Understanding the healthcare system and who you can turn to when you need information and emergency financial support.
Dealing with an accident or illness can be difficult and expensive. Maintaining good health can be expensive too. A person dealing with significant healthcare issues is more likely to experience financial hardship – and someone experiencing financial hardship is also more likely to experience healthcare issues.
Prevention
The best way to avoid healthcare costs is to be healthy. While it’s not always possible to predict what will happen to yourself and your family in terms of medical expenses, see what you can do to look after your health.
Medicare and private health insurance
Medicare is Australia’s free health insurance scheme. It provides access to a wide range of health and hospital services at low or no cost for all Australians and some overseas visitors. Medicare also gives access to cheaper pharmaceuticals under the Pharmaceutical Benefits Scheme.
There is also optional private health insurance available, which many people choose for medical expenses not covered by Medicare. Some government policies are designed to encourage people to take out private health insurance.
📌 To find out more about private health insurance, see our insurance and making claims page.
What Medicare doesn’t cover
- Any ‘gap’ between the cost of a doctor’s visit covered by Medicare and the fees the doctor chooses to charge
- Ambulance services
- Private hospital costs
- Hospital procedures deemed ‘unnecessary’ like cosmetic surgery
- Glasses and contact lenses
- Most dentistry
- Hearing aids
- Physiotherapy
- Most psychology services
- Medicines not on the Pharmaceutical Benefits Scheme
- Acupuncture not performed as part of a doctor’s consultation
- Occupational therapy, speech therapy
- Chiropractic services
- Podiatry
- Most prostheses
- And more
Waiting times for procedures
One of the big issues for Australians is that procedures under Medicare are performed by the public health system, which is always overstretched. Waiting times for procedures covered by Medicare can be very long, even if they seem urgent. This is a reason why some people choose to take out private health cover to help pay for private hospital care.
📌To learn about how insurance works, see our insurance and making claims page
Your financial rights as a patient
You’re entitled to ask about any extra money you may have to pay out of your own pocket before you receive medical treatment. You can ask your doctor or health care provider, your health insurer, or the hospital.
Knowing how much your treatment will cost is called ‘informed financial consent’. If you feel at any time that your right to informed consent is denied, you can contact the relevant ombudsman.
Contacting the ombudsman
If you feel you haven’t been treated fairly, and a complaint hasn’t led to a satisfactory outcome, you can contact the ombudsman in your state or territory.
Ombudsmen are independent agencies that help to resolve disputes between people and companies or government agencies. It’s a free and independent service, and while the process can be lengthy, your complaint, once submitted, will be resolved.
There are many ombudsmen organisations for various industries and government sectors, both at the federal and state or territory level.
| Australian Capital Territory | ACT Human Rights Commission 02 6205 2222 |
| New South Wales | NSW Health Care Complaints Commission 1300 582 113 |
| Northern Territory | Health and Community Services Complaints Commission 1800 004 474 |
| Queensland | Office of the Health Ombudsman 133 646 |
| South Australia | Health and Community Services Complaints Commission 1800 232 007 |
| Tasmania | Health Complaints Commissioner Tasmania 1800 001 170 |
| Victoria | Health Complaints Commissioner 1300 582 113 |
| Western Australia | Health and Disability Services Complaints Office 08 6551 7600 |
Budgeting for health costs
If you’re used to getting by on a low income, you’re probably already keeping a close eye on your expenses. To make a budget for health care, start by making a list of everything you’ve spent in the past on health-related items.
- Medicines/pharmacy
- Glasses/eye care
- Dental
- Doctors
- Allied health (chiropractors, physiotherapists)
- Mental health professionals
- Sporting activities and gym memberships
Online budgeting tool
The Moneysmart website has a useful budgeting tool that can save your information, be updated at any time, and be downloaded as a spreadsheet.
- Record your income
- Add up your expenses
- Set your spending limit
- Set a savings goal
- Adjust your budget as you go
The tool also allows you to add custom entries to what’s already there, and you can set individual credits or expenses on a weekly, fortnightly, monthly, quarterly or yearly basis.
Ways to save money on healthcare
There’s a range of programs that could help you manage the cost of healthcare. Some of these have eligibility requirements.
Low Income Health Care Card
The Low Income Health Care Card is an Australian Government concession card that provides access to cheaper healthcare and many other government and non-government support services and payments.
The card is available to people meeting certain eligibility requirements, such as your income and whether you have dependent children.
You must also be an Australian citizen, or hold:
- a Permanent visa
- a Special Category visa
- certain types of temporary visa, like Partner Provisional or Temporary Protection.
See if you are eligible for the Low Income Health Care Card.
More concessions
State and territory governments run concession programs for eligible people. These can cover healthcare costs as well as utilities, housing, transport, legal costs, recreation, and more. Eligibility and concessions offered differ by region.
| Australian Capital Territory | Assistance |
| New South Wales | Concessions, rebates and assistance |
| Northern Territory | Concessions and payments |
| Queensland | Concessions |
| South Australia | Concessions |
| Tasmania | Concessions |
| Victoria | Concessions and benefits |
| Western Australia | Concessions |
Bulk billing medical services
You can choose to visit a doctor who bills to Medicare to avoid any cost to you this is called ‘bulk billing’.
Not all doctors bulk bill
Many doctors place a dollar value on their services above the amount they receive from Medicare, and request you pay the ‘gap’ – which is the difference between the cost of their service and the Medicare rebate that is returned to them. Any added cost of healthcare, such as paying this gap, is usually called an ‘out-of-pocket expense’.
