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What is a Reciprocal Health Care Agreement?

A Reciprocal Health Care Agreement (RHCA) is an agreement between Australia and a select few countries to provide each other’s citizens with certain medical services for free or at a subsidised cost. However, RHCAs are usually conditional and limited, so they’re certainly no substitute for an adequate travel insurance policy.

Just so you know, different travel insurance policies (and insurers) will offer varying levels of cover. To be sure of what you’re covered for, read the Product Disclosure Statement (PDS) before buying the policy.

Which countries have reciprocal medical agreements with Australia?

As of June 2021, 11 countries around the world have Reciprocal Health Care Agreements with Australia, and each provides different services and coverage.

Belgium

Belgium’s RHCA with Australia will only provide essential care (i.e. cannot wait until you return to Australia).1 If you require emergency or essential medical care while in Belgium, the RHCA may cover:

  • your stay in hospital, except for the admission fee and a small daily fee, which you’ll be required to pay;
  • partial reimbursement for the services you receive in hospital;
  • part of the cost of seeing a GP or specialist. You’ll be required to pay between 25% and 40% of this cost;
  • part of the cost of receiving dental care, provided you have a referral from a doctor. You’ll be required to pay between 25% and 40% of this cost;
  • part of the cost of certain allied health services (like physiotherapy), provided you have a referral from a doctor. You’ll be required to pay between 25% and 40% of this cost;
  • some prescription medicines; and
  • half of the ambulance travel costs. You’ll be required to pay the other 50%.

You aren’t covered for anything that’s not on this list, including certain pharmaceutical medicines.

To claim your reimbursement under Belgium’s RHCA, you’ll need to pay for the services upfront and take your receipt, along with your passport and Australian Medicare card, to a Belgian health insurance provider.

Belgium flag at Gravensteen

Finland

To receive care under Finland’s RHCA with Australia, it needs to be essential and can’t wait until you come back to Australia.2 You’ll also need to pay a fee for all the treatment you receive from Finland’s health system. The treatment and services you may be entitled to include:

  • medical and nursing care from health centres
  • outpatient care in hospitals (e.g. when you attend hospital but aren’t admitted as a patient), whether you have a doctor’s note or have gone on your own volition
  • dental care in some clinics
  • prescription medicines
  • some costs incurred while travelling to receive medical care.

Finland’s RHCA with Australia doesn’t extend to covering (either for free or at a partial cost) the daily fees of staying in hospital or specialist and outpatient (i.e. treated in hospital without admission) charges.

To receive reciprocal health care, you’ll need to show your passport and Australian Medicare card. You’ll then have to pay for treatment at that time before you can go to a Finnish health insurer to claim your refunds.

Finland flag at Joensuu City Hall

Ireland

You can receive medically urgent care within 12 months of your arrival in Ireland under its reciprocal agreement with Australia, but you’ll be required to pay a fee for each service covered by the agreement.3 These services include:

  • maternity care
  • care you receive as a public patient in a public hospital
  • part of the cost of prescription medicines (if you have already spent a certain amount within one month).

The agreement won’t cover you for:

  • accommodation costs and care as a private patient at a private hospital
  • GP visits
  • prescription medicines if you haven’t spent the below the specified amount in one month
  • anything you organised before arriving in the country.

Ireland flag in a countryside fence

Italy

You can only receive reciprocal health care in Italy if:

  • it’s essential
  • you receive it through the national health system
  • it occurs within six months of your arrival in Italy.4

Italy’s RHCA may cover:

  • care in a public (and authorised) hospital as a patient or outpatient (i.e. when you’re treated in hospital but not admitted as a patient)
  • GP and specialist treatment in public clinics, authorised hospitals or health centres
  • emergency dental treatment in public hospitals.

You won’t be covered for the cost of medications and testing. You’ll have to show your passport and Medicare card to receive treatment.

