also called a chemist). Australia has the Pharmaceutical Benefits Scheme (PBS), which subsidises the cost of many common medications.

• PBS-listed medications: Maximum $31.60 per script (general patients) or $7.70 (concession card holders) in 2025-26
• Non-PBS medications: Full price — can be anywhere from $5 to hundreds of dollars
• Safety net: Once you or your family spend $1,637.20 on PBS scripts in a year (general) or $262.40 (concession), further scripts are cheaper or free for the rest of the year

Prescriptions are usually for 1-6 months of medication with optional repeats. Common medications like blood pressure tablets, contraceptives, and antibiotics are almost always on the PBS.

Mental Health Care Plans

Australia has excellent subsidised mental health support through the Better Access to Mental Health Care initiative. Here's how it works:

1. See your GP and explain that you're struggling with your mental health
2. Your GP creates a Mental Health Care Plan (MHCP) — this is a longer appointment (allow 40-60 minutes)
3. The plan gives you access to up to 10 Medicare-subsidised sessions with a psychologist per calendar year
4. After 6 sessions, you review the plan with your GP before the remaining sessions

With a MHCP, the Medicare rebate for a psychologist session is approximately $93. If the psychologist charges $200, your gap is about $107. Some psychologists bulk bill under the scheme, meaning you pay nothing.

Telehealth — Seeing a Doctor from Home

Since 2020, telehealth has become a permanent part of Australian healthcare. You can see a GP or specialist via video call or phone for many types of consultations. Benefits include:

• No travel or waiting room time
• Often easier to get same-day appointments
• Medicare rebates apply the same as in-person visits
• Many clinics bulk bill telehealth consultations
• Ideal for follow-ups, prescription renewals, and minor issues

Telehealth is available through HotDoc, your regular clinic's booking system, and dedicated telehealth services like InstantConsult and 13SICK.

What to Bring to Your First Appointment

When you visit a doctor for the first time in Australia, bring:

1. Medicare card (or your Medicare number from the app)
2. Photo ID (passport or driver's licence)
3. Any previous medical records — especially from overseas (translated to English if possible)
4. List of current medications — names, doses, and how long you've been taking them
5. Private health insurance card (if applicable)
6. Questions you want to ask — write them down so you don't forget

Frequently Asked Questions

What is bulk billing and how does it work?

Bulk billing means the doctor bills Medicare directly and you pay nothing out of pocket. The doctor accepts the Medicare rebate as full payment. Not all doctors bulk bill — it depends on the clinic. Use HotDoc or HealthEngine to find bulk billing clinics, or check our Bulk Billing Finder.

Do I need a referral to see a specialist in Australia?

Yes, for most specialists. To receive a Medicare rebate for a specialist visit, you need a referral from a GP. Without a referral, you can still see a specialist but you'll pay the full fee with no Medicare rebate. GP referrals are valid for 12 months.

Can I go to the emergency department for a non-emergency?

You can, but you shouldn't. Emergency departments prioritise by severity (triage), so non-urgent cases wait 4-8+ hours. For non-emergencies, see a GP or visit an after-hours clinic. If unsure, call Healthdirect on 1800 022 222 for free advice.

What is a Mental Health Care Plan?

A Mental Health Care Plan is created by your GP and gives you access to up to 10 Medicare-subsidised sessions with a psychologist per calendar year. The plan is free to create (part of your GP visit). You'll typically pay a gap of $0-$80 per psychology session depending on the provider.

How do prescriptions work in Australia?

Doctors write prescriptions that you take to any pharmacy. Many medications are subsidised under the PBS, costing a maximum of $31.60 per script ($7.70 with a concession card). Non-PBS medications cost full price. You can compare pharmacy prices using apps like MedAdvisor.

Can I bring medications from overseas?

You can bring up to a 3-month supply of prescription medications for personal use. They must be in their original packaging with a letter from your doctor. Some medications that are legal overseas are controlled substances in Australia — check the TGA website before travelling.

Disclaimer: This article is for general information only and does not constitute medical advice. Always consult a qualified healthcare professional for advice specific to your situation. If you're experiencing a medical emergency, call 000 immediately.