Bulk billing for medical services

Bulk billing means you don't have to pay for your medical service provided by a healthcare professional. Instead, Medicare pays the full cost directly to your healthcare professional.

For example, if you see a doctor who bulk bills, after your visit the doctor bills Medicare directly and accepts the Medicare benefit as full payment. This means you do not have any out-of-pocket costs.

You can be bulk billed for a medical service if you are:

• enrolled in Medicare, and
• your healthcare professional chooses to bulk bill

Bulk billing can cover:

• visits to GPs and specialists
• tests and scans, such as x-rays and pathology tests
• eye tests from optometrists

If you and your regular GP are both registered with MyMedicare, you may be able to access additional services, such as:

• longer Medicare Benefits Schedule (MBS) funded telehealth phone calls (levels C and D) with your usual general practice
• triple bulk billing incentive for longer MBS telehealth consultations (levels C, D and E)

Not all healthcare professionals bulk bill. Before you see a doctor, ask if they bulk bill and if you will have any out-of-pocket costs. Sometimes doctors only bulk bill people with a concession or health care card.

At the doctor's office: You can ask if they can submit an electronic claim on your behalf. This means that Medicare will process your claim. Medicare then pays the benefit electronically into the bank account registered with Medicare or the account linked to the card that you paid with.

Online, by mail or at a service centre: If you did not claim your benefit at the doctor's office and your doctor did not make a claim for you, then you can claim:

• online through your myGov account or your Medicare online account
• by posting a completed Medicare claim form
• by visiting a Services Australia service centre.

If you are unsure if you can submit a claim, call Medicare general enquiries on 132 011.

Sometimes, you need to pay part of the cost of health services yourself. This is called a 'co-payment'.

The difference between the doctor's charges and the Medicare benefit is known as a 'co-payment', 'gap payment', 'gap fee' or 'out-of-pocket' cost.

Medicare sets a 'schedule fee' for each medical service. Medicare benefits are based on these fees to reflect a reasonable, average cost for that service.

Medicare will cover:

• 100% of the schedule fee for GPs
• 85% of the schedule fee for specialists
• 75% of the schedule fee for services provided during hospital treatment as a private patient

This means that if your specialist or the hospital bulk bills, they accept the Medicare benefit (which is only part of the schedule fee) as their full fee, and you will have no out-of-pocket costs.

For more information on bulk billing, visit the Services Australia bulk billing page.

The Australian Government's Medical Costs Finder can help you find and understand the cost to see a GP or medical specialist.

To learn more about MyMedicare, visit the Department of Health, Disability and Ageing.

Other Medicare services include the Australian Immunisation Register and the Australian Organ Donor Register.

You can find a full list of all Medicare services by visiting Services Australia. For all Medicare general enquiries, phone 132 011.

Read more on the healthdirect page What is Medicare?

Information for Aboriginal and/or Torres Strait Islander peoples

Find out how to get started with Medicare on the Services Australia website.

Read more about available health services and Medicare benefits as part of the Indigenous Access Program.

You can also call the Indigenous Access Line on 1800 556 955 for help with a Medicare service or payment.

Languages other than English

The Department of Health, Disability and Ageing provides more information about how bulk billing works in a range of community languages.

Easy Read resources

You can find Easy Read information about accessing healthcare services, including public and private hospitals:

• Adult health services — Easy Read explains how to access healthcare and what services you may need.
• When you go to hospital — Easy Read helps you understand what to expect when you are in hospital.
• MyMedicare: what it is and how to sign up — Easy Read explains how MyMedicare works and how to join.