28th Nov 2019 – UPDATE:
Firstly, thank you to David W who let us know via Facebook, that the Department of Human Services website has recently been changed to omit a key statement about the ability for non-residents to continue to use Medicare for a period of up to 5 years after departing Australia.
In my original article under the heading “Can I still use Medicare when I am a non-resident?” (below), I referred to the Department of Human Services website and provided a link to the relevant page on that site. To maintain the integrity of the original article, I have retained the link as it was originally written in my original article.
Please note note that the information on the Medicare site has now changed and that the following original statement (in italics) has now been omitted:
If you’re an Australian citizen and you live overseas
If you’ve moved overseas, you continue to be eligible for Medicare for 5 years. The 5 years starts from the date you first left Australia.
You can’t access Medicare services from outside of Australia. If we have a Reciprocal Health Care Agreement with the country you’re in, you may get access to medically necessary care. You’ll need a Medicare card to do this.
If you live overseas for more than 5 years you’ll no longer be eligible for Medicare. You will need to re-enrol in Medicare when you move back to Australia to live.
If you wish to see the original webpage before the statement was omitted you can view a historical snapshot of Medicare’s website from the internet archive website (the “Wayback Machine”) – see below:
The original Medicare webpage (referred to in our article below)
Notwithstanding that the statement (in italics) above has been removed from the Department of Human Services’ website, in researching this issue extensively, we did not find any reference to any change in policy. As such, we are not aware of any changes to the original policy. We will seek clarification from Medicare and will update this article as we learn more.
We do however, highly recommend that if you are unsure about your circumstances at all, please be sure to call Medicare and check your entitlements based on your own personal circumstances.
28 Nov 2019
Original post below
Am I entitled to use Medicare when I return home to Australia for short visits?
Moving overseas is daunting. There is new work, trying to find a decent place to live, new maps to scrutinise, new cities to get used to and a whole new set of rules when it comes to the country’s you’ve moved to.
But learning about your new country isn’t all, there’s a lot of things that you’ll need to learn about Australia and how things work when you’re an Australian expat living and working overseas.
And so in this article, I want to take you through a question about Medicare for Australian citizens overseas, that’s very commonly asked by many of our expat clients – are you entitled to use Medicare when you return home for short visits (e.g. for work or to visit family and friends)?
Medicare for Australian citizens overseas – clearing up the confusion
For any Australian expat who is confused about the Medicare for Australian citizens overseas, take a look below.
An Australian resident (i.e. a resident of Australia for Australian tax purposes), living and working overseas as an expat will remain liable for a 2% Medicare Levy (i.e. 2% of their taxable income), if their taxable income exceeds $27,475 (for singles) and $46,361 (for couples) plus $4,257 for each dependent child for 2017-18.
In addition to the Medicare Levy, if the income of an Australian tax resident exceeds $90,000 (singles) or $180,000 (couples) a further Medicare Levy Surcharge of between 1 – 2% applies if they do not maintain private health cover for all their dependents, even when they are not living in Australia.
Note that the Australian Taxation Office (ATO) uses a special definition of income called “Income for Medicare Levy Surcharge purposes” in determining who is required to pay the surcharge. For the purposes of this email I won’t run through every element of income that is included in that definition as too much detail is required, but you might be surprised to learn that tax losses (e.g. losses made on negatively geared rental properties) are added back in as income, as are any tax exempt income that you may have earned (e.g. income earned from government approved foreign aid projects where you’ve worked overseas for 91 days or more).
So what are the implications if I am an Australian tax resident whilst living and working overseas?
In short, if you’re working overseas, you’ll remain liable for the Medicare Levy. And since you are liable for the levy, it also means that you remain eligible to use Medicare as and when you need it, whenever you are present in Australia.
What about the Medicare Levy Surcharge? Do I have to pay that too?
If you’re a relatively high income earner, earning above $90,000 as a single or $180,000 combined as a couple, then it’s highly recommended that you maintain an appropriate level of Australian private health insurance.
The key word to note here is the word “Australian”, because in order to qualify as appropriate private health insurance your health cover MUST be provided by a health fund registered under the Private Health Insurance Act 2007 – to check your fund, take a look at the list of registered funds on the Private Health Insurance Ombudsman’s website.
If you do maintain an appropriate level of Australian private health insurance, although you will still be required to pay the Medicare Levy, you’ll be exempt from paying the Medicare Levy Surcharge.
Take Care: – Don’t assume that just because your overseas employer provides you with health insurance that you are exempt from paying the Medicare Levy Surcharge. Most, if not all overseas health funds ARE NOT registered funds under the Private Health Insurance Act 2007. So if that’s the case, then you should consider taking out some basic Australian health insurance cover in addition to your overseas health cover.
