Reciprocal health care agreement (RHCA)

What is a reciprocal health care agreement?

Reciprocal health care is an agreement that gives Australians access to medically necessary care when they visit certain countries and, in return, allows visitors to access some of Australia's public health care when they visit Australia.

At the time of writing, the Australian government has reciprocal health care agreements with 11 other countries. They allow eligible people visiting from those countries to access free or reduced-cost health care via Australia's Medicare system.

How does a reciprocal health care agreement work?

A reciprocal health care agreement gives foreign visitors from certain countries the right to access some of Australia's public health services. In return, Australians travelling to any of the 11 countries that the government has an agreement with can also access their public healthcare systems.

For eligible visitors to Australia, it's important to remember that you will have access to the benefits available under Medicare, not your own healthcare system. This means that you will only get access to basic medical services and emergency treatment under certain circumstances.

Medicare is not as wide-ranging as health services in other countries and does not cover you for ambulance, dental work or treatment as a private patient. Depending on which country you're from, you may be able to get subsidised medicines and Medicare benefits for GP visits. As a result, many Australians have private health insurance; this is essentially to make up for the gaps in the public healthcare system. If you want the same level of care you are used to back home, you might want to get overseas visitors health cover (OVHC).

Which countries have an RHCA with Australia?

Australia has RHCAs in place with the following countries:

If you're visiting from one of these countries, you may be able to get subsidised healthcare while you're here. Who's eligible depends on the agreement. For some countries it's based on where you've been living rather than your citizenship, so check the rules for your country. Visitors with student visas from Norway, Finland, Malta and the Republic of Ireland who visit Australia are not covered under the RHCA.

Australian citizens can also access cover for the cost of essential medical treatment when they visit any of the 11 countries above.

What treatments are included in RHCAs?

For most agreement countries, visitors are entitled to the following while in Australia:

• Free or reduced-cost treatment as a public inpatient or outpatient in a public hospital
• Subsidised prescription medicines under the Pharmaceutical Benefits Scheme (PBS)
• Medicare benefits for out-of-hospital medical treatment and GP visits

The wording does vary slightly based on which country you're coming from. Click the dropdowns below for details on each of the 11 RHCA countries.

• Belgium

  Belgian visitors are entitled to the following:

  • Free or reduced-cost treatment as a public inpatient or outpatient in a public hospital
  • Subsidised prescription medicines under the Pharmaceutical Benefits Scheme (PBS)
  • Medicare benefits for out-of-hospital medical treatment and GP visits

  Cover is available until the expiry date on your Belgium or European Health Insurance Card or for the length of your stay in Australia, whichever is earlier.

• Finland

  Finnish visitors are entitled to the following benefits when they arrive in Australia:

  • Free or reduced-cost treatment as a public inpatient or outpatient in a public hospital
  • Subsidised prescription medicines under the Pharmaceutical Benefits Scheme (PBS)
  • Medicare benefits for out-of-hospital medical treatment and GP visits

  Cover is available until the expiry date on your Finnish Health Insurance or visa, whichever is earlier.

• Ireland

  If you're visiting Australia from Ireland, you'll be able to enjoy cover under the RHCA for the length of your stay. This entitles you to inpatient and outpatient treatment as a public patient in a public hospital as well as medically necessary prescription medicines under the PBS.

• Italy

  Italian visitors are entitled to the following for up to 6 months from the day they arrive, or until their visa expires if that's sooner:

  • Free or reduced-cost treatment as a public inpatient or outpatient in a public hospital
  • Subsidised prescription medicines under the Pharmaceutical Benefits Scheme (PBS)
  • Medicare benefits for out-of-hospital medical treatment and GP visits

• Malta

  Maltese visitors can enjoy access to the following benefits for up to six months from the date they arrive in Australia:

  • Free or reduced-cost treatment as a public inpatient or outpatient in a public hospital
  • Subsidised prescription medicines under the Pharmaceutical Benefits Scheme (PBS)
  • Medicare benefits for out-of-hospital medical treatment and GP visits

• The Netherlands

  If visiting from the Netherlands, you are entitled to the following:

  • Free or reduced-cost treatment as a public inpatient or outpatient in a public hospital
  • Subsidised prescription medicines under the Pharmaceutical Benefits Scheme (PBS)
  • Medicare benefits for out-of-hospital medical treatment and GP visits

  Cover is available until the expiry date on your European Health Insurance Card or for the length of your stay in Australia, whichever is earlier.

