Australia’s healthcare system

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Key facts

Primary care is usually the first point of contact in the Australian healthcare system.
General practitioners (GPs) are a part of primary care. They can prescribe medicine or refer you for specialist care.
The cost of public health services is usually covered by Medicare, while private health services require private health insurance.
In Australia, medicines are available over the counter or with a prescription.
The cost of some medicines is subsidised by the Pharmaceutical Benefits Scheme (PBS).

What is primary healthcare?

Primary care is provided by:

doctors (General Practitioners — GPs)
community nurses
dentists
pharmacists
allied health professionals (such as physiotherapists, dietitians and speech pathologists)

It's delivered in a variety of settings, including at:

general practices
community health centres
pharmacies
dental practices
at home

General practice

General practitioners (GPs) are also known as doctors. They work in the community to keep people healthy. Your doctor can check and treat your:

physical health
mental health

Your doctor can also help you access other health services, or specialist care, through a referral. You can read more about referrals here.

It can be helpful to have a GP who knows you and your medical history. This is called ‘continuity of care’. It should be someone that you feel comfortable with.

Allied health

Allied health practitioners are trained health professionals. They can help you manage your physical or mental health. Allied health professionals include:

They can provide: diagnosis, treatment or rehabilitation services.

Unlike specialist services, you don’t need a referral from your doctor to see an allied health practitioner.

Can I see a doctor after-hours?

Many general practices are only open during business hours. However, there are several after-hours options if you need treatment.

After-hours services are available at:

general practices with extended hours
hospital emergency departments
Medicare Urgent Care Clinics (UCCs)

After-hours doctor call-out services are available in major cities and centres. These are private services, where a doctor can come to your home. In some cases, this service may be covered by Medicare.

Learn more about after-hours health services.

You can also call the healthdirect helpline free* on 1800 022 222 to speak to a registered nurse. They may offer you a call back or video call from a GP.

^* call charges may apply from mobiles.

If you think you have a medical emergency, immediately dial triple zero (000) for an ambulance.

Should I go to the emergency department or Medicare Urgent Care Clinic?

Emergency departments (EDs) are able to treat patients who need urgent medical or surgical care for:

acute (severe and sudden) illnesses
life-threatening medical emergencies

Most EDs are found in public hospitals in Australia.

Medicare Urgent Care Clinics can help if you have a medical problem that can't wait for your GP, but doesn’t need a hospital emergency department. For example, minor infections, coughs and colds, gastroenteritis, sprains and back pain. They are open early and late, seven days a week and you don’t need an appointment or referral.

If you are not sure whether your medical condition is urgent, contact your doctor or call healthdirect on 1800 022 222 (known as NURSE-ON-CALL in Victoria).

When would I need to go to a hospital?

You may get treatment in a hospital in a few different ways, such as:

through the emergency department — in the case of an emergency
when referred by a specialist — for an ongoing issue

The costs of care differs between public and private hospitals. You can read more about healthcare costs later in this article.

What are specialists?

Medical specialists are doctors who work in a specific area of medicine. You will need a referral from your GP (doctor) to see a specialist.

Medical specialists include doctors such as:

cardiologists
dermatologists
nephrologists
psychiatrists
ophthalmologists
rheumatologists
vascular surgeons

How much do health services cost?

Health services in Australia are provided by both the public and private sectors.

Public hospitals are owned and managed by state and territory governments.

The cost of your healthcare depends on whether you receive care in a public or private practice.

The Australian government’s Medical Costs Finder tool can help you find and understand the cost to see a GP or medical specialist.

Medicare

Medicare provides free access to services in public practices, as well free treatment and accommodation in public hospitals.

Medicare is available for:

Australian residents
overseas visitors from countries with a reciprocal arrangement

You can choose to have:

Medicare cover only
a combination of Medicare and private health insurance

Medicare can partly or fully cover a specialist visit. However, you will need a referral from your doctor.

Private health insurance

Some people choose to get private health insurance. This can cover some costs of care in private hospitals and practices.

You are also able to use a public hospital as a private patient. Your private health insurance may cover some of the costs.

How can I access healthcare?

Your contact with the healthcare system will often begin through either:

a general practice
an emergency department (ED)

They act as the main gateways to other health services, including:

diagnostic tests
specialist consultations
hospital admission
inpatient care
residential care

How does healthcare differ across Australia?

Some aspects of the Australian healthcare system are the same nationwide. Others depend on where you live.

Parts of healthcare managed by states, territories and local governments may vary such as:

immunisation programs
screening services
emergency services
public hospitals

It may be more difficult to see a health professional the farther you live from a city.

How do I choose the right health service?

Watch these videos to learn which services are best for your health needs.

How much do medicines cost?

The Pharmaceutical Benefits Scheme (PBS) ensures that Australians have access to affordable medicines. The PBS covers most of the cost of prescription medicines. This means you can get a wide range of medicines without having to pay full price.

Medicines on the PBS must first be approved by the Therapeutic Goods Administration (TGA), which also regulates:

vaccines
sunscreens
vitamins and minerals
medical devices
blood and blood products

Over the counter medicine

Some medicines are available "over the counter" at pharmacies and supermarkets. This means you can buy them without seeing your doctor. They’re usually for mild health problems, such as:

headache
sore throat
upset stomach

Over the counter medicines include:

Prescription medicine

Some medicines are higher risk, as they:

have potentially serious side effects
have to be taken in a complicated way, such as through injection
can be addictive
can be misused

These medicines require a prescription, which is a legal document given to you by a doctor or specialist.

Prescription medicines include:

To get prescription medicine, take your prescription to your local pharmacy. The pharmacist will fill your script.

Your doctor may also electronically send your prescription to you or your pharmacy.

Your prescription contains important information, such as:

how to take your medicine
when to take your medicine
how many times you can use the same prescription for the same medicine (this is the number of repeats)

Once you have used your repeats, you need to see your doctor again.

How do I access my health information?

My Health Record is an online summary of your key health information. It allows you to share your health information with doctors, hospitals and other healthcare providers if you want to. The information is private, and you have control over who sees the information.