Travel insurance for Australians: what Medicare actually covers overseas

Start with the blunt version: Medicare does not cover you overseas. Not in Bali, not in London, not anywhere. The moment you leave Australia, you're paying full private rates for any medical care you need.

What partially fills the gap is a set of Reciprocal Health Care Agreements, and understanding exactly what they do — and don't — do is the difference between a manageable bill and a catastrophic one.

The 11 countries with agreements

Australia has Reciprocal Health Care Agreements with the United Kingdom, New Zealand, Ireland, Sweden, the Netherlands, Finland, Norway, Belgium, Slovenia, Malta and Italy.

Note who is not on that list: the United States, Japan, Thailand, Indonesia, Singapore, the UAE, and every other destination in Asia and the Pacific.

What the agreements actually cover

They cover immediately necessary treatment in the public health system of that country. Broadly, that means care you couldn't reasonably wait until you got home for.

They do not cover:

• Medical evacuation or repatriation to Australia — the single biggest cost in a serious overseas incident
• Ambulance transport in most of the countries listed
• Treatment in private hospitals
• Non-urgent or elective treatment
• Anything at all that isn't medical: cancelled flights, lost luggage, stolen phones, a cancelled trip

Malta and Italy also cap the cover at six months, and each country's agreement has its own quirks. Services Australia publishes the specifics country by country, and it's worth reading for your destination rather than assuming.

Practically: bring your Medicare card and your Australian passport. In the UK, those two documents get you NHS treatment at resident cost. That's genuinely valuable — and it still isn't travel insurance.

Why evacuation is the real number

A GP visit overseas costs a few hundred dollars. That's annoying, not ruinous.

The number that ruins people is medical evacuation. An air ambulance from Bali to Darwin runs $40,000 to $100,000. From a Fijian outer island, similar. From Europe, more. Nobody pays that out of savings.

That's the risk travel insurance actually exists to cover, and it's why "I'm only going to Bali for a week" is not a reason to skip it.

The United States is its own category. There's no reciprocal agreement, and US healthcare is the most expensive in the world — an ambulance ride alone is around USD $1,500, and a few days in hospital can exceed AUD $100,000. For the US specifically, look for unlimited or very high medical cover, not a $5 million cap.

What to compare in an Australian policy

Price is the least useful number on the page. These are the ones that matter:

Overseas medical and evacuation limit. "Unlimited" is standard on comprehensive Australian policies and is what you want. Be suspicious of anything capped below $5 million.

Excess. Often $200 – $250, and often reducible to zero for a higher premium. A low excess matters if you're likely to make a small claim; it's irrelevant to the evacuation scenario.

Pre-existing conditions. This is where most declined claims originate. Australian insurers require you to declare pre-existing conditions, and many are automatically covered while others need assessment and an extra premium. Undeclared conditions void the claim — including things you might not think of as conditions, like blood pressure medication.

Activity exclusions. Standard policies exclude a lot: riding a motorcycle or scooter (especially without the correct licence class), scuba diving below certain depths or without certification, skiing off-piste, and anything described as an "adventure activity". If it's on the itinerary, check the PDS and pay for the add-on.

Cancellation cover. Should at least match what you've paid upfront and can't get back. Unlimited cancellation cover is only worth paying for if your trip is genuinely expensive.

"Do not travel" exclusions. Almost every Australian policy voids cover in regions Smartraveller rates "Do not travel". This matters in the Philippines (parts of Mindanao) and in several destinations where the national advisory differs from the regional one. Check the region, not just the country.

Two things that catch Australians out

Credit card insurance is real, but narrow. Many Australian premium cards include travel insurance, and it can be genuinely good cover. The conditions are strict: you usually have to pay for a minimum portion of your trip on that card, activate the cover in advance, and accept lower limits and tighter age restrictions. Read the policy document, not the marketing page.

Buy it when you book, not when you fly. Cancellation cover only works if the policy exists before the thing that causes the cancellation. Buying insurance the week you leave means you've had no cancellation cover for the months your money was already committed.

The bottom line

For the 11 reciprocal countries, the agreement is a useful backstop that reduces your exposure to routine medical costs. Everywhere else, and for evacuation everywhere, you're on your own.

Compare policies for your destination, read the PDS for the exclusions that apply to what you'll actually be doing, and buy it the day you book the flights.

This is general information, not personal financial advice. Always read the Product Disclosure Statement and Target Market Determination before buying a policy.