• New Zealand

  Visitors from New Zealand are covered under the RHCA for the length of their stay in Australia. Under the agreement, you are entitled to inpatient and outpatient treatment as a public patient in a public hospital as well as medically necessary prescription medicines under the PBS.

• Norway

  If visiting from Norway, you are entitled to the following:

  • Free or reduced-cost treatment as a public inpatient or outpatient in a public hospital
  • Subsidised prescription medicines under the Pharmaceutical Benefits Scheme (PBS)
  • Medicare benefits for out-of-hospital medical treatment and GP visits

• Slovenia

  Slovenians are entitled to the following:

  • Free or reduced-cost treatment as a public inpatient or outpatient in a public hospital
  • Subsidised prescription medicines under the Pharmaceutical Benefits Scheme (PBS)
  • Medicare benefits for out-of-hospital medical treatment and GP visits

  Cover is available until the expiry date on your European Health Insurance Card or for the length of your stay in Australia, whichever is earlier.

• Sweden

  Swedish visitors to Australia are entitled to the following cover for the length of their stay:

  • Free or reduced-cost treatment as a public inpatient or outpatient in a public hospital
  • Subsidised prescription medicines under the Pharmaceutical Benefits Scheme (PBS)
  • Medicare benefits for out-of-hospital medical treatment and GP visits

• The United Kingdom

  Visitors from the UK are entitled to the following cover:

  • Free or reduced-cost treatment as a public inpatient or outpatient in a public hospital
  • Subsidised prescription medicines under the Pharmaceutical Benefits Scheme (PBS)
  • Medicare benefits for out-of-hospital medical treatment and GP visits

  Cover starts the day you arrive and ends when your visa expires.

What is not included in RHCA?

It's important to know that Medicare doesn't cover all health services. These are some of the healthcare services you will not be covered for:

• Treatment in a private hospital or as a private patient
• Ambulance
• Dental treatment
• Extras services, e.g. out-of-hospital care like optical, physio, chiro and more

You will need to pay for these services if you want them, which can cost a lot. Alternatively, you can get health insurance for overseas visitors which can cover all of the above.

Overseas visitors health cover vs reciprocal health care agreement

Foreign visitors to Australia also have another option available to them to ensure they receive the cover they need for medical treatment while in Australia: taking out private health insurance. Several Australian health funds offer what is known as overseas visitors health cover (OVHC), which is health insurance specifically designed to cover foreign residents while they visit Australia.

OVHC is designed to cover a portion of an overseas visitor's healthcare expenses while they are in Australia. This includes cover for the following:

• Hospital accommodation and surgical fees for medically necessary hospital admissions
• Partial cover for medical fees
• Emergency room costs
• Emergency ambulance
• Cover for some pharmaceuticals
• Cover for some extras services, such as dental and optical

Do I need overseas visitors health cover if I am from a country that has an RHCA with Australia?

Not always. If you're on a student visa, you still need Overseas Student Health Cover (OSHC), even if you can use Medicare under an RHCA. On some other visas with a health insurance condition, you may be able to apply to Home Affairs for an exemption once you've enrolled in Medicare. This is assessed case by case. You can't enrol until you've arrived in Australia, so you'll usually need complying insurance to start with. Having said that, OVHC is an essential consideration for all visitors to Australia. Because Medicare doesn't take care of all your health needs, you could be left with substantial out-of-pocket medical and hospital expenses if you suffer an illness or injury while in Australia. RHCAs do not cover the following:

• Ambulance transport
• Dental care
• Elective treatment
• Medical evacuation to your country of residence
• Treatment and accommodation in a private hospital or as a private patient in a public hospital
• Treatment that is not immediately necessary

It's recommended that you consider OVHC before coming to Australia even if it is not a requirement of your visa. Having private health insurance in place means you can access the health care you need whenever you need it, and that you won't be left with a substantial bill for the cost of treatment.