Italy flag at Vittoriano

Malta

Malta’s RHCA with Australia may cover you for essential medical care that occurs within six months of your arrival in the country.5 You may be entitled to:

  • operations, medications, nursing care, accommodation and meals you receive in a government hospital
  • hospital outpatient care (i.e. when you’re treated in hospital but not admitted as a patient) you receive from government-employed specialists, public doctors and nurses at a health centre
  • emergency ambulance transport to hospital
  • urgent dental treatment in a government hospital.

You won’t be covered for non-urgent dental treatment, appliances and prostheses, and you’ll have to show your passport and Medicare card when receiving reciprocal medical treatment.

Malta flag at Port of Valletta

The Netherlands

If you’re visiting the Netherlands and need urgent medical care, the country’s RHCA can help you, provided it’s within the first 12 months of your arrival in the Netherlands.6 However, you’ll first need to apply for an A111 Certificate of Eligibility, which you can do before leaving Australia or once you arrive in the Netherlands. You’ll need your passport and Medicare card when filling in the application form.

You may be entitled to free medical care if Dutch health insurer Zilveren Kruis employs your treating doctor and you show them your A111 certificate.

If, however, you’re treated by a doctor who isn’t from this company, or you don’t provide your certificate, you may have to pay the bill up front and apply to Zilveren Kruis for a refund. You’ll still need to provide your certificate, along with the original bill or receipt and a completed claim form, to get a refund.

The Netherlands’ RHCA medical treatment can include:

  • GP, specialist or psychiatry services
  • nursing and specialist care in a hospital
  • childbirth in a hospital
  • treatment by paramedics
  • partial refund for ambulance or taxi transport to get urgent medical care
  • partial refund for prescription medicines in a hospital.

The Netherlands’ RHCA doesn’t extend to cover you for staying in a single room in hospital (unless essential), psychiatric care if you’re under 18 years old, repatriation costs or non-specialist dental treatment if you’re 18 years or older.

The Netherlands flag next to Spaarne in Haarlem

New Zealand

New Zealand’s public health system can treat you under the RHCA if you require urgent medical care (that can’t wait until you return to Australia) within two years of arriving in the country.7 All you have to do is show your passport and Australian Medicare card.

New Zealand’s RHCA covers hospital care, partial costs of GP-prescribed medications, maternity services and pharmaceuticals.

You won’t be covered for ambulance transport and treatment from a GP or other primary care.

New Zealand flag in Devonport Auckland

Norway

You’ll only be able to receive essential medical treatment from Norway’s public health system under the RHCA.8 ‘Essential treatment’ refers to care that can’t wait until you get home, and it must occur within 12 months of your arrival to Norway.

You’ll also need to show your passport and Medicare card for this treatment. Unfortunately, students and diplomats aren’t covered under Norway’s RHCA, and other adults may be required to pay a small fee for each service covered by the agreement.

Norway’s RHCA with Australia may cover you for:

  • care you receive from a National Insurance Scheme (NIS) GP, in a NIS hospital and as an outpatient (when you receive treatment in a hospital without being admitted as a patient) in a NIS hospital
  • specialist or other medical treatment as prescribed or referred by a NIS GP
  • ambulance transport
  • urgent dental treatment
  • childbirth care
  • prescription medicine (after you’ve spent a certain amount on medicines in 12 months)
  • oxygen therapy
  • dialysis.

The RHCA also provides free:

  • health care for children up to 12 years old
  • doctor consultations for children up to 16 years old
  • prescription medications for children up to 16 years old
  • psychological care for children up to 18 years old.

Norway flag in Port Bergen

Slovenia

When visiting Slovenia, you’ll be able to receive urgent medical care for only part of the total cost; you’ll just need to show your passport and Medicare card.9

Slovenia’s RHCA could cover you for:

  • partial costs of treatment in hospitals, health centres and pharmacies within the public health system
  • partial costs of treatment you receive from private GPs, specialists, dentists and pharmacies contracted to the Health Insurance Institute of Slovenia (HIIS)
  • a percentage of the cost of certain prescription medications and medicines
  • emergency ambulance transport if referred by a doctor, and part of the cost of other ambulance transport.

