Doctors & Medical Centres Guides & Resources

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Cost of Doctor Visit in Australia

With many doctors, you should expect to pay between $35 and $50 for a standard GP appointment. Australia is known for low-cost medical treatment or free access to citizens' healthcare services. In Australia, you can get a bulk of medical treatment free or for a low price. Here are examples of general practitioner's fees covered by the Australian healthcare system; | Service | Estimated cost | | -- | -- | | Doctor consultation fee | $35 to $50 | true | | Medicare schedule fee | $36.30 | true | | Medicare rebate to the patient (100 per cent of schedule fee) | $36.30 | true | ## What is a Medicare rebate? Medicare is a system of universal health insurance for citizens and permanent residents, funded by the Federal Government that ensures payment of doctors' visits and hospital treatment. The government provides a rebate on medical expenses paid through Medicare which includes: Medicare benefits are divided into two parts, schedule fee and MBS (Medical Benefits Scheme). Schedule fee is the approximate cost or value of service provided by doctor or hospital. Medical Benefits Scheme (MBS) covers the cost of a number of health services and depends on the kind of treatment, [how much doctors charge](/guides/doctors-medical-centres/how-much-does-it-cost-to-see-a-doctor-in-australia) (e.g., surgery), whether it's fully private (paid privately with no rebate from Medicare ) or partly private (paid privately, with some rebate from Medicare). ## Can I see a doctor in Australia without a Medicare card? You can see your doctor without a Medicare card. If you do not have a Medicare card, the doctor will charge the full cost of the consultation fee plus any additional doctor charges for special treatments, any necessary out of hospital services, or investigations that are not covered by Medicare. Medicare does not cover overseas students. They should have an Overseas Student Health Cover instead. ## How much is a doctor's consultation without Medicare? With many doctors, you should expect to pay between $35 and $50 for a standard GP appointment. A GP may charge more if they are providing special treatments or if they are visiting you at home. Expect to pay between $200 and $300 for a standard consultation with a specialist. Specialist fees are usually higher than general practice GP fees. There is no standard fee, so you may need to ask your doctor or specialist how much the appointment will cost. You may be required to make a gap payment where the doctor's fee is higher than what the doctor charges MBS. However, you can apply for a Medicare rebate for gap payments you've made. Eligible Medicare rebates are payable to your bank account via Medicare Online services. ## Are specialist fees covered by Medicare? No. Medicare pays for GP services but does not cover specialist fees. This means you may incur out of pocket cost by paying for all or part of the appointment, depending on your level of health cover and whether you are eligible for Medicare rebates. Australian citizens with private health insurance can have their specialist medical services costs paid by the private health insurers. However, your insurance company may require that specialist and allied health services be recommended by your general practitioner before seeking such specialised services. ## What does my health insurance cover? It depends on the health insurance policy. Some policies provide cover for doctor's visits. Some only pay a percentage of what is covered under the Medicare Benefits Schedule (MBS) of costs. Others might not cover doctor's visits at all. Costs will vary from one private health insurer to another. Most private health insurance companies have a clause stipulating the waiting periods before enjoying the private health fund benefits. A private hospital will charge a private patient the full doctor's charge applicable during the waiting period. Others have a co-payment requirement for certain private hospital visits or appointments to allied health professionals. New patients enrolled with private health insurance firms should familiarise themselves with the applicable terms and conditions. ## How much does a visit to a specialist cost? It depends on the healthcare provider's specialty, but you can expect to pay between $200 and $300 for an appointment with a specialist. If you have private health insurance, the rebates vary from insurer to insurer. This is why it's important to check your policy documents or ask your private health insurer what discounts will be given on specialist fees before you go ahead with any procedure. Some of the specialist services beyond the scope of general practitioners include the below. - Surgical procedures - Pathology tests - Theatre fees - Specialised in-hospital services such as physiotherapy ## What is included in a standard doctor consultation? Standard doctor consultation is the time spent with a GP or other medical professional (e.g., psychiatrist) that generally involves asking about your symptoms, history, and lifestyle, reviewing your health records, and perhaps conducting some exams. The doctor may ask questions like these below. - How often do you get each of these problems? Are they continuous or occasional? How long have they been going on? - Have any family members had similar problems? - Do you notice a pattern in when the problem occurs (for example, does it happen more often during certain times of the year)? Does anything seem to trigger it? - What makes it better or worse? - Is there anything you can identify as making it better? ## What are out-of-pocket costs? Out-of-pocket costs are medical costs you pay to doctors and specialists for consultations, procedures, and treatments not covered by the Medicare Benefits Scheme. You may have to pay from your own pocket, or you could be invoiced directly by your doctor/ specialist for anything over a Medicare rebate. The amount you pay depends on your level of health cover, whether you are eligible for a rebate through Medicare and the costs charged by the doctor/ specialist. ## What is MBS? Medical Benefits Schedule (MBS) lists services subsidised under Medicare. Patients can claim benefits under Medicare when they visit doctors, during any visit to a public hospital or when buying prescribed medicines available through the Pharmaceutical Benefits Scheme. ## How long does a doctor appointment take? Most GP appointments last around 20 minutes. If you have a chronic condition, this appointment time may be increased to accommodate more frequent visits or consultations with other members of your health care team. Specialist appointments can take longer depending on the type of treatment/appointment required. ## What is bulk billing? Bulk billing is where a doctor or specialist will charge full payment to the Australian Government (Medicare) directly for your consultation and treatment, rather than charging you. A public or private patient will not have to pay out of pocket or claim a rebate for a visit. If you are eligible, bulk billing is an option for free medical care. ## Can I be bulk billed if I don't have Medicare? Not all, but most doctors and specialists offer bulk billing services to those who do not hold a Medicare card. Some doctors charge their own fees as they like and may still choose to bulk bill some patients even if they don't hold a Medicare card; however, this is at their discretion, so it's always best to ask your doctor if they bulk bill before making an appointment. For more information on general practitioners and the work they do, take a look at the Victorian Government's [Better Health channel.](https://www.betterhealth.vic.gov.au/health/serviceprofiles/general-practitioner-services)