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I'm an Australian overseas, how does RHCA work for me?

The cover available to Australians travelling overseas varies depending on the RHCA country you visit:

• Australians in Belgium

  You are covered for the following in Belgium:

  • Staying in hospital, where you'll pay an admission fee and daily fee
  • Medical treatment received in a hospital
  • Care from a GP or specialist doctor (you will pay between 25% and 40% of the cost)
  • Some dental care (you will pay between 25% and 40% of the cost)
  • Some allied health services like physio (you will pay between 25% and 40% of the cost)
  • Some prescription medicines
  • 50% cover for ambulance service

• Australians in Finland

  You are covered for the following in Finland:

  • Medical care
  • Nursing care
  • Out-patient care from hospitals
  • Some dental care
  • Prescription medicines
  • Some travel costs to get medical care

• Australians in Italy

  You are covered for the following in Italy:

  • Cover provided for up to six months
  • Medical treatment, including specialist services at public hospitals and other authorised hospitals and clinics
  • Treatment as an inpatient in public and authorised hospitals
  • Immediately necessary public hospital dental treatment

• Australians in Malta

  You are covered for the following in Malta:

  • Cover provided for up to six months
  • Medical attention at a health centre
  • Nursing care provided by a public nurse or doctor
  • Inpatient care (including surgery, medicines, accommodation and meals)
  • Hospital outpatient consultations provided by government specialists
  • Ambulance travel to hospital after accidents or emergencies
  • Immediately necessary dental care in government hospitals

• Australians in the Netherlands

  You are covered for the following in the Netherlands:

  • Hospital care (including specialist care and nursing)
  • Full or partially refunded prescription medicine
  • Partially refunded transport (urgent ambulance or taxi)
  • Paramedics
  • Childbirth
  • Out-of-hospital care including GPs, specialists and psychiatrists if you're 18 or over

• Australians in New Zealand

  Australian visitors to New Zealand can access limited subsidised health care for the duration of their stay. Inpatient treatment and accommodation at a public hospital is covered, maternity and some pharmaceuticals, but you will have to pay for all other medical treatment, ambulance and prescription medicine.

• Australians in Norway

  You are covered for the following in Norway:

  • You are entitled to health care under Norway's National Insurance Scheme (NIS)
  • Medical treatment from an NIS GP or outpatient department
  • Specialist services when referred by a GP
  • Hospital inpatient treatment
  • Ambulance travel
  • Emergency dental treatment
  • Ancillary care prescribed by a doctor
  • Prescription medicine – it's free after you spend around $347 over the course of a year
  • Free visits to a doctor for children aged up to 16
  • Services free for children up to the age of 12
  • Free psychological care up to the age of 18
  • Birth care, oxygen therapy and dialysis

• Australians in Ireland

  You are covered for the following in Ireland:

  Free public hospital care is provided as well as maternity care and part of the cost of prescription medicines if you spend over a certain amount in a month.

• Australians in Slovenia

  You are covered for the following in Slovenia:

  • Subsidised medical treatment in the public health system (in hospitals, health centres and pharmacies)
  • Subsidised treatment by private GPs, specialists, dentists and pharmacies contracted to the Health Insurance Institute of Slovenia (HIIS)
  • Free ambulance travel when referred by a doctor in an emergency
  • 30% for some prescription medication costs

• Australians in Sweden

  You are covered for the following in Sweden:

  • Medical treatment by a doctor or at a hospital outpatient department
  • Free health services for children
  • Free maternity services
  • Cover for the cost of some prescription medicines

• Australians in the United Kingdom

  You are covered for the following in the United Kingdom:

  • Medical treatment from doctors
  • Inpatient treatment (including medicine, nursing care and accommodation in a public ward)
  • Outpatient treatment
  • National Health Service (NHS) prescription medicine
  • Ambulance travel to or from and between NHS hospitals

Frequently asked questions

• How long does my RHCA coverage last when visiting Australia?

