Medicare - Eligibility - Your Health 011-44000000

To be eligible for Medicare customers must be living in Australia and be any of the following:

• An Australian or New Zealand citizen
• An Australian permanent resident
• Applying for permanent residency (some conditions apply)
• A temporary resident covered by a ministerial order
• A citizen or permanent resident of Norfolk Island, Cocos (Keeling) Islands, Christmas Island or Lord Howe Island

Customers may also be eligible for Medicare if they are visiting from a Reciprocal Health Care Agreement country.

To establish whether the customer is eligible for Medicare, see Medicare eligibility for enrolments.

Medicare is Australia’s universal health care system. Enrolment is not compulsory and individuals can choose to enrol, or cancel their Medicare card if preferred.

Individuals who are eligible for Medicare but choose not to enrol or cancel their Medicare card are still considered eligible.

There is no process for cancelling a Medicare card on request from a customer.

A consumer end-date can be applied to the individual’s record to prevent any further Medicare cards or correspondence being sent. Their eligibility to Medicare remains, but they will not be able to claim Medicare benefits or receive services until the consumer end-date has been lifted. The consumer end-date will also affect a provider’s ability to claim if they bulk bill the customer.

A Medicare card does not hold personal or medical information. Medicare cards are not intended to be used as proof of eligibility for customers accessing health services. They are intended to be used by those listed on the card and provide access to:

• free or subsidised treatment by health professionals such as doctors, specialists, optometrists and in specific circumstances dentists and other allied health practitioners
• free treatment and accommodation as a public Medicare patient in a public hospital
• 75% of the Medicare Schedule fee for services and procedures if a person is a private patient in a public or private hospital. This does not include hospital accommodation and items such as theatre fees and medicines, and
• the Pharmaceutical Benefits Scheme (PBS) and the PBS Safety Net which reduces the cost of medicine

Any historical personal records in the Medicare system cannot be deleted for auditing purposes.

Individuals who choose not to enrol or cancel their Medicare card are still considered eligible and would not qualify for a Medicare Entitlement Statement (MES). The MES is intended for those who are ineligible for Medicare, not those who choose not to have a Medicare card.

Customers may contact Services Australia in the future to restore their status and resume accessing services covered under Medicare. They will need to complete a Medicare enrolment form (MS004) and provide the required supporting documents.