How Much Does It Cost to See a Doctor in Australia?

If you're not covered by a health fund, or if you have a large bill to pay, some doctors may offer a payment plan. The average cost of an appointment with a GP (general practitioner) in Australia is around $50, while the average cost of a specialist appointment is around $130. | Service | Estimate of fee | | -- | -- | | Doctor consultation fee | $50.00 | true | | Medicare schedule fee | $36.30 | true | | Medicare rebate to a patient (100 per cent of schedule fee) | $36.30 | true | | Out-of-pocket expense to patient | $13.70 | true | Medicare is a public health system run by the Australian Government. It covers general medical treatments sought in a public hospital. Medicare rebates are also extended for in hospital services to minimise the gap of out of pocket expenses payable. ## Can a GP bulk bill my payments? About 80% of GP practices bulk bill, and 20% or less charge a fee for each visit. Medical services provided in a bulk billing arrangement imply that the public or private patient does not foot any medical costs. Medicare pays for all general practice medical costs. Many doctors also accept the medicare schedule fee without asking the patient to meet the out of pocket costs. Bulk billing does not cover all allied health services and specialist appointments. Out of hospital services can only be bulk billed if your GP recommends and refers you to specialist service providers. These specialist allied health professionals must register with Medicare to be eligible. ## What if I can't afford to see a doctor? If you [can't afford a doctor's fee](/guides/doctors-medical-centres/cost-of-doctor-visit-in-australia), there are a few things you can do. - Check if your health fund offers cover for doctors' standard consultation costs. - Visit a local community health centre or free clinic. - Speak to your local GP about a payment plan. If you're seriously ill and need to see a specialist, you may be able to get help from Medicare under the Chronic Disease Management (CDM) program. To be eligible for this program, you must have at least one of the following conditions: diabetes, heart disease, asthma, chronic obstructive pulmonary disease (COPD), arthritis, or mental health issues. The Health Care Card also gives you access to a range of health services at a reduced cost or for free. To be eligible for a Health Care Card, your income must be below a certain level. If you're not eligible for Medicare, there are a number of community organisations that may be able to help. Try contacting your local council or searching online for 'community health services' in your area. ## What is bulk billing? Bulk billing is a term used to describe the process of charging a health fund for a patient's visit rather than the patient. Bulk billing is common in Australia and is offered by around 80% of GP practices. It's a great way to save money on doctors' visits, as you don't have to pay any fees upfront. However, not all services are bulk billed. If you choose to see a doctor privately, they may charge you what is known as an 'out-of-pocket fee.' Out of pocket costs is a co payment plan where the patient pays fees not catered for by the medicare cover. If you're not covered by a health fund, or if you have a large bill to pay, some doctors may offer a payment plan. This allows you to break the bill up into smaller payments. Speak to your doctor or local council about this option if it's available. Medicare also offers the Health Care Card, which gives you access to a range of health services at a reduced cost or free. ## What is Medicare? Medicare is Australia's national health insurance system covering people living in Australia but not those with "no legal residency" status. It provides free hospital treatment as a public patient in a public hospital but lower costs for treatment as a private patient in either a public or private hospital. In addition to Medicare benefit, there are also concession cards that can provide further savings on medical costs. These concession cards include the health care card, pensioner concession card, and veteran's affairs card. Medicare rebates and gap payments by private health insurers enable patients to seek specialised medical services in a private hospital facility. The Medicare benefit system works in collaboration with the Pharmaceutical Benefits Scheme. This scheme exists to offer subsidised drugs and prescribed to patients during GP appointments. ## What can