Medicare in Australia: when Brits can enrol

Medicare is Australia's answer to the NHS, but it's not quite the same deal, and your visa, not your accent, decides if you get it.

The short version

Medicare is for Australian citizens, permanent residents and some people who've applied for permanent residence. Most Brits on temporary work visas aren't eligible in their own right.
The UK–Australia reciprocal health care agreement covers some, not all, treatment for people ordinarily resident in the UK, and since 1 September 2022 you've had to prove that UK residence [1][2].
Australian residents pay a 2% Medicare levy through their tax return, plus a Medicare levy surcharge of 1% to 1.5% if they earn above the threshold and have no private hospital cover [3][4].
New migrants have until the later of the 1 July after their 31st birthday or one year after full Medicare registration to take out hospital cover without a Lifetime Health Cover loading [5].

Pound conversions in this guide use the Bank of England spot rate of 5 November 2026 (£1 = AUD 1.9363), rounded.

How Medicare differs from the NHS

Back home, you register with a GP and almost everything is free at the point of use. In Sydney, Medicare pays a set benefit for each service. Some GPs bulk bill, which means they accept the Medicare benefit as full payment and you pay nothing. Many don't, so you pay the fee and claim part back, leaving a "gap". Public hospital treatment as a public patient is free, but you don't choose your specialist and waiting lists for planned surgery can be long.

Private health insurance sits alongside it, covering private hospital stays and "extras" such as dental, physio and optical. The FCDO's Living in Australia guide sums it up: Medicare covers some healthcare for residents, and Australia uses tax rebates to nudge people into private cover [1].

	NHS (UK)	Medicare (Australia)
GP visits	Free	Free if bulk billed, otherwise you pay a gap
Public hospital	Free	Free as a public patient
Prescriptions	Set charge in England, free elsewhere in the UK	Subsidised under the PBS, with a co-payment
Dental	NHS dentistry, with charges	Mostly private; extras cover helps
Paid for by	National Insurance and general tax	General tax plus the 2% Medicare levy

Who can enrol in Medicare

Services Australia's own pages wouldn't load for us, so we've kept the eligibility rules in words. In broad terms, you can enrol if you live in Australia and you are:

an Australian citizen (including Brits who've taken Australian citizenship)
a permanent visa holder, for example on a 186 employer-sponsored, 189 independent or 100/801 partner visa
someone who has applied for a permanent visa, in certain circumstances, such as being the partner, parent or child of an Australian citizen or permanent resident, or holding permission to work. Many partner visa applicants on a 820 qualify this way
a New Zealand citizen living in Australia
covered by a reciprocal health care agreement

That leaves a big group out: Brits on temporary work visas such as the Skills in Demand visa, who aren't applying for permanent residence yet. Most temporary work visas carry a condition that you hold adequate health insurance for your whole stay, so you'll buy an overseas visitor or overseas worker policy instead. International students must hold Overseas Student Health Cover as a condition of their visa.

The UK–Australia reciprocal health care agreement

The UK is one of a handful of countries with a reciprocal deal. It's genuinely useful, but it's not a free pass.

What it covers

Treatment that's medically necessary during your visit, such as after an accident or a sudden illness, as a public patient in a public hospital [2].
Some GP treatment and subsidised medicines under the PBS.

It doesn't cover treatment as a private patient, planned admissions, or getting you home. It isn't a substitute for travel insurance [2]. Unlike the deals with Italy and Malta, the UK agreement has no six-month cap listed [2].

The catch: you must live in the UK

Since 1 September 2022, visitors from the UK must be ordinarily resident in the UK and show evidence of it to enrol under the agreement [6]. People who enrolled before that date and are in Australia on long-term visas don't need to provide residency evidence [6].

What that means in practice:

Your situation	Reciprocal Medicare?
Holiday in Sydney, still living in Manchester	Yes, with proof of UK residence
Working holiday visa, UK still your home	Possibly, if you can show you're ordinarily resident in the UK
Moved to Sydney on a work visa, house sold, P85 sent to HMRC	Unlikely; plan on private cover
Applied for or granted permanent residence	Enrol in full Medicare instead

If you've told HMRC you've left the UK, it's hard to argue you're still ordinarily resident there. Our guide to the NHS when you live abroad covers the other side of that coin: you lose free NHS hospital care when you move away, too.

Visitors from the UK can submit a digital Medicare application, with their passport, visa and proof of UK residence [6].

The Medicare levy and the surcharge

The 2% levy

Australian tax residents usually pay a Medicare levy of 2% of taxable income on top of income tax [3]. Low earners get a reduction. If you're a tax resident but not entitled to Medicare, for example on a temporary visa, you can claim an exemption. You'll need a Medicare Entitlement Statement from Services Australia, to back up the claim.

The Medicare levy surcharge

This is the stick that pushes higher earners into private cover. If your income is above the threshold and you don't have an appropriate level of private hospital cover, you pay an extra 1% to 1.5% [4]. Extras-only cover doesn't count.

Income for MLS purposes	2025–26 single	2026–27 single	Surcharge
Base tier	Up to AUD 101,000 (about £52,200)	Up to AUD 105,000 (about £54,200)	0%
Tier 1	AUD 101,001–118,000	AUD 105,001–123,000	1%
Tier 2	AUD 118,001–158,000	AUD 123,001–164,000	1.25%
Tier 3	Over AUD 158,000	Over AUD 164,000 (about £84,700)	1.5%

Family thresholds are double the single ones: AUD 210,000 (about £108,500) for the base tier in 2026–27, plus AUD 1,500 for each dependent child after the first [4]. On a Sydney salary of AUD 130,000, the surcharge would be 1.25%, or about AUD 1,625 (about £840) a year. A basic hospital policy can cost less than that, which is why so many people buy one.

Lifetime Health Cover: the deadline nobody mentions

Lifetime Health Cover (LHC) adds 2% to your hospital premium for every year you're over 30 when you first take out hospital cover, up to a maximum loading of 70%. The loading drops off after 10 years of continuous hospital cover [5].

New migrants get a grace period. Your deadline is the later of the 1 July after your 31st birthday, or the first anniversary of your full Medicare registration [5]. Reciprocal Medicare doesn't count for this [5]. Miss it and a 45-year-old moving from Bristol could pay a loading for a decade.

Getting set up: step by step

Check your visa and if you're on track for permanent residence.
If you're eligible, enrol in Medicare (form MS004, or online through myGov where offered) and note the date you're registered.
If you're not, keep the health insurance your visa requires and request a Medicare Entitlement Statement for your tax return.
Diary the LHC deadline: one year after full Medicare registration.
Compare hospital policies on the government's privatehealth.gov.au before that date and before your income crosses an MLS threshold.
Find a GP who bulk bills, or at least ask about fees when booking. Ask around in our community group for Brits in Australia for recommendations in your suburb.

If your partner is Australian and you're splitting time between Sydney and the UK, our sister site ExpatCooee explains how Medicare works when Australians live abroad.

Medicare in Australia: when Brits in Sydney can enrol, and when you need cover