The agreement doesn’t cover:

  • other medicines
  • treatment by non-HIIS GPs, specialists and dentists.

Slovenia flag at Lake Bled

Sweden

You can access essential medical treatment in Sweden by showing your passport and Medicare card.10 This may entitle you to:

  • free maternity services
  • partial costs for prescription medicines
  • care from a doctor and as a hospital outpatient (i.e. you’re not admitted into hospital as a patient).

Children will receive all health services for free, while adults may still be required to pay a small fee for the above health services. However, Sweden’s RHCA with Australia doesn’t cover the cost of staying in a hospital.

Sweden flag at Skerry Coast

United Kingdom

If you’re visiting the UK and need urgent medical care that can’t wait until you return to Australia, the UK’s RHCA will cover you so long as you seek treatment through the National Health Service (NHS) within six months of you arriving there.11

Ask to be treated as an NHS patient and have your passport and Medicare card ready to show the staff. You’re then eligible for:

  • treatment by NHS GPs and nurses in clinics (provided you register as an NHS patient)
  • care while in a public ward of an NHS hospital
  • care in an NHS hospital when you’re not admitted as a patient (i.e. outpatient care)
  • ambulance transportation to an NHS hospital or other facility
  • partial costs for prescription medications as an NHS patient.

You wouldn’t be covered for any type of dental care, as well as costs for medication that isn’t subsidised or prescribed to you if you weren’t treated as an NHS patient.

United Kingdom flag at The Moat in Donaghadee

woman embracing the view in Santorini Greece

How do Reciprocal Health Care Agreements benefit visitors to Australia?

Thanks to the Reciprocal Health Care Agreement with the 11 countries listed above, visitors to Australia can also access our public health system. However, you must meet eligibility conditions to access Australian health care under your country’s Medicare reciprocal agreement; these conditions vary between the 11 countries. What’s more, your Reciprocal Health Care Agreement cover may only last for a certain amount of time, which also varies.

Visitors to Australia can also take out health insurance for overseas visitors while in Australia.

Belgium

You must have been living in Belgium prior to your arrival in Australia and have insurance through Belgium’s health system to enrol in Medicare and receive the benefits and payments from your treatment.12 Students visiting Australia on student visas and diplomats and their families are also eligible.

To enrol in Medicare, you’ll need to visit a service centre once in Australia with the completed enrolment form and supporting documents. These documents can include passports, visas and Belgian and European Health Insurance Cards. Visit the Services Australia website to find out which documents you may need to provide and any other conditions you might need to meet.

You’ll be covered under the RHCA from the day you arrive in Australia until your Belgian Health Insurance Card, European Health Insurance Card or visa expires (whichever comes first). If you receive medical treatment before you’ve enrolled in Medicare, you may be able to claim the benefit once your enrolment is completed.

The treatments covered by the RHCA can include medically necessary hospital care and some Pharmaceutical Benefits Scheme (PBS) medications.

Finland

To be eligible for treatment under the RHCA, you’ll need to have been living in Finland before your arrival.13 Once you’ve arrived, you’ll also need to enrol in Medicare by going to a Medicare service centre with your completed enrolment form.

To assist your Medicare application, you’ll need to provide documentation, like your passport, visa, European Health Insurance Card, Sickness Insurance card and evidence that you live in Finland (this could include work contracts or bank statements). You can find out which documents you’ll need to supply through the Services Australia website.

Diplomats and their families are eligible to enrol in Medicare, but people travelling to Australia from Finland on a student visa are not.

Those who qualify for RHCA services will be covered from when they first arrive in Australia until either their visa or Finnish health insurance expires. If you receive treatment between this time and when your Medicare enrolment is complete, you may be able to claim retrospectively. Finland’s RHCA with Australia covers necessary medical care in and out of hospitals, as well as certain PBS medications.

