If you have a serious medical condition and need life-saving medical treatment that is only available overseas, the Medical Treatment Overseas Program offers financial support.
If you’re diagnosed with a life-threatening medical condition, in some cases the medical treatment you need may not be available in Australia. In situations when the only place you can get treatment is overseas, the Medical Treatment Overseas Program can help.
The Medical Treatment Overseas Program provides financial support to Australians who need to travel overseas to access life-saving treatment. Read on to find out how the program works and exactly what it covers.
What is the Medical Treatment Overseas Program?
The Medical Treatment Overseas Program is administered by the Australian Government Department of Health. It provides financial assistance to Australians who have been diagnosed with a life-threatening medical condition and who require overseas medical treatment.
The program is designed to ensure that expensive overseas medical costs don’t prevent Australians from accessing the high-level medical care they need. However, in order to qualify for funding under the Medical Treatment Overseas Program, you’ll need to satisfy a range of eligibility criteria detailed later in this article.
What does the it cover?
If you’re eligible to receive financial support under the Medical Treatment Overseas Program, you can receive cover for:
- Travel costs. The program will cover the cost of return airfare (business class for international flights and economy class for domestic flights) for you and one travel attendant (if medically required). You and your attendant will also receive cover for travel costs to and from the airport, both in Australia and in the country where you receive treatment.
- Accommodation costs. The program covers 100% of non-hospital accommodation costs for you and a travel attendant in 3.5-star equivalent accommodation.
- Travel insurance. The cost of travel insurance for you and your attendant is automatically covered.
- Passport and visa costs. You and the attendant will also be covered for any passport and visa costs you incur in order to obtain entry and stay legally in the treatment country.
- Medical costs. All overseas medical costs associated with the approved treatment for the specified life-threatening condition will also be covered under the program.
- Repatriation. The Australian Government will also offer financial assistance to help repatriate the remains of any Australian who dies overseas while receiving treatment funded under the program.
In order to be reimbursed for costs under the program, you will need to provide proof of expenditure in the form of invoices and receipts. You must submit these documents electronically or by post within 30 days of returning to Australia following treatment, or at an earlier date if requested by the Government.
What’s not covered?
There are certain expenses that are not covered under the Medical Treatment Overseas Program, including:
- Any medical treatment you receive in Australia in preparation for overseas treatment
- Routine travel to and from the hospital when overseas
- Your day-to-day living expenses such as food and drink, car hire, room service, phone and Internet, laundry costs etc
- Medical costs for the approved travel attendant
- Any transport or accommodation costs for unapproved travel attendants
- Medications that are not prescribed by the overseas treating specialist
- Any subsequent overseas travel to review the success of treatment at the treating facility
- The cost of post-operative care received when back home in Australia
It’s also worth pointing out that the program cannot provide financial assistance for overseas travel for the purposes of obtaining medical advice or a medical assessment before a definitive treatment plan has been developed.
How can people take advantage of the program?
To qualify for financial support under the Medical Treatment Overseas Program you will need to be an Australian citizen or an Australian resident who is eligible to receive Medicare benefits. You must reside in Australia and also be suffering from a life-threatening condition.
You will also need to provide evidence that addresses each of the four following mandatory medical criteria, as outlined by the Department of Health:
- The proposed overseas treatment or an effective alternative treatment must not be available in Australia in time to benefit the applicant.
- The treatment must be significantly life extending and potentially curative.
- There must be a real prospect of success for the applicant.
- The treatment must be accepted by the Australian medical profession as a standard form of treatment for the applicant’s condition.
The Department of Health provides detailed guidelines on the information and evidence you need to provide to receive funding under the Medical Treatment Overseas Program, so read these guidelines in full before applying.
Applications are assessed by a panel of medical advisers in the Department of Health and take at least six weeks to be processed.
Is it covered by health insurance?
Australian private health funds only provide cover for the medical expenses you incur inside Australia. As a result, they do not cover the cost of life-saving medical treatment you receive overseas. However, private health funds can cover the hospital costs you incur in Australia before heading overseas to receive treatment.
Australia also has Reciprocal Health Care Agreements in place with 11 other countries, allowing Australians travelling overseas to access subsidised medical care in those countries. However, these agreements are designed to cover the cost of unexpected emergency medical expenses you incur while travelling, not the cost of pre-arranged medical treatment overseas.