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Expatriate health insurance in Australia

Destination Australia
>The key to your visa
>Health coverage for your "non-resident" years
>Reimbursements set in accordance with expensive medical care
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A costly health care system for non-residents

The Australian health care system is excellent, but they have chosen to charge exorbitant health care prices to non-residents. If you aren’t covered by the local Medicare system, you’ll have to take out an appropriate international insurance. If you have a temporary visa, there are less expensive solutions for urgent care of all kinds.

Summary
Trait

Key figures for health insurance
in Australia

Key figures for health insurance in Australia
Health care expenditure per capita €4370
Indexation annuelle des dépenses de santé 3,2%
CFE hospitalization reimbursement rate 42%
Number of insurance companies providing services 15
Cost of hospital coverage for people 30 years old/year €792
Cost of hospital coverage for people 50 years old/year €1260
Trait

The Australian health care system

An efficient system if you have good private insurance

In Australia, there is really nothing to fear in terms of health care. The quality of care, both in the public and private sector, is excellent. As long as you don't venture into certain rural areas, you can be sure that the health conditions in medical facilities will be more than adequate.

But beware. Australia may provide a warm welcome to potential expats, but it does so on a give-and-take basis: you have to prove that you’re there to contribute something to the country. This is reflected in the health care system: During your first two years there, you will not be entitled to any local social protections (Medicare), especially not if you are French.

That means that you’ll need to take out private health insurance to be covered, unless your country of origin (like Belgium or Italy) has signed a reciprocal agreement with Australia.

If you are a student and have a student visa, you are required to take out OSHC insurance (Australia Overseas Student Health cover). Since it provides only limited coverage, it’s important to have supplementary insurance as well, to limit your out-of-pocket expenses and to have the option of repatriation assistance and civil liability coverage in case of major problems.

If you have received a WHP (Working Holiday Program) visa, you already know that health insurance is mandatory for the validation of your file. There are many options are available. Our advisors can help you find the best one for you.

Health conditions and precautions to take

There are no specific health risks in Australia. For those coming from Europe, there are practically no required vaccinations. Nonetheless, it is always a good idea to be careful of what you eat and the various changes in climate (rain, temperature, etc.). The risk of infection is similar to that in Western Europe. You can drink the water, and diseases transmitted by water and food are no more frequent than in Western Europe.

However, if you have recently traveled to an area infected with yellow fever, you should be vaccinated before entering Australia. It’s also advisable to get or update certain vaccinations, based on your age and health. In particular: tetanus (DTP), viral hepatitis B, hepatitis A and measles, which has been on the rise in recent years.

The sun also presents a significant risk, and one that we don’t always think about. Australia is very close to the hole in the ozone layer, so the ultraviolet rays are strong. Remember to protect your skin, even in winter, by using sunscreen, hats and t-shirts (UV).

Given the high cost of health care in Australia, we recommend having check-ups before you go, especially for dental and vision care.

Price of local care

Medical services in Australia are relatively expensive. In the private sector they can be almost as expensive as those in the USA. Several insurers have ranked Australia as somewhere between the 5th and 15th most expensive country in the world.

It is always difficult to identify the average price of a consultation in different establishments, but on average, for a 10-15 minute consultation at a general practice facility, you will pay between €30 and €50. A consultation with a specialist will cost you much more, of course: the first visit is between €90 and €120, and follow-up visits cost an average of €60.

Even if you have taken out the local health insurance (Medicare), you will still pay out-of-pocket for medication, which is expensive. You should expect medication to cost at least €10. That’s one of the reasons why so many Australians (nearly 30%) aren’t happy with Medicare.

Expenses related to dental care, medical prostheses, and vision care are just a few of the costs not covered by Medicare. Since filling a cavity costs between €60 and €180, and a crown costs between €680 and €1,250, vision/dental coverage can be very helpful.

As for maternity, a pregnancy can cost between €5,500 and €20,000, depending on your place of residence, whether the hospital is approved by your insurer or not, and the rates charged by the various practitioners. The average copay is estimated at €4,300. Be sure to request an estimate before choosing your physician/obstetrician (between €50 and €90 per consultation). An ultrasound costs about €120, and lab work costs between €20 and €120, depending on the tests to be performed.

Quality of care in the public and private sectors

Australia has a very good reputation in terms of health care.

