No. Germany has no Reciprocal Health Care Agreement with Australia, so German working holiday makers are not entitled to Medicare and pay for treatment privately. Not being entitled is also what makes the 2% Medicare levy exemption available at tax time.
Which countries have an agreement, and which do not?
Australia has Reciprocal Health Care Agreements with eleven countries. There is no partial cover, no EU wide arrangement and no reciprocity through a third country.
- United Kingdom
- Ireland
- New Zealand
- Sweden
- Netherlands
- Finland
- Norway
- Belgium
- Slovenia
- Malta
- Italy
Germany is not on it, and neither are France, Spain, Austria, Switzerland, the United States, Canada or Japan. Our guide to countries with a Medicare agreement sets out what each agreement covers, because they are not identical.
What does that mean at a doctor's surgery?
You are a private patient paying the full fee, with no Medicare rebate and no PBS subsidy on prescriptions. In genuine emergencies treatment is provided regardless of ability to pay, and the bill follows afterwards.
The statutory system at home gives no preparation for paying at the counter. Ambulance is the sharpest version: it is not covered by Medicare for anyone in most states, so a single callout is a direct cost.
Does German statutory cover follow you?
No. Cover under the gesetzliche Krankenversicherung does not extend to Australia. The statutory system reaches EU countries and a small number of treaty countries, and Australia is not among them.
Some private German policies include international travel cover, but typically cap at around six weeks per trip, short of a working holiday visa. The usual approach is Anwartschaftsversicherung or another way of managing the German cover while away, plus separate cover for Australia. That is a personal financial question rather than a tax one, and easier to settle before leaving Germany.
What cover does the visa require?
The visa requires adequate health cover for the whole stay as a condition of grant, without specifying a product. It must be valid for the full visa period, cover medical treatment in Australia, and cover repatriation.
Most meet it with comprehensive travel insurance, Australian Overseas Visitors Health Cover from a private health fund, or both. Travel insurance covers wider risks including cancellation and repatriation but usually caps at twelve months. OVHC is built for medical cover in Australia, renews indefinitely while you are here, and does not cover non medical travel risks. Our guide to travel insurance versus OVHC sets out which fills which gap.
How does this change your tax position?
The 2% Medicare levy is charged to people who are entitled to Medicare. A German national with no reciprocal agreement is generally not entitled, so the levy should not apply, and the exemption is worth about $500 on $25,000 of earnings.
The exemption is not automatic. It is claimed on the return and requires a Medicare Entitlement Statement from Services Australia, one for each financial year claimed. Services Australia commonly takes weeks to issue one, which is why most people never get it. Our guide to the Medicare levy covers the process.
A British backpacker is entitled through the agreement and generally pays the levy whether or not they ever saw a doctor. A German backpacker can claim the exemption, provided the paperwork is in hand.
What is the real financial exposure without cover?
The exposure is not the GP visit, it is the admission. Surgery and a hospital stay are the scenario the visa condition exists for, with air evacuation from a remote area or a medical repatriation flight to Germany at the top end.
That matters more on a working holiday than on a two week trip. Farm work, construction and station work carry real physical risk and take people hundreds of kilometres from a major hospital. Our guide to emergency care without Medicare covers what an uninsured presentation costs.
When should you apply for the Medicare Entitlement Statement?
Early. The statement is issued per financial year and commonly takes weeks rather than days, so it has to be started long before the return.
Applying in your first months means the document is in hand well before the return is due. Applying in October means lodging without the exemption or waiting, and several hundred dollars is commonly given up.
What decides your position?
Three facts. Your nationality, which settles the entitlement question and therefore the levy. Whether you obtained the Medicare Entitlement Statement, which decides whether the exemption is claimed rather than merely available. And whether your cover matches the work you do, since a policy written for sightseeing is not one that pays out after a fall on a construction site.
Our guide to amending a return covers the alternative of lodging without it and amending afterwards, which works but is slower. When we prepare a tax return the Medicare position is settled before anything is lodged, because it is one of the few items on a working holiday return worth a fixed several hundred dollars.