The scheme either partially or fully covers the cost of most health care, with services being delivered by state and territory governments or private enterprises.
All Australian citizens and permanent residents are eligible to enrol in Medicare, as well as international visitors from 11 countries that have reciprocal agreements for medically necessary treatment.
Most health care services are covered by Medicare, including medical imaging and pathology, with the notable exception of dentistry.
[1] The states and territories operated hospitals, asylums and other institutions for sick and disabled people not long after their establishment, replicating the predominant model of treatment in the United Kingdom.
[2] An 1876 British Empire royal commission into friendly societies considered the establishment of Victorian colony-run health insurance, and decided against it.
[10] The Whitlam government, elected in 1972, sought to put an end to the three-tier system by extending healthcare coverage to the entire population.
[24] Before the Labor Party came to office, Bill Hayden, the Minister for Social Security, took the main responsibility for developing the preliminary plans to establish a universal health scheme.
According to a speech to Parliament on 29 November 1973 by Mr Hayden, the purpose of Medibank was to establish the "most equitable and efficient means of providing health insurance coverage for all Australians.
In 1981, access to Medibank was restricted further, and an income tax rebate was introduced for holders of private health insurance to encourage its uptake.
[33] In recent years, this has largely been replaced with the National Australia Bank service HICAPS (Health Insurance Claim at Point of Sale).
This was addressed when the 2013 Australian federal budget (ALP) established the National Disability Insurance Scheme, which was progressively rolled out across the country between 2013 and 2020.
"[38] Leader of the Liberal Party, Malcolm Turnbull, had not announced such plans, and the Department of Human Services denied sending the message.
The affair was widely dubbed "Mediscare," which in turn was used to describe fears of the Liberal National Party's alleged devolution of Medicare.
MyMedicare participants are also eligible for more Medicare funded services if they are frequent hospital users or in residential aged care.
[49] Currently, Services Australia operates the scheme in consultation with the national Department of Health and Aged Care, and provides assistance for other related programs such as the Australian Organ Donor Register.
Services Australia also issues each patient enrolled with the scheme a unique Medicare card and number which is required for a benefit to be made.
[50] The minister for health and aged care determines the items on the MBS, based on the recommendation of the Medicare Services Advisory Committee.
A 2012 study of the OECD found that Australia was the only country out of the 29 surveyed that gave service providers the right to charge more or less than the rebate amount.
Many industry and professional groups, such as the Australian Medical Association (AMA), maintain their own list of recommended fees that their members can use to base their charges off.
For example, the AMA's List of Medical Services and Fees recommends that general practitioners charge $102 for appointments lasting less than 20 minutes.
Since the introduction of the MBS, the items listed have been subject to annual indexation aimed at keeping the Medicare benefit in-line with the costs of delivering care.
[58] While the rate of bulk billed services remained steady during this period, the gap payment for providers already charging above the MBS amount increased.
[68] Where the service is not covered by Medicare, private health insurance policies may provide an annual "extras" balance that can be used to contribute towards these costs.
[69] For patients receiving mental health care, Medicare provides up to 10 fully covered individual and group counselling sessions per year as part of the Better Access Scheme.
[70] The Better Access Scheme also covers the cost of other mental health supports, including care from related professions such as occupational therapists, social workers, general practitioners and psychiatrists.
The Extended Medicare Safety Net was added in 2004, providing similar assistance for heavy users of scheduled medical services.
To provide additional relief to those who incur higher than usual medical costs, Medicare safety nets have been set up.
In 1997, the Howard government implemented a higher level of Medicare levy for high income earners where they did not have a private health insurance policy.
Individuals 31-year or older, and not exempted, are charged an additional 2% on any private hospital insurance policy they purchase for each year after their 30th birthday that they do not have coverage.
They are required to pay this additional loading, up to a maximum of 70%, for 10 years, and the federal government rebate does not include the cost of LHC.