There are many hospitals, and an abundance of highly qualified personnel. The equipment is also high quality and up to date.

Both in the public and private sectors: In a public hospital, a clinic or a private practice, the quality of care is always very good, even excellent. This excellence has a direct impact on the price of care.

We recommend taking out an insurance plan that offers robust coverage to avoid excessive out-of-pocket expenses.

Our advisors can recommend the most suitable plans for the country’s high health care costs based on your budget.

How to choose a physician

It can be difficult to find a French physician in Australia. French physicians who want to practice in Australia must undergo rigorous exams to evaluate their skills. But nobody goes to Australia to find a French physician...

On the other hand, the French embassy, consular services and expatriate assistance department have many Australian physicians that they are happy to recommend. Some of them even speak French.

You should know that, before going to a specialist, you’ll need to get a referral from a GP (general practitioner). The GP can provide the specialist with a referral letter. This is necessary in order for your treatment to be covered.

Some specialized exams can also be performed by a GP, namely routine pediatric or gynecological checkups.

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Social security in Australia

Social security coverage in your home country

Australia has signed social security agreements with the following countries: Belgium,
Finland, Italy, Malta, the Netherlands, New Zealand, Norway, the Republic of Ireland, Slovenia, Sweden and the United Kingdom. However, these agreements only concern temporary stays and coverage for emergencies. Repatriation is not covered, and Australia specifies that these agreements do not replace subscribing to an appropriate insurance. With or without a bilateral agreement, moving to Australia without health insurance can be very costly.

11 countries have entered into this type of agreement with Australia. They are: Belgium, the United Kingdom, Finland, Ireland, Italy, Malta, New Zealand, Norway, the Netherlands, Slovenia and Switzerland. If you have lived in one of these countries, it may be worthwhile to ask your social security office about the content of these agreements.

However, the coverage provided will only include essential medical care, and will not be as good as the medical coverage provided to permanent residents.

The Caisse des Français de l'Etranger (CFE): not only for the French

CFE coverage is available to all EU citizens, not just the French. It will cover your expenses incurred in Australia, but it will only provide partial reimbursement. For example, for a consultation with a physician, the CFE reimburses a lump sum of €17.50, based on the French social security reimbursement.

The same principle applies for all treatments, including hospitalizations. CFE reimbursement is based on the reimbursement percentages for zone 3 (CFE). If you are hospitalized, the CFE will cover 42% of the bill. Pharmacy bills are covered at 55%, and blood tests at 30%. As you can see, that won’t be enough to ensure that you are properly taken care of in an emergency, not in a country whose health care prices are among the highest in the world.

CFE contributions are calculated according to your age (and whether you are the only insured party, or at least one other person will be covered), and also provide coverage for members in France. The Caisse des Français à l'Etranger is mainly intended for temporary residents who do not have access to Medicare (2 years of residence).

We recommend subscribing to supplementary insurance as well, to ensure adequate coverage for the high cost of Australian health care expenses.

For those with WHVs (Working Holiday Program visas), the CFE isn’t necessarily the best solution. There are many specialized private insurances that are much more affordable.

Local social security

Australia has its own social security system that covers: sickness-maternity-disability (MEDICARE), old age/survivors, unemployment, workplace injuries and work-related illness, long-term care and family benefits.

Only citizens and permanent residents are eligible. In Australia, a permanent resident is someone who has lived in the country for at least two consecutive years. To enroll and receive your card, go to a Medicare center or call 132 011.

Health services, along with disability, old age and survivors' benefits, are provided regardless of employment status, with no contributions to pay (as long as you are a citizen or permanent resident). Illness are fully or partially covered, according to a list of standard expenses: Schedule fees.

If you are admitted to a public hospital as a “public patient,” your medical expenses will be fully covered. If a physician charges more than the rate shown on the Medicare fee list, Medicare will only reimburse 85% of the fee; you will be responsible for the rest.
If the physician charges Medicare rates, you will be “bulk-billed”: Simply swipe your Medicare card and sign the form, and you won’t have to pay a thing. Minors are always bulk-billed. A consultation at the standard rate is currently 36.30 AUD (€22.35).

