Usually not. Medicare covers Australian citizens and permanent residents, and a 417 or 462 visa does not make you either. The exception is your passport: eleven countries hold a Reciprocal Health Care Agreement with Australia, and their nationals get limited cover.
What decides whether you are covered?
One fact, and it is your passport rather than your visa. Australia has Reciprocal Health Care Agreements with the United Kingdom, the Republic of Ireland, New Zealand, Sweden, the Netherlands, Finland, Norway, Belgium, Slovenia, Malta and Italy, and nationals of those eleven countries can enrol for limited Medicare benefits while their visa is valid.
If your passport is German, French, Japanese, Korean, Taiwanese, Canadian, American, Israeli, Spanish or anything else, there is no agreement and there is no Medicare. That is roughly two thirds of the working holiday population in Australia. Check the full agreement country list rather than assuming, because people assume wrong in both directions.
What does an agreement actually get you?
Less than the word Medicare suggests. Reciprocal cover is for medically necessary treatment, meaning something that arises while you are here and cannot reasonably wait until you go home. In practice that is a subsidised GP visit, public hospital treatment as a public patient, and prescriptions at the subsidised rate.
It does not cover ambulance transport, billed separately in most states and running into hundreds of dollars for a single trip. Nor dental, optometry, physiotherapy, elective procedures, private hospitals or, in most cases, pre-existing conditions. That is why British and Irish backpackers who technically have cover still commonly carry insurance, and why the ambulance gap is the most common expensive surprise.
What does it cost if you are not covered?
You are treated as a private patient and you pay the published fee. A GP consultation is commonly $80 to $120. A specialist appointment runs from $200 upward. Prescriptions are full retail rather than subsidised. Public hospital emergency departments will treat you, but the follow up and any admission is chargeable.
Health insurance is a condition of the 462 visa and is strongly expected on the 417, and this is why. A broken wrist falling off a ladder in a Mildura packing shed is a manageable expense with cover and a genuinely serious one without.
How does this affect your tax?
Directly. The Medicare levy is 2% of taxable income charged to people who are entitled to Medicare. If you are not entitled, the levy should not apply to you, and on $25,000 of earnings that is about $500.
The exemption is not automatic. It has to be claimed on your return, and claiming it requires a Medicare Entitlement Statement from Services Australia, which commonly takes up to six weeks to issue and is needed separately for each financial year. Six weeks is the whole problem: most people learn the document exists in October, when the return is already due.
Does having private insurance change the exemption?
No. The exemption turns on whether you are entitled to Medicare, not on whether you bought anything else. Private cover neither creates an exemption nor removes one.
The mirror of that is more painful. A British or Irish traveller who never enrolled in Medicare and never used it is still generally entitled to it, and entitlement is what the exemption tests. The levy applies.
Your passport decides both halves of this.
Coverage and the levy exemption are decided by the same fact, your passport, and they move in opposite directions.
- Your passport, which is the whole question. Eleven countries in, everyone else out.
- Whether you enrolled part way through the year, which produces a partial exemption for the days you were not covered rather than an all or nothing result.
- Whether you ordered the Medicare Entitlement Statement in time. Six weeks of lead time is what stands between most people and about $500.
- Whether you hold dual nationality. The agreement follows the passport you are here on, and a second passport can change the answer completely.
- Whether you already lodged a year without claiming it, since the levy can usually be recovered by amending the return, generally within two years of the original lodgement.
The exemption is claimed as part of your working holiday tax return, and you can estimate your tax refund with and without it to see what it is worth on your income.