Coverage and tax references checked 1 October 2026. 2026–27 MLS rules
Explore Medicare pathways, find care and compare coverage
Health cover in Australia is a mix of public Medicare, private hospital insurance, extras cover and overseas visitor policies. New arrivals often ask one question - "Am I covered?" - but the better question is what happens if you need a GP, an emergency department, a planned surgery, pregnancy care or dental treatment.
Start by checking Medicare eligibility. Permanent residents, many people who have applied for permanent residence, New Zealand citizens living in Australia and visitors from RHCA countries may be able to enrol. If you are not eligible, compare OVHC or OSHC before relying on travel insurance. A cheap policy can still be expensive if it excludes pregnancy, joint replacement, ambulance or the GP visits you expect to use. Keep the policy information statement handy when comparing waiting periods and exclusions.
Use these categories as a starting point. Domestic policies are community rated; permitted discounts, LHC loading and rebates are separate from the base premium. Actual premiums and benefits depend on the policy.
| Cover type | Premium level | Hospital cover | Best suited to |
|---|---|---|---|
| Medicare only | No premium, but Medicare levy may apply through tax. | Public patient care in public hospitals, Medicare rebates for GP/specialist services. | Citizens, PRs and eligible visa holders comfortable using the public system. |
| Basic hospital | Lowest private hospital tier. | Limited hospital categories, often with restrictions. Does not replace Medicare for GP visits. | Check actual categories and restrictions before choosing minimal cover. |
| Bronze | Lower to mid private hospital tier. | More categories than Basic, but major items like heart, joint replacement and pregnancy may be excluded. | Check whether the included categories match the treatment you need. |
| Silver | Mid to higher tier. | Broader hospital categories. Some policies add Plus cover for extras like pregnancy or cataracts. | Check optional categories such as cataracts, joint replacements and pregnancy. |
| Gold | Highest hospital tier. | Must include all clinical categories, including pregnancy and birth-related services. | All mandated categories; excesses, waits and gaps can still apply. |
| OVHC / OSHC | Varies by visa and policy. | Designed for overseas visitors or students. Benefits and exclusions vary widely. | Temporary visa holders without Medicare, especially students, 482 workers and working-holiday makers. |
Sources: Services Australia Medicare enrolment | Services Australia RHCA list | Health.gov.au product tiers | ATO MLS thresholds
Related tools from other pillars
Use an existing guide or coverage tool for the next step
Check residence, visa/application and reciprocal-agreement conditions with Services Australia.
Explore support services and their eligibility, referral and fee arrangements.
Compare clinical categories and prepare a quote checklist. Check actual policy terms and prices.
These are common starting points. Always check the policy statement before buying cover.
A new PR family can usually enrol in Medicare, then decide whether private hospital cover is worth it. If family income for MLS purposes is above $210,000 in 2026-27 and they do not have appropriate hospital cover, MLS can apply. Use Medicare vs Private Health before choosing Basic, Bronze or Silver.
A 482 worker may need OVHC because they are not usually Medicare eligible unless an RHCA or other rule applies. The key upgrade question is not just price - it is hospital excess, waiting periods, pregnancy exclusions and whether GP visits are rebated. Compare policy documents before relying on employer-provided cover.
A working-holiday maker may have country-specific RHCA benefits. Ireland and New Zealand visitor agreements generally do not cover outpatient GP visits. Check prior-residence, documentation and benefit rules; ambulance and repatriation can remain uninsured. Use the Bulk Billing GP Finder.
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