An Australian public hospital will treat you in an emergency whether or not you have Medicare, insurance or money. It will then bill you as a private patient.
What number do you call in an emergency?
Triple zero, dialled as 000, for anything genuinely urgent. It is the Australian equivalent of 999 in the United Kingdom and 112 in Germany, works from any mobile with or without credit, and the operator asks which of police, fire or ambulance you need.
For situations that are worrying but not life threatening, healthdirect on 1800 022 222 gives free advice from registered nurses around the clock. For a doctor out of hours in most metropolitan areas, the National Home Doctor Service on 13 SICK, dialled as 137 425, visits your accommodation. Both are worth having in a phone before they are needed.
Does your passport change what emergency care costs?
Substantially. Australia has a Reciprocal Health Care Agreement with eleven countries, and a national of one of them is generally entitled to Medicare for medically necessary treatment while in Australia, which covers public hospital emergency care and subsidised medicines.
The list is the United Kingdom, Ireland, New Zealand, Italy, Malta, the Netherlands, Belgium, Finland, Norway, Sweden and Slovenia. A British backpacker arrives with a route into the public system that a German, Japanese, French or Canadian backpacker does not have. The same entitlement removes the Medicare levy exemption at tax time: the nationals covered in a hospital are the nationals who pay the 2% levy on their tax return.
- RHCA passport: public hospital emergency treatment and subsidised medicines, levy generally payable
- Non-RHCA passport: billed as a private patient, levy generally exempt with a Medicare Entitlement Statement
- Neither route covers repatriation home, which is insurance territory only
What does insurance actually cover?
It depends which of the two products you bought, and they are not interchangeable. Overseas Visitors Health Cover is Australian private health insurance sold for visitors, built around hospital treatment: emergency department attendance, admission as a private patient, surgery, inpatient medicines, and most imaging and pathology.
Travel insurance is built around the trip. It typically covers emergency treatment, ambulance and repatriation, plus cancellation and lost baggage, but the medical cover is often capped and frequently excludes anything connected to a pre-existing condition or to alcohol. The two gaps that catch working holiday makers are ambulance cover, which varies by state and by policy, and mental health, which is limited or excluded on a great many policies.
- Ambulance: charged separately in most states and not always included
- Repatriation: travel insurance usually, Medicare and RHCA never
- Dental: limited under almost everything
- Working while insured: some travel policies exclude manual work entirely, which is worth reading before a farm job
What happens if you cannot pay the bill?
The treatment still happens, because Australian hospitals do not condition emergency care on payment. Billing is dealt with afterwards, and a public hospital will generally negotiate a payment plan, sometimes over a long period, rather than pursue an immediate lump sum.
It does not forget. Hospitals pursue unpaid accounts, including through international debt collection after you have gone home, so leaving the country is not a resolution. The costs that turn a bad week into a life altering one are air retrieval from a remote area and a medically escorted flight home. That is why insurance for a non-RHCA passport holder is closer to essential than to optional.
Should you go to a public or a private hospital?
For a serious emergency, the public hospital, and for most working holiday makers the ambulance decides. Public emergency departments are free for Medicare eligible patients, which includes RHCA nationals, and where you are billed as a private patient the rates are still lower than the private equivalent.
Private emergency departments charge from the first minute regardless of who you are. The trade is waiting time for cost, which is reasonable for a broken finger and poor for anything that needs a large hospital behind it.
What should you keep afterwards?
Everything on paper. The discharge summary, the medication list, the imaging results and every bill are what an insurer needs to assess a claim, and reconstructing them months later from a hospital you have already left is difficult.
The consequences also run past the medical file. An extended period unable to work changes your income for the year, which usually means a larger refund rather than a smaller one, and it can change your super position and your DASP timing if you end up leaving Australia earlier than planned. If the recovery pushes past the visa expiry, raise that with Home Affairs early rather than late.