What you need to know
Bulk billing is when a medical service is free to you – you do not have any upfront costs.
Instead of you receiving a partial rebate, your medical specialist will bill Medicare directly.
Some medical practices will bulk bill for all patients.
A wide range of medical services can be bulk billed in Australia, including:
- Visits to your doctor. Many medical practices around Australia offer bulk billing to all patients when they visit their GP. However, some practices that provide bulk billing will only do so for specific patients, for example children or seniors.
- Specialist services. Some specialists, including pathologists and radiologists, will choose to bill Medicare directly rather than bill you.
- Optometry. Eye tests can be bulk billed so that there are no out-of-pocket expenses for you.
- Dental. Bulk billing services for preventative dental check-ups and treatments are provided at some dental practices.
- Podiatry. Medicare will pay a rebate for the consultation fee only and any extra services received will be out-of-pocket expenses.
- Psychology. Some practices offer bulk billing to customers who attend pre-booked appointments with a psychologist.
To be eligible for bulk billing, you need to be enrolled in Medicare. Some medical practices, for example certain GPs, will bulk bill for all patients. However, in other cases, your age and income will depend on whether you are eligible for bulk billing. If the practice doesn't bulk bill for all people, you might be eligible if you are a:
- Child under 16 years of age
- Commonwealth Seniors Health Card holder
- Ex-Carer Allowance (Child) Health Care Card holder
- Foster Child Health Care Card holder
- Health Care Card holder
- Low Income Health Care Card holder
- Pensioner Concession Card holder
Generally, no. A gap fee, sometimes called out of pocket expenses, is the difference between the amount your doctor charges and the Medicare rebate you receive.
If your consultation is bulk billed, you usually won't have any fees to pay.
However, if you receive more than one service in a visit, you might not be bulk billed for everything.
For example, many GPs will bulk bill for consultations but you will need to pay a fee for prescriptions they issue you. Check with your medical practitioner beforehand if you're not sure whether bulk billing applies to all the services you're receiving.
Medicare benefits include:
- Free or subsidised treatment from GPs, specialists, optometrists, dentists (in some circumstances) and other allied health practitioners.
- Free accommodation and treatment as a public patient in a public hospital.
- 75% of the Medicare Benefits Schedule (MBS) fee covered for services and procedures received as a private patient in a public or private hospital (this excludes hospital accommodation, theatre fees and medicine).
- Lower cost medications under the Pharmaceutical Benefits Scheme (PBS).
Medicare benefits are only payable for treatments and services received within Australia. The MBS provides a full list of all services that are subsidised by the Australian Government under Medicare. Visit the Department of Health MBS Online website for a complete list of what Medicare covers.
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