  The duration of your RHCA coverage in Australia typically depends on your country of origin and the length of your visa. For most countries, coverage is available for the length of your authorised stay in Australia. However some countries like Malta and Italy have a maximum cover period of six months from your arrival date. You should check the specific details for your country in the 'What treatments are included in RHCAs' section above or with Services Australia for precise information.

• Does a reciprocal health care agreement cover pre-existing medical conditions?

  Yes a reciprocal health care agreement generally covers medically necessary treatment for pre-existing conditions. If you need immediate or emergency medical care in a public hospital, or subsidised prescription medicines, these are usually included. However it is important to remember that the RHCA only provides basic public health care similar to Medicare and does not cover private hospital treatment or extensive long term care. For broader coverage including private hospital admission or elective treatments you should consider overseas visitors health cover OVHC.

• Can my family members or dependents also be covered under the RHCA?

  Yes, family members and dependents can be covered if they're eligible under the same agreement and hold valid Australian visas. Each individual must separately enrol in Medicare upon arrival in Australia to access the benefits. Whether each family member is eligible depends on the agreement's rules, which for some countries are based on where you've been living rather than your citizenship.

• Are working holiday visa holders or other temporary residents covered by RHCA?

  Working holiday visa holders from countries with a reciprocal health care agreement are generally covered for medically necessary treatment in Australia under the RHCA. Similarly many other temporary visa holders from RHCA countries are also eligible. However there are specific exclusions such as student visa holders from Norway, Finland, Malta, and the Republic of Ireland. It is always best to confirm your specific eligibility with Services Australia based on your country of origin and visa subclass.

• What should I do if I need medical care before my Medicare enrolment is processed?

  If you require immediate or emergency medical attention before your Medicare enrolment is complete you should still seek treatment. Public hospitals are obliged to provide necessary care in emergencies. You should keep all your medical records, receipts and documentation of your RHCA eligibility. Once your Medicare enrolment is processed you may be able to claim a refund for eligible expenses. Contact Services Australia for guidance on retrospective claims.

• Can I use my European Health Insurance Card EHIC in Australia for RHCA benefits?

  No, your European Health Insurance Card (EHIC) is not directly used in Australia to access reciprocal health care benefits. While some RHCA countries are also EU member states and may issue an EHIC you must enrol in Australia's Medicare system to access services under the RHCA. The EHIC is primarily for use within Europe. However some RHCA countries may require proof of your home country's health insurance membership such as your EHIC when enrolling for Medicare in Australia.

• Does the RHCA cover mental health services in Australia?

  The RHCA provides access to medically necessary mental health services through the public hospital system and subsidised GP visits. This means if you require emergency or acute mental health care as a public inpatient or outpatient in a public hospital you would generally be covered. Consultations with a GP are also subsidised. However private psychiatric care, long term therapy or non-emergency mental health services outside the public system would typically not be covered. For more comprehensive mental health support you may need private overseas visitors health cover.

To make sure you get accurate and helpful information, this guide has been edited by Tim Bennett as part of our fact-checking process.

Written by

Gary Ross Hunter

Journalist

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Gary Ross Hunter has over 6 years of expertise writing about insurance, including life, health, home, and car insurance. Having reviewed hundreds of product disclosure statements and published over 800 articles, he loves simplifying complex insurance topics for everyday readers. Gary has contributed to major outlets like Yahoo Finance, The Sydney Morning Herald, and news.com.au, and holds a Bachelor of Arts (Honours) in English Literature from the University of Glasgow, along with a Tier 2 General Advice certification, ensuring his work adheres to ASIC’s RG146 standards. See full bio

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