Medicare, OVHC and OSHC: which one applies to you?
Health cover in Australia comes in three flavours that often get confused. Medicare is the public system that covers Australian citizens, permanent residents, and a handful of temporary visa holders from Reciprocal Health Care Agreement countries. Overseas Visitor Health Cover (OVHC) is private insurance that work and family visa holders are required to hold to satisfy their visa conditions. Overseas Student Health Cover (OSHC) is a similar product but specifically for student visa holders, and is mandatory for the duration of every student visa.
Picking the right one is not really a choice for most people: your visa decides for you. But understanding what each one covers (and what it doesn't) is the difference between a $50 GP bill and a $5,000 hospital bill, so it pays to learn the basics before you need them.
What Medicare actually covers
Medicare is the cornerstone of the Australian public health system and covers a surprising amount, but it is not unlimited:
- GP visits are subsidised. Bulk-billing GPs charge you nothing; non-bulk-billing GPs charge a gap (typically $30-$50 in 2025-26)
- Public hospital treatment as a public patient is free, including emergency, surgery, and most inpatient care
- Specialist visits with a GP referral are subsidised, but the gap is often $50-$200 per visit
- Most prescriptions are subsidised under the PBS, capped at $31.60 per script in 2025-26 ($7.70 for concession card holders)
- Diagnostic tests, scans, and pathology ordered by a doctor are usually fully or partly covered
- Mental health care under a GP Mental Health Treatment Plan covers up to 10 subsidised sessions per year
Medicare does not cover most dental care for adults, optometry beyond a basic eye test, physiotherapy, chiropractic, psychology outside the 10-session plan, ambulance transport (except in Queensland and Tasmania, where it's state-funded), or treatment as a private patient in a private hospital.
Reciprocal Health Care Agreement countries
If you hold a temporary visa and your home country has a Reciprocal Health Care Agreement (RHCA) with Australia, you can usually enrol in Medicare for the duration of your visit, even without permanent residency. The countries with current RHCAs (as at 2025-26) are: United Kingdom, Republic of Ireland, Sweden, Netherlands, Belgium, Finland, Italy, Malta, Norway, Slovenia, and New Zealand. The coverage is "medically necessary" care only, not elective treatment, but for most everyday needs it's equivalent to full Medicare access. You enrol at a Services Australia centre with your passport and proof of cover from your home country's health system.
OVHC vs OSHC at a glance
| Feature | OVHC (work/family visas) | OSHC (student visas) |
|---|---|---|
| Who needs it | 482, 485, 491, 494, 188, 870, partner provisional, others | 500 student visa holders |
| Visa requirement | Required to satisfy visa condition 8501 | Mandatory for whole visa duration |
| Typical monthly cost (single) | $90 - $250 | $50 - $80 |
| Pre-existing conditions | Often 12-month wait | Often 12-month wait |
| Pregnancy & birth | Usually 12-month wait | Usually 12-month wait |
| Ambulance | Usually included | Usually included |
| Major providers | Bupa, Medibank, NIB, allianz, IMAN | Bupa, Medibank, NIB, allianz, OSHC Worldcare |
Levels of OVHC cover
OVHC typically comes in three tiers, and the difference matters more than the price suggests:
- Basic / Working visa cover: meets the minimum visa requirement but excludes things like rehabilitation, dental, optical, and many out-of-hospital services. Cheapest option, but most "gaps" come out of pocket.
- Mid-tier / Standard cover: adds physio, dental, optical, and some extras. Better value if you actually use healthcare regularly.
- Comprehensive / Working visa premium: covers nearly everything Medicare covers plus extras like pregnancy and major dental. Usually 2-3x the cost of basic.
Frequently asked questions
I'm on a 482 visa - do I really need OVHC?
Yes. Holding adequate health insurance is a condition of the 482 visa (condition 8501). If you let your cover lapse, the Department of Home Affairs can cancel your visa or refuse a renewal. The minimum legal cover is "Working Visa Insurance" or equivalent, but most people on 482s find the basic tier too restrictive and upgrade to mid-tier.
Can I switch from OVHC to Medicare when I get PR?
Yes. Once your permanent visa is granted, you enrol in Medicare at a Services Australia centre, usually the same day or week. Once Medicare is active, you can drop your OVHC. Some people keep a private health policy alongside Medicare to avoid the Medicare Levy Surcharge if their income is over $97,000.
What's the Medicare Levy Surcharge and how does private cover help me avoid it?
The Medicare Levy Surcharge (MLS) is an extra 1.0%-1.5% income tax for higher-earning Australians who don't hold appropriate private hospital cover. It kicks in at $97,000 single or $194,000 family in 2025-26. A cheap basic hospital policy ($90-$120/month) is usually less than the surcharge would be, which is why so many high earners take out hospital insurance even if they never use it. See our tax calculator for how this interacts with your overall tax.
I'm pregnant - what cover do I need?
Most OVHC and OSHC policies impose a 12-month waiting period for pregnancy and birth, meaning you generally must have held cover for at least 12 months before conception (not before birth). Without cover, public hospital birth as a non-Medicare patient can cost $8,000-$15,000+. Always check your specific policy before falling pregnant, and consider upgrading early if you're planning a family.
Can I claim a Medicare levy exemption if I'm not eligible for Medicare?
Yes, and most people on temporary visas without RHCA coverage qualify. You apply to Services Australia for a Medicare Entitlement Statement, then attach it to your tax return. This refunds the 2% Medicare levy that's withheld from your pay throughout the year.
What if I have a medical emergency without insurance?
Australian public hospitals will treat anyone in a genuine emergency regardless of insurance status, but you'll be billed afterward as a private patient if you're not Medicare-eligible. Bills can easily reach $5,000-$20,000+ for an overnight stay. Most providers will negotiate payment plans, and charity care is available in extreme hardship, but the simplest fix is keeping your OVHC current.
What this comparison doesn't include
- Pharmaceutical Benefits Scheme (PBS) access - generally only available to Medicare-enrolled people
- State and territory health concessions for low-income earners with HCC cards
- Dental and optical extras coverage, which varies enormously between insurers
- Travel insurance, which is separate from OVHC and covers different things
- Workers' compensation for work-related injuries (covered by your employer)
For the official Medicare enrolment process, visit Services Australia. For comparing OVHC/OSHC policies, the federal government's PrivateHealth.gov.au is the only independent source.