Ireland

If you’re an Irish resident and lived there in the six months before you came to Australia, you can be treated under the RHCA.14 You also don’t need to enrol in Medicare.

You can be covered for necessary inpatient and outpatient hospital care, in addition to some PBS medicines. When treated at a public hospital or pharmacy, you’ll need to ask the staff to treat you as a patient under Australia’s RHCA with Ireland. You’ll also have to show your Irish passport and European Health Insurance Card, and you might also have to prove that you live in Ireland.

You’ll be covered from the day you arrive in Australia until your visa expires.

Italy

If you’re travelling to Australia from Italy, you must be an Italian citizen and eligible for your home country’s national health insurance to access health care under Australia’s RHCA.15 You can access necessary healthcare from a public hospital and certain PBS medications.

You’ll first need to enrol in Medicare. People with student visas and diplomats and their families are eligible to enrol in Medicare.

To enrol in Medicare in Australia, you’ll need to take a completed enrolment form to a Medicare service centre, along with documentation that proves your Italian citizenship. These can include:

  • your passport and current visa
  • your valid European and Italian Health Insurance Cards
  • a statutory declaration of your eligibility to receive medical care under national health laws in Italy.

You can be covered under Australia’s RHCA with Italy from the day you arrive in Australia until either six months have elapsed or your European Health Insurance Card, Italian health insurance or visa expires. You can still submit a Medicare claim if you receive treatment between arriving in Australia and enrolling in Medicare.

Malta

Maltese visitors to Australia can access medically necessary health care and some PBS medications under the Medicare reciprocal agreement provided you are a citizen of Malta and were living there before arriving in Australia.16 Unfortunately, if you travelled to Australia on a student visa, you’re not eligible to receive RHCA benefits.

You need to enrol in Medicare once you’re in Australia to receive your benefits, which you can do by completing a Medicare enrolment form and taking it to a service centre, along with supporting documentation. This documentation can include your passport and visa as well as residential proof, like work contracts or bank statements.

You’ll be covered by the reciprocal agreement for six months after you arrive in Australia, or sooner if your visa expires before that time. If, however, you receive medical treatment after arriving in Australia, but before you can enrol in Medicare, you may still be able to submit a claim once you have enrolled.

The Netherlands

If you were living in the Netherlands before you came to Australia and are enrolled in the Netherlands Health Insurance Scheme, you could receive necessary treatment from a public hospital, as well as certain PBS medications, under your country’s RHCA with Australia.17 This is provided you enrol in Medicare, and people with student visas and diplomats and their families are all eligible for Medicare.

To receive Medicare payments for your health care under the RHCA, you’ll need to enrol by completing an enrolment form and taking it to a Medicare service centre once in Australia. You’ll also be required to supply Medicare with documentation, like your:

  • passport
  • Visa
  • proof of insurance with the Netherlands Health Insurance Scheme
  • a valid European Health Insurance Card or proof that you reside in the Netherlands.

You can find out which documents you’ll need through the Services Australia website.

Australia’s RHCA with the Netherlands will cover you from the day you arrive in Australia until your Netherlands health insurance, European Health Insurance Card or visa expires (whichever comes first). If you need medical treatment after you arrive in Australia, but before you’ve enrolled in Medicare, you can still submit a claim after your enrolment is completed.

New Zealand

If you’re a New Zealand citizen or permanent resident and temporarily visiting Australia, you can receive inpatient and outpatient treatment in a public hospital and some PBS medications under the RHCA.18 You don’t need to enrol in Medicare to be eligible, but when in a public hospital or pharmacy, you must provide them with your New Zealand passport and ask your treating staff to treat you under the agreement. You’ll be covered from your arrival in Australia until your departure.

