Healthcare and health insurance in Sydney

Australia's health system will feel half familiar: a public system a bit like the NHS, with a big private sector bolted on, and a few bills that would never land on your doormat back home.

The short version

Thanks to the UK–Australia reciprocal health care agreement, Brits on most visas can enrol in Medicare for medically necessary care from the day they arrive, until their visa expires [1][2].
That reciprocal cover leaves out ambulances, private hospitals, dental, optical and most physio, among other things [2].
Once you're a permanent resident (and in some cases once you've applied), you can enrol in full Medicare.
Private health insurance is optional for most residents, but the Medicare Levy Surcharge and Lifetime Health Cover loading make it a money question as well as a health one [3][4].
An emergency ambulance in NSW starts at AUD 464 (about £240) for the call-out, so get ambulance cover [5].

How the system works

Medicare is Australia's public health scheme, paid for partly through the Medicare levy on your tax return. It covers treatment as a public patient in public hospitals, and pays a set benefit towards seeing a GP or specialist. The Pharmaceutical Benefits Scheme (PBS) subsidises many prescription medicines.

The big difference from the NHS is the GP. Doctors set their own fees. Some "bulk bill", meaning they accept the Medicare benefit as full payment and you pay nothing. Others charge more and you pay the gap. In parts of Sydney, a bulk-billing GP is easy to find; elsewhere it takes some searching. Ask when you book.

Specialists need a GP referral, as at home. Dentists and opticians are mostly private, and Medicare largely doesn't cover them for adults.

Pound conversions use the Bank of England spot rate of 5 November 2026 (£1 = AUD 1.94).

The UK reciprocal health care agreement

The UK and Australia have a reciprocal health care agreement, and the FCDO's Living in Australia guide confirms it covers some, but not all, healthcare costs for people with a valid visa [6]. It's what lets you use Medicare before you're a permanent resident.

Who can enrol

You can enrol under the agreement if you lived in the UK (or Jersey, Guernsey or the Isle of Man) before arriving. Student visa holders are included. Cover starts on the day you arrive and ends when your visa expires, and you can extend it online if your visa is extended [1].

Since 1 September 2022, you must show you were ordinarily resident in the UK [2]. Services Australia accepts a GHIC, a UK EHIC, or two dated documents showing you lived in the UK, such as a lease, bank statement or utility bill [1]. Pack them before you leave.

You enrol through myGov or with a Medicare enrolment form, using your passport and visa [1].

What it covers, and what it doesn't

Covered under the UK agreement	Not covered
Medically necessary care outside hospital, such as a GP visit	Ambulance travel
Treatment as a public patient in a public hospital, inpatient and outpatient	Private hospital care, or being a private patient in a public hospital
Some PBS prescription medicines	Treatment that was the reason for your trip, or planned before you arrived
	Glasses, contact lenses, hearing aids and other devices
	Most allied health such as physio, unless under an eligible care plan
	Home nursing, cosmetic surgery, IVF

Sources: Services Australia [1][2].

That's decent cover for illness and accidents, but it isn't the full package. Many temporary visas also carry a condition that you hold adequate health insurance, and the reciprocal agreement may not be enough to meet it. Check your visa grant letter, and if in doubt, buy Overseas Visitors Health Cover from an Australian insurer.

Full Medicare once you're a resident

Permanent residents can enrol in full Medicare. Some people who have applied for a permanent visa, such as many partner visa applicants, can enrol before the visa is granted, depending on their circumstances. Our guide to Medicare in Australia: when Brits can enrol goes through the rules.

Full Medicare covers more than the reciprocal version, but the same broad gaps remain: no ambulance, no private hospital choice, and little dental or optical cover.

Private health insurance

Most Australians who can afford it hold some private cover. It comes in two parts:

Hospital cover pays for treatment as a private patient, so you choose your specialist and skip public waiting lists for planned surgery.
Extras cover (also called general treatment) helps with dental, optical, physio and similar.

Two government rules push people towards hospital cover.

The Medicare Levy Surcharge

If you earn above a set income and don't have an appropriate level of private hospital cover, you pay an extra surcharge on top of the Medicare levy [3]. For singles:

Income (singles)	2025/26	2026/27	Surcharge
Base tier	AUD 101,000 or less	AUD 105,000 or less (about £54,200)	0%
Tier 1	AUD 101,001 – 118,000	AUD 105,001 – 123,000	1%
Tier 2	AUD 118,001 – 158,000	AUD 123,001 – 164,000	1.25%
Tier 3	AUD 158,001 or more	AUD 164,001 or more (about £84,700)	1.5%

Source: Australian Taxation Office [3]. Family thresholds are double the single ones, plus AUD 1,500 for each dependent child after the first [3]. Australian tax years run from 1 July to 30 June.

On a decent Sydney salary, the surcharge can cost more than a basic hospital policy, which is why so many people take one out.

Lifetime Health Cover loading

If you don't have private hospital cover by the 1 July after your 31st birthday, you pay a 2% loading on hospital premiums for every year you're over 30 when you join, up to 70% [4]. It drops off after ten continuous years of cover.

The good news for migrants: your deadline is the later of that 1 July and the first anniversary of your full Medicare registration. Reciprocal Medicare doesn't count [4]. So a Brit who becomes a permanent resident at 40 has a year from full Medicare enrolment to take out hospital cover without any loading. Diary it.

Seeing a doctor in Sydney

Find a GP near home. The healthdirect service finder lists GPs, pharmacies and after-hours clinics. Ask if they bulk bill.
Take your Medicare card (or the number from the Medicare app) to every appointment.
For advice out of hours, ring healthdirect on 1800 022 222. It's free and staffed by nurses 24 hours a day [7].
For emergencies, call 000 (triple zero), not 999, or go to a hospital emergency department.
Get prescriptions filled at any pharmacy ("chemist"). PBS medicines have a capped co-payment, lower with a concession card.

Sydney's big public hospitals include Royal Prince Alfred in Camperdown, St Vincent's in Darlinghurst, Royal North Shore in St Leonards, Prince of Wales in Randwick and Westmead in western Sydney. Children's emergencies go to Sydney Children's Hospital in Randwick or the Children's Hospital at Westmead. Waits in emergency departments can be long, much like A&E at home.

Bring any UK medical records, a list of your medicines with their generic names, and your vaccination history. UK brand names often differ in Australia.

The ambulance bill

This one surprises nearly every Brit. Medicare doesn't cover ambulances, and in NSW the patient pays, whoever made the call [5].

From 1 July 2025, an emergency road ambulance in NSW costs AUD 464 (about £240) for the call-out plus AUD 4.18 (about £2.15) per kilometre, up to AUD 7,601 (about £3,925) [5]. NSW residents pay less because the NSW Government subsidises 49% of the call-out charge [5]. Helicopters are charged the same way.

Most private hospital and extras policies include ambulance cover, and you can buy ambulance-only cover cheaply. Do it in your first week.

Keeping a foot in the NHS

The NHS is a residence-based service. Once you've moved to Australia, you're no longer entitled to free NHS hospital treatment as a matter of course when you visit the UK. Our guide to the NHS when you live abroad explains what you keep. Tell your UK GP you've moved, and ask for a copy of your records first.

People in our community group for Brits in Australia swap tips on bulk-billing GPs by suburb and which insurers they rate.

Healthcare in Sydney: Medicare, the UK agreement and private cover