I claim under Medicare? There are different rules about what you can claim through Medicare depending on which level of cover you have: general or private. This includes different costs for seeing a doctor or having X-rays and scans. You can find a list of what you're covered for on the Medicare website. Generally, if you see general practitioners and they bulk bill, you will not pay anything. Medicare foots the full fee. However, most doctors occasionally require patients to see a specialist for pathology tests, surgical procedures, specialised diagnostic tests, theatre fees, physiotherapy, or related medical treatment procedures. In such situations, you may have to pay an out-of-pocket fee. This is usually around $30, but it can be more or less depending on the doctor. You can claim some of these specialist charges back through Medicare, but you will need to show your receipt as proof of payment. Refunds are typically paid back into the claimer's bank account. The Medicare Safety Net mechanism is a provision to protect patients who have recurrent doctor visits from paying excessive gap fees. The safety net threshold is met if annual gap fees reach a certain amount. ## How long do you have to wait to see a doctor? Average waiting times vary from one location to another across major cities as well as day vs night GP services appointments. However, you should be able to see a doctor the day you call or within 1-2 days after making an appointment, depending on the severity of your health. ## What is an out-of-pocket fee? An out-of-pocket fee is an amount charged by a medical practitioner (a GP or specialist) for seeing them privately, rather than under Medicare arrangements where the Government makes a full payment or pays a greater portion of the total costs of your consultation. ## What is the difference between medicare and a health fund? Medicare is Australia's national health insurance system covering people living in Australia. Health funds are private companies that offer cover for the medical expenses of private patients. If you're not covered by a health fund, or if you have a large bill to pay, some doctors may offer a payment plan. This allows you to break the doctor's charge up into smaller, more manageable payments for you. Speak to your doctor or local council about this option if it's available. For more information on general practitioners and the work they do, take a look at the Victorian Government's [Better Health channel](https://www.betterhealth.vic.gov.au/health/serviceprofiles/general-practitioner-services). ## Do I need to be in a private health fund in Australia? No, you do not need to be in a private health fund in Australia to access medical care. However, if you are not covered by a health fund and need to see a specialist, you may have to incur out-of-pocket costs. ## Is a private health fund expensive? Private health funds in Australia vary in price, but on average, they cost around $70 - $200 per week per person. This price may change depending on the level of cover you have. The more medical benefits you get, the more money you pay as a medical insurance premium. ## What does private health insurance cover? Private health insurance covers you for the cost of your medical expenses. If you have an accident or illness, private health insurance will cover some of your costs. Types of private health funds in Australia include the below. - Hospital Only Cover. This covers some or all of the costs for hospital stays. - Extras Cover pays some or all the cost for extras like dental and optical fees. - Combined Cover provides both types of cover above combined into one policy with premiums that vary depending on how much coverage you want to receive.

Frequently Asked Questions

What does the term "GP" stand for?

GP stands for General Practitioner.

What does the term "bulk billing" mean?

This is where the doctor bills medicare directly for a medical consultation or treatment, with no out-of-pocket cost to the patient.

How often are medical checkups recommended?

This depends. Your doctor may advise you on a recommendation based on your age, medical history and any other information required.

Do I need an extended consultation?

If you think you need more time with your doctor, advise the clinic at the time of your booking.

Can a GP help me with weight loss?

You doctor may be able to provide you with general healthy eating and exercise advice, as well as referrals to other health professionals if required.