Norway

You may be eligible for medical treatment in an Australian public hospital and certain PBS medications if you were living in Norway before coming to Australia, are a member of Norway’s National Insurance Scheme and enrol in Medicare when you arrive here.19

However, if you’re visiting Australia on a student visa or are a diplomat or member of a diplomat’s family, you won’t be eligible for RHCA services.

To enrol in Medicare and receive your payments for medical treatment, you’ll need to take a completed enrolment form to a Medicare service centre after arriving in Australia. You’ll also need to provide documentation, like your passport, current visa, proof of insurance under the Norwegian National Insurance Scheme and a valid European Health Insurance Card.

Cover under the RHCA will begin when you arrive in Australia and cease when your visa, Norwegian health insurance or European Health Insurance Card expires (whichever comes first). You can still submit a Medicare claim once you’ve enrolled if you received medical treatment before you were able to enrol.

Slovenia

As a visitor from Slovenia, you can be eligible for some public hospital services and PBS medications if you were living there before you arrived in Australia and are insured by the Slovenian health system.20 Diplomats, their families and people travelling on student visas are eligible for cover.

You’ll first need to enrol in Medicare, and you can do that by completing the enrolment form and providing Medicare with some documentation at a service centre in Australia. These documents could include your passport, current visa and Slovenian and European Health Insurance Cards. Visit the Services Australia website to find out what documentation you’ll need to provide.

Your RHCA coverage will begin when you arrive in Australia and end once your visa or Slovenian or European Health Insurance Cards expire (whichever expires first). If you received medical treatment in Australia before you could enrol in Medicare, you might still be able to submit a claim for benefits.

Sweden

Swedish visitors to Australia could receive medical care under the RHCA if they lived in Sweden before coming to Australia.21 People travelling on student visas and diplomats and their families are also eligible.

If you’re visiting Australia from Sweden, you’ll need to enrol in Medicare if you want to be treated under the RHCA by visiting a service centre in Australia. You just need to complete the enrolment form and supply Medicare with documentation like your passport, visa, proof of Swedish residency, your valid European Health Insurance Card and your Swedish Social Insurance Health Insurance Certificate. You’ll then be covered by the Medicare reciprocal agreement from the day you arrive in Australia until either your visa or Swedish health insurance expires.

Sweden’s reciprocal agreement with Australia covers medically necessary care in public hospitals and certain PBS medications. If you happen to need medical treatment before you can enrol in Medicare, you can still submit a claim for benefits once you have enrolled.

United Kingdom

If you were living in the UK before arriving in Australia, travelling from the UK on a student visa or are a diplomat or member of a diplomat’s family, you’re eligible to receive medical care under your country’s RHCA with Australia.22 The agreement covers medically necessary care in Australian public hospitals and certain medications listed on the PBS.

You’ll need to enrol in Medicare to receive the benefits and payments for your medical services and treatments. To do this, complete an enrolment form, take it to a service centre once in Australia and, depending on your UK citizenship status, provide the following documentation:

  • British or Northern Irish passport
  • current visa
  • proof of British citizenship or residency
  • European Health Insurance Card
  • National Health Insurance Card (for residents of Great Britain and the Isle of Man)
  • Health Service card (for residents of Northern Ireland)
  • Health and Social Services Department health card (for residents of the States of Jersey)
  • proof of insurance coverage from the Guernsey States Insurance Authority or other evidence of your residency in Guernsey
  • proof that you live in the UK.

Visit the Services Australia website to find out which documents you’ll need to provide to enrol in Medicare.

Your RHCA coverage will start when you arrive in Australia and cease once your visa or British health insurance expires (whichever comes first). You can still submit a claim for medical treatment if you received it before enrolling in Medicare.

man with backpack walks through a market in Thailand

Please note: All information on this page is correct as of June 2021. Cover and requirements are subject to change.

Do I still need travel insurance when I visit Medicare reciprocal countries?

It’s still important to take out travel insurance when you’re visiting a reciprocal health care country – or any country in the world, for that matter.