Details of bulk billing from Services Australia
Find health services that bulk bill from the Australian Government’s Health Direct website
The ‘Ask Izzy’ resource
Ask Izzy is a website that connects people in need with everyday necessities, housing, a meal, money help, family violence support, counselling, and more all, around Australia. To look for affordable healthcare options in your area, select ‘health’ and follow the prompts.
Generic medicine
You’re usually offered a ‘brand-name’ or ‘generic’ medicine when you buy medicine. Generic medicines are usually a fair bit cheaper than the brand-name choice, as the company may not be spending money on developing and marketing their product. In Australia, you can only sell generic medicines if they work the same way as the brand-name medicine.
Renegotiating terms of payment
When you’re trying to focus on rest and recovery while having trouble paying your medical bills, it isn’t easy to negotiate payments. That said, you have several options to explore that could reduce, postpone, or spread-out payments.
Speak to your doctor about the following:
- payment extension
- payment plan
- payment matching
- concession information
- financial counselling service referral.
Finding support
If you need extra support, help comes in a variety of different ways, depending on your circumstances.
📌To make things a bit easier, the National Debt Helpline has some information on negotiating bills, or see our paying bills and negotiating page.
Support for long-term illnesses
Some government departments and community organisations run support services for people living with chronic illnesses. You might find the following helpful, although we note this list is by no means exhaustive.
| Condition or issue | Resource / organisation |
| Cancer | Cancer Council |
| Diabetes | National Diabetes Services SchemeServices, NDSS |
| Back pain, arthritis, and osteoporosis | Musculoskeletal Australia supportMusculoskeletal Australia financial support |
| Asthma | National Asthma Council Australia links10 ways to cut your asthma costs |
| Mental health | Beyond BlueFinancial wellbeing |
| Cardiovascular disease | Heart FoundationSorting out finances after a heart attack |
| Chronic obstructive pulmonary disease | Lung Foundation Australia |
Travelling for medical treatment
Commonwealth, state and territory governments run support services if you need to travel for the purpose of medical treatment.
Government support payments
The Australian Government provides income support payments through Centrelink. This includes the Carer Payment, Carer Allowance, Child Dental Benefits Schedule, and other supports. You can use this tool to learn about your eligibility for payments. Alternatively, head to Services Australia to learn more about the services and support they offer.
If you are dealing with a sudden unexpected expense like a health issue, you can see if you can get an advance payment on your income support.
See the following Services Australia pages for more information:
Child Dental Benefits Schedule
Dealing with Centrelink
Many people find dealing with Centrelink difficult. Applying for payments can be confusing. Most payments are set too low and have overly strict requirements.
📌 See our payments and dealing with Centrelink page
Using Centrepay to pay bills
If you receive income support, you can use Centrepay to directly pay your bill from your income support payment. This service is entirely voluntary. You choose which payments the deduction comes from, how much you want to pay, and to whom you want to pay.
Aged care services
My Aged Care is run by the Australian Government and provides access to a host of aged care services, which have eligibility requirements. You can learn about the types of aged care services, where to get help, and how to make a plan at their website.
At My AgedCare you can:
- check your eligibility for aged care
- apply for an assessment
- estimate the fees you might have to pay for a Home Care package or an aged care home
- find a provider
- find support for financial hardship
- create a four-step personalised guide.
Aged care services often come with long waiting lists, and unfortunately, it isn’t always as simple as calling up to get help.
Withdrawing funds from super
You might be able to access part of your superannuation funds before you reach retirement age in a small number of emergency circumstances, including compassionate grounds or if you’re experiencing severe financial hardship.
To start the process, speak to your super fund about early access to super.
Compassionate grounds
Examples of compassionate grounds include:
- medical treatment or care at the end of life
- expenses associated with the death of a dependant
- expenses associated with disability for you or a dependant
- payment on a home loan to avoid losing your home.
Financial hardship
You need to meet two conditions to be considered for early access to super for financial hardship: you must have been receiving eligible government income support payments continuously for 26 weeks, and you have not been able to meet reasonable and immediate family living expenses.
Risks involved in withdrawing superannuation early
It’s important to remember that any superannuation you have is there for your retirement. Also, even a small amount of money in your super account could earn interest and build up to a larger amount by the time you retire. So taking even a small amount out now could mean a large amount of lost interest.
This said, sometimes short-term needs must be addressed before long-term considerations when it comes to health, wellbeing and getting back on your feet.
Find out more about withdrawing superannuation on compassionate grounds from the National Debt Helpline website.
📌 To learn more about what superannuation can do for you when you stop work, see our understanding superannuation page.
No interest loans
No Interest Loans (NILs) allow you to borrow money to help you get back on your feet without having any of the crippling interest or high fees that come with other forms of loans.
How does it work?
NILs are typically offered for up to $2,000-$3,000 for rent or bond, essentials like fridges, washing machines, furniture, kitchenware, medical expenses, car repairs, education fees, and other goods and services you might need.
There are certain rules around who can apply for NILs. Generally, you must:
- have a Health Care Card, a Pensioner Concession Card (or an income less than $45,000 per year after tax)
- have lived at your current address for more than three months
- show that you can repay the loan.
Who provides NILs?
NILs are a service offered by community organisations. You can find providers over at the Good Shepherd website.
This information was last updated 5 June 2023.
The links and resources in this article have been compiled and reviewed by the Brotherhood of St. Laurence. We aren’t responsible for what you’ll find at the links, though we do hope you find the information useful. See our disclaimer if you’d like to know more.
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