In the private sector, health care isn’t reimbursed very well considering the prices charged. If you are admitted as a private patient in a public or private hospital, Medicare will only cover 75% of the costs. That’s why, to avoid having to pay the remaining 25% of the bill, supplementary insurance is recommended.

In general, dental expenses, alternative medicine and medications are not reimbursed by Medicare (except under special conditions). That’s why both residents and expatriates often take out private health insurance.

Calculating the Medicare levy

The contributions that fund Medicare are deducted directly from your taxable income by your employer, at a rate of 2% (2019). This tax is known as the “Medicare Levy.” If you make at least 28,501 AUD per year (€17,550), it is deducted automatically.

If you have a spouse and/or dependent child, and you earn between 28,501 AUD and 48,092 AUD per year (€17,550 to €29,612), you may be eligible for a family discount.

If you are a temporary resident AND an employee, the Medicare levy will be deducted from your salary automatically, even though you are not eligible for Medicare! You can be exempted, however, as long as you report it on your tax return. At the end of each tax year, you will receive a refund for the amounts withheld from your salary throughout the year.

For additional information, visit the Australian Taxation Office (ATO) website. You can also find out more about the Medicare levy on the Etax website.

Trait

Expatriate and traditional health insurance in Australia

Why should you subscribe?

As an expat, during the first 2 years of your stay you will not be covered by the social security system in your country of origin, and will not be eligible for Australian Medicare. Taking out expatriate health insurance is essential, both to ensure that your health expenses are covered and to comply with local health insurance requirements. Australia plays by the rules, and you will be sent home if you do not comply.

If you subscribe to an international insurance policy, your coverage will apply worldwide, both in Australia and on a getaway to New Zealand, for example.

If necessary, your insurance will assist with repatriation, which can help you avoid complications in case of serious illness. It will also provide assistance with any legal or medical procedures.

Even after living in Australia for 2 years, many expats hold onto their health insurance for easy access to private sector care.

What kind of coverage should you choose?

If you are on a tight budget, find an insurance that just covers hospitalization, which is the absolute minimum. Choose a plan with an annual coverage limit of at least 500,000 EUR.

If you can spend a little more on your health care, choose a plan that covers other health care expenses in addition to hospitalization. This can be particularly useful for pharmacy services and exams.
Lastly, if you have specific needs in terms of vision/dental care (other than annual cleanings), a more comprehensive plan may be worthwhile, considering the local rates.

For more information, compare global health care insurance offers online.

Australia is often classified as an expensive country, so don't hesitate to use a deductible to lower your premium. Our consultants can help you.

Do I have to pay up front?

Do you have Medicare (local health insurance)? You will have to pay the price difference out of pocket if your physician is not affiliated with Medicare. At practices that advertise “direct billing" or "bulk billing," you won’t have to pay anything if you bring your Medicare card.

With expatriate health insurance: If you are hospitalized for over 24 hours, your insurer will see to it that the hospital/clinic is paid directly. Regular medical and vision/dental expenses must be paid up front.

Claims can be filed easily online (no need to send anything by mail). All insurance companies provide online customer support via their websites, and sometimes apps, to manage your reimbursements.

In general, invoices for €1,000 or less can be submitted digitally. Invoices for over €1,000 (which are rare) still have to be sent by mail.

When and how should you subscribe?

Apply around 30 days before your departure, since the procedure for taking out expatriate coverage is more complicated than for traditional insurance.

Use our website to compare coverage and get price quotes online.
Then one of our advisors can help you through the whole subscription process.

Repatriation assistance

Given the high quality of care in Australia, you shouldn’t need to be repatriated for health reasons. However, assistance can be provided within the country or abroad in case of accident or illness during a trip. (Australia is big and sparsely populated!)

It also provides services that can be qualified as “for your comfort" but are very welcome in case of a serious event: paying for a relative’s trip so they can come to your bedside, organizing child care or transportation, access to medical advice and guidance, etc.

Additional insurance
for expatriates

Civil liability and legal protection

In a country where civil lawsuits for damages are a lucrative business, civil liability insurance and legal protection are a must.

It covers all material and immaterial damage that an expat or a member of their family may cause to a third party.

Disability insurance

In case of a medical leave of absence or disability, neither the local social security nor your home country’s social security will provide income continuation.

Subscribing to a private insurance, or to one of the CFE options, is essential in order to be covered.

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