While reciprocal health care agreements are helpful, they offer a limited amount of coverage for your medical costs and are intended for those who are staying in the reciprocal country for an extended amount of time (i.e. not holidaymakers). What’s more, only 11 out of the 190+ countries in the world have this type of agreement in place with Australia.

Travel insurance policies can generally cover you for so much more than the urgent medical care you could get through reciprocal agreements. Aside from cover for emergency medical expenses and medical repatriation back home, travel insurance can cover:

  • cancellations and journey amendments
  • lost, stolen or damaged luggage
  • lost, stolen or damaged personal belongings
  • legal liability (e.g. when you cause injury or death to someone else)
  • emergency dental treatment
  • rental car excess
  • delayed travel costs
  • theft of cash.

Many insurers offer varying levels of cover, so you can choose how much insurance you want based on your type of travel and your budget.

Having travel insurance in place is far more effective compared to relying only on a limited health care agreement in a handful of countries around the world. This is especially true when you consider the choice, flexibility and peace of mind that comes with having cover.

Compare travel insurance today to find great value!

If you’re heading on an overseas trip soon, you could stand to benefit from comparing travel insurance policies – whether you’re going to a Reciprocal Health Care Agreement country or not!

Our fast, free and simple travel insurance comparison service can help you do just that. Just enter in some details about your trip, and you can compare travel quotes, features, terms and conditions in one place.

What’s more, we don’t mark up the prices of the travel policies on our service. How’s that for convenience?

Sources

1 Australian Government: Services Australia – Visiting Belgium. Last updated September 2019. Accessed June 2021.
2 Australian Government: Services Australia – Visiting Finland. Last updated January 2020. Accessed June 2021.
3 Australian Government: Services Australia – Visiting the Republic of Ireland. Last updated September 2020. Accessed June 2021.
4 Australian Government: Services Australia – Visiting Italy. Last updated January 2020. Accessed June 2021.
5 Australian Government: Services Australia – Visiting Malta. Last updated January 2020. Accessed June 2021.
6 Australian Government: Services Australia – Visiting the Netherlands. Last updated May 2021. Accessed June 2021.
7 Australian Government: Services Australia – Visiting New Zealand. Last updated January 2020. Accessed June 2021.
8 Australian Government: Services Australia – Visiting Norway. Last updated January 2020. Accessed June 2021.
9 Australian Government: Services Australia – Visiting Slovenia. Last updated March 2021. Accessed June 2021.
10 Australian Government: Services Australia – Visiting Sweden. Last updated January 2020. Accessed June 2021.
11 Australian Government: Services Australia – Visiting the United Kingdom. Last updated January 2020. Accessed June 2021.
12 Australian Government: Services Australia – Visiting from Belgium. Last updated March 2021. Accessed June 2021.
13 Australian Government: Services Australia – Visiting from Finland. Last updated March 2021. Accessed June 2021.
14 Australian Government: Services Australia – Visiting from the Republic of Ireland. Last updated May 2021. Accessed June 2021.
15 Australian Government: Services Australia – Visiting from Italy. Last updated March 2021. Accessed June 2021.
16 Australian Government: Services Australia – Visiting from Malta. Last updated March 2021. Accessed June 2021.
17 Australian Government: Services Australia – Visiting from the Netherlands. Last updated March 2021. Accessed June 2021.
18 Australian Government: Services Australia – Visiting from New Zealand. Last updated May 2021. Accessed June 2021.
19 Australian Government: Services Australia – Visiting from Norway. Last updated March 2021. Accessed June 2021.
20 Australian Government: Services Australia – Visiting from Slovenia. Last updated March 2021. Accessed June 2021.
21 Australian Government: Services Australia – Visiting from Sweden. Last updated March 2021. Accessed June 2021.
22 Australian Government: Services Australia – Visiting from the United Kingdom. Last updated March 2021. Accessed June 2021.

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