Health insurance for German working holiday makers in Australia: what cover do you need?

Without proper insurance, a single hospital admission in Australia can cost tens of thousands of euros. German travellers regularly underestimate the gap because their experience with the German social health insurance system gives them no preparation for a country where treatment must be paid for upfront.

Which countries have RHCAs with Australia?

Australia has Reciprocal Health Care Agreements with a limited list of countries. The current list is:

• United Kingdom
• Ireland
• New Zealand
• Sweden
• Netherlands
• Finland
• Norway
• Belgium
• Slovenia
• Malta
• Italy

Germany is not on the list. Neither is France, Spain, Austria, Switzerland, the United States, Canada, or Japan. See our article on which countries have a Medicare agreement with Australia for the full detail.

What does this mean in practice?

Without RHCA cover, a German working holiday maker who needs medical treatment in Australia is treated as a private patient. The costs include:

• GP visit: typically $80 to $120 for a standard consultation
• Specialist visit: $200 to $400
• Emergency room visit: $400 to $800 for a non-admitted visit
• Hospital admission: $1,500 to $5,000 per day in a public hospital as a private patient
• Surgery: $10,000 to $100,000+ depending on procedure
• Ambulance: $400 to $1,500 per ride (also not Medicare-covered for anyone)
• Prescription medicines: full price (no PBS subsidy)

Treatment is provided regardless of ability to pay in genuine emergencies, but the bills follow afterwards. Australian hospitals routinely pursue overseas patients for unpaid bills through international debt collection.

What insurance is required for the working holiday visa?

The German working holiday visa to Australia (subclass 462 for Germans under the Work and Holiday Programme) requires adequate health insurance for the duration of the stay as a condition of grant. The Department of Home Affairs does not specify a particular insurance product, but the cover must be:

• Valid for the full duration of the visa
• Cover at least basic medical treatment in Australia
• Cover repatriation if needed

In practice, most German working holiday makers meet this requirement through one of:

• A comprehensive travel insurance policy for the full visa duration
• Australian Overseas Visitors Health Cover (OVHC), purchased from an Australian private health fund
• A combination of both

The Australian OVHC option is broadly equivalent to Medicare cover and is purchased month-by-month or for the full visa period.

Travel insurance vs Overseas Visitors Health Cover

The two options have different strengths:

Travel insurance:

• Covers a broader range of risks (cancellation, lost baggage, theft)
• Includes repatriation
• Usually has higher excess amounts
• Often excludes pre-existing conditions
• Limited duration (usually 12 months maximum)

OVHC:

• Specifically designed for medical cover in Australia
• Lower excess for routine medical visits
• Can include extras (dental, optical) for an additional premium
• Renewable indefinitely while in Australia
• Does not cover non-medical travel risks

Most German working holiday makers benefit from having both, particularly if they plan to travel within Australia or to nearby countries during the visa period.

German statutory health insurance and travel cover

If you are insured under the German statutory health system (gesetzliche Krankenversicherung) before leaving Germany, your cover does not extend to Australia. The statutory system covers EU countries and a small number of treaty countries; Australia is not included. Some private German health insurance policies do include international travel cover, but this typically caps at 6 weeks per trip, which is insufficient for a working holiday visa.

The practical approach for most German travellers is:

• Suspend or maintain German statutory cover according to the Anwartschaftsversicherung rules
• Take out separate Australian or international travel/health cover for the visa period
• Reactivate German cover on return to Germany

This is a personal financial planning question rather than a tax one, but it is worth being aware of before departing Germany.

How does this interact with the Medicare levy?

Because German working holiday makers are not eligible for Medicare, the Medicare levy does not apply to them. The 2% Medicare levy is charged to Australian residents who are eligible for Medicare, and working holiday makers are generally not in that category. The levy is therefore excluded from German working holiday makers' tax assessments.

What about emergencies and repatriation?

In a genuine medical emergency, Australian hospitals provide treatment regardless of insurance status. The bill is presented afterwards. Without insurance, the costs can be catastrophic:

• A serious injury requiring hospital admission and surgery can result in bills over $100,000
• ICU treatment can run to $5,000 to $10,000 per day
• Air ambulance evacuation from a remote area can exceed $50,000
• Repatriation to Germany on a medical flight can exceed $80,000

Adequate travel or health insurance is not optional for a German working holiday maker in any practical sense. The visa condition exists for a reason.

How does our service support German working holiday makers?

While we do not sell health insurance, the Medicare and insurance status affects:

• Whether the Medicare levy applies to your tax return (usually no for Germans)
• Whether private health insurance premiums interact with the tax system
• Your overall tax position in Australia

When you lodge your tax return through our service, we account for your Medicare status correctly so the levy is excluded if you are not eligible. Get in touch with our team if you are uncertain about how Medicare and the levy affect your German tax position.