Note: ‘Extras Cover’ also known as ‘General Cover’ (including items such as optical, dental, chiropractic treatment and physiotherapy etc) is not private patient hospital cover. So there’s no need to purchase ‘Extras Cover’ as this will just increase your costs unnecessarily. Similarly, travel insurance is not private patient hospital cover for the purposes of the Medicare Levy Surcharge.
What is an appropriate level of health cover?
As stated on the ATO website, for singles, an appropriate level of cover must have an excess of $500 or less. Couples or families must have an excess of $1,000 or less.
What if I am a non-resident?
If you are a non-resident for Australian taxation purposes, then you will NOT be required to pay the Medicare Levy, and neither will you be liable to pay the Medicare Levy Surcharge.
Can I still use Medicare when I am a non-resident?
There are so many misconceptions about a non-resident’s entitlement to Medicare, particularly from the Australian accounting profession, but also among expat circles generally.
In fact most expats and their accountants will emphatically state that if you are a non-resident and you’re not required to pay the Medicare Levy then, under no circumstances will you be eligible to claim Medicare benefits.
However, that advice is nonsense. In fact, if you’ve ever received that advice, then your advisor has done you a great disservice as that advice it is INCORRECT.
So let’s lay this question to rest once and for all.
If you are an Australian citizen who is a non-resident expat, living and working overseas, although you can’t use Medicare forever, you CAN use Medicare and claim Medicare benefits for a period of up to 5 years from the date that you first left Australia.
So let me just reiterate that again . . . the bottom line is, that non-resident Australians who are living abroad, are eligible to use Medicare and claim Medicare services on trips back to Australia for a period of up to 5 years after departing Australia originally. For further information, take a look at the Department of Human Services website where you can confirm this fact.
Note though that if your Medicare card has an expiry date of less than the 5 years, practically speaking you won’t be able to renew your Medicare card whilst living overseas and so in that instance, you will be limited in claiming Medicare benefits to the date of expiry of your card.
Can I access Medicare services outside of Australia?
Typically you won’t be able to access Medicare services from outside of Australia unless you live in (or a visiting) a country that has a Reciprocal Health Care Agreement with Australia.
In that case, you may be able to access to medically necessary care however you’ll need to check the eligibility rules of that specific Reciprocal Health Care Agreement. If seeking access to medical care under a reciprocal Health Care Agreement, you’ll also need to take with you, your passport and your Medicare card.
Additionally, if you live overseas for longer than 5 years you’ll no longer be eligible for Medicare and you’ll need to re-enrol in Medicare when you eventually move back to Australia to live.
What countries does Australia have a Reciprocal Health Care Agreement with?
As at the date of writing, Australia has Reciprocal Health Care Agreements with 11 countries around the globe – take a look below:
I’ve heard that if I claim Medicare benefits whilst I am a non-resident, this may affect my residency status. Is that true?
As much as I’d truly love to give a definitive answer, the only answer that I can give is “possibly”.
Unfortunately, residency is a very complex topic that hinges around the facts and circumstances of a your life, along with constantly evolving principles laid down in precedential court cases, court ruling and ATO tax rulings. So unfortunately the answer is not as easy as it seems.
But, let me try and answer it this way.
Non-residents who claim Medicare benefits whilst visiting Australia, will show a stronger connection, or durability of association with Australia than those that don’t. The durability of association that a person has with Australia is a key factor in determining a person’s residency status and so claiming Medicare benefits will be a stronger indicator for residency.
However, it should be noted that this factor alone will not mean that you are a resident for Australian taxation purposes. Combined with a bunch of other factors that also support lean towards the residency side of the equation, claiming Medicare benefits could tip you over the edge, in which case you could be found to be a resident of Australia.
However, just because you’ve claimed Medicare benefits whilst in Australia it doesn’t necessarily mean that you will lose your non-residency status.
If you want to learn more about how these rules affect you, or if you are nervous about your losing your non-residency status by claiming Medicare benefits, I highly recommend that you book in for a tax consultation (below) so that we can run through all the issues for you and set your mind at ease:
One last thing
If you feel that the information in this article was useful, please feel free to share this with any other expat Australians that you feel my benefit from this information.
Thanks for reading.
Shane’s an Australian Chartered Accountant and Australian expat tax specialist who’s also an expat himself (based in Asia). Shane’s passionate about tax and legitimate tax minimisation, tax-planning and structuring, particularly as it relates to Australian expats who are often subject to high rates of tax back home in Australia.
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