What is a reciprocal health care agreement?
A Reciprocal Health Care Agreement (RHCA) is an arrangement between two countries where each of their citizens and permanent residents will be able to access the public health system of the other. Australians can access these agreements in 11 countries around the world. Likewise, travellers from those countries can access the Australian public health system if they’re on a tourist or working visa.
What's covered under reciprocal health care agreements?
What you’re covered for under a RHCA will depend on the country you’re travelling to. Generally, you can expect to be covered for some of the costs of emergency medical treatment, medical transport like the use of ambulances, medication, and specialist services. Because this healthcare may only be subsidised, you may still need to pay a portion of the cost out of your own pocket.
To be treated under a RHCA, you’ll need to show your Australian passport or another valid passport that shows you’re a permanent Australian resident, as well as your current Medicare card. If you’re travelling to New Zealand, you may only need to show proof of Australian residency.
It’s also important to note that being treated under a RHCA isn’t a substitute for travel insurance, as coverage is limited and won’t help if you need to fly home.
What isn't covered by reciprocal health care agreements?
- Non-urgent or medically unnecessary care.
- Out-of-pocket gaps or co-payments required by the host country
- Private healthcare system treatments, accommodation, and doctors.
- Non-subsidised medicines, elective treatments, or medical equipment.
Who does Australia have reciprocal health care agreements with?
There are 11 countries that have RHCAs with Australia:
- Belgium
- Finland
- Italy
- Malta
- The Netherlands
- New Zealand
- Norway
- The Republic of Ireland
- Slovenia
- Sweden
- The United Kingdom (including England, Scotland, Wales, Northern Ireland, the Isle of Man, Jersey, and Guernsey)
Here’s a breakdown of what you may be entitled to when visiting each of these countries, per the Services Australia website:
Belgium
- The cost of hospitalisation, but you’ll need to pay an admission fee and a small daily fee
- Partial reimbursement of hospital treatment and services
- Treatment from a GP or specialist doctor and some dental care and allied health services if referred by a doctor, in which you’ll pay the full cost upfront before receiving a 60-75% rebate
- Some prescription medicines
- 50% of the cost of ambulance transportation
Exclusions: Some pharmaceutical medicines, as well as health services and products that aren’t in the benefit package or don’t meet the conditions.
Finland
- Medical and nursing care from health centres
- Out-patient care provided by a hospital
- Dental care from some centres
- Prescription medicines
- Some travel costs required to get medical care (a Social Insurance Institution of Finland or Kela office can tell you which ones are eligible).
Exclusions: Daily accommodation fees charged when staying in hospital or fees for specialist or non-hospital care.
Italy
- Care as a hospital patient or out-patient at public and other authorised hospitals
- GP and specialist care from public clinics, health centres, and authorised hospitals
- Urgent dental care at public hospitals.
Exclusions: non-approved medicines and medical testing.
Malta
- Care in government hospitals, including operations, medicine, nursing, accommodation, and meals
- Out-patient care provided by specialists in government service and health centres from a public doctor or nurse
- Emergency ambulance travel to hospital
- Urgent dental care provided by a government hospital.
Exclusions: Non-urgent dental work or dental prostheses and appliances.
The Netherlands
- Care including specialist care, nursing, prescription medicine (a full or part reimbursement), paramedics, and childbirth services
- Urgent medical transport (partial reimbursement)
- Treatment from GPs, specialists, and psychiatrists (for those over 18 years of age)
Exclusions: non-specialist dental care for those over 18, psychiatric care for under 18s, and repatriation costs (costs associated with sending you back to your home country).
New Zealand
- Hospital care
- Maternity services
- Pharmaceuticals
Exclusions: care from a GP, non-subsidised GP prescriptions, and ambulance travel.
Norway
- Care from a National Insurance Scheme (NIS) GP, as well as specialist care if you have a referral from one of these GPs and medical care prescribed by them
- Care, as well as out-patient treatment, in an NIS hospital
- Ambulance travel
- Emergency dental care
- Prescription medicine: you pay full price until reaching the annual threshold of about $347, after which it’s free.
- Health care for children up to the age of 12, including physiotherapy
- Free visits to the doctor and prescription medicines for children up to the age of 16
- Free psychological care for children up to the age of 18
- Birth care
- Oxygen therapy
- Dialysis.
Exclusions: cover for students and diplomats.
The Republic of Ireland
- Care as a public patient in a public hospital
- Maternity care
- Part of the cost of prescription medicines if you spend over a set amount in one month.
Exclusions: accommodation as a private patient in either a private or public hospital, as well as visits to a GP.
Slovenia
- Part of the cost for medical treatment in the public health system, including for hospitals, health centres, and pharmacies
- Part of the cost of medical treatment by private GPs, specialists, and dentists and pharmacies contracted to the Health Insurance Institute of Slovenia (HIIS)
- Emergency ambulance travel if you have a doctor’s referral
- 30% of the cost of prescription medicines on the positive list.
Exclusions: non-HIIS GPs, specialists, and dentists, medicines on the negative list, and 90% of the cost of medicines on the interim list and other ambulance travel.
Sweden
- Care from a doctor and as an out-patient at a hospital
- Free health services for children
- Free maternity services
- Part of the cost of prescription medicines.
Exclusions: daily fees charged when staying in hospital.
United Kingdom
- Care from an NHS doctor or nurse at a GP surgery (you’ll need to register as an NHS patient)
- Care in a public ward of an NHS hospital, as well as out-patient care
- Ambulance travel to an NHS hospital or other facilities
- Subsidised prescription medicine if the doctor treats you as an NHS patient (standard prescription fees apply).
Exclusions: non-subsidised medicine from pharmacies, prescription medicines for non-NHS patients, and any dental services.
How can citizens and permanent residents of countries with RHCAs with Australia access Medicare?
If you’re a citizen or permanent resident from one of the countries listed above, you may be eligible to enrol in Medicare for medically necessary treatment. You’ll usually need to provide a current visa, valid passport, and your public healthcare card from your home country.
You may also only be covered for a certain period of time, like six months. Other conditions and requirements may apply, so it’s best to check with your home country’s public healthcare body for more information.
Overseas Visitors Health Cover vs reciprocal health care agreements
If you’re from a country that doesn’t have a RHCA with Australia, there’s another option available: Overseas Visitors Health Cover (OVHC).
This cover generally comes in two different forms: Overseas Student Health Cover (OSHC) and Working Visa Health Cover.
Several insurers in Australia offer OVHC and depending on your policy, this can include cover for:
- Hospital accommodation
- Partial cover for medical fees
- Surgical fees for hospital admissions
- Emergency ambulance and room costs
- Cover for certain prescription pharmaceuticals
- Cover for services such as dental or optical, depending on length and duration of your stay.
Do I still need OVHC if I’m from a country with a reciprocal health care agreement?
This will depend on the conditions of your visa. For example, you’ll need to take out OSHC as a requirement of your student visa. Even if you don’t require cover, it’s always recommended you consider taking out travel insurance or OVHC when travelling, as the cost of emergency treatment can be substantial.
OVHC policies can also cover items that aren’t covered by Medicare and therefore are not available to RHCA visitors without health insurance:
- Ambulance transport (varies by state and territory)
- Dental care
- Elective treatments
- Treatment and accommodation in hospital.
