In general, while in Australia, trans and gender diverse people have the right to pursue gender‑affirming care regardless of visa status. This factsheet explores how visa issues may impact the affordability of gender-affirming care, and common concerns people have about accessing gender-affirming care while on a temporary visa.
Accessing gender-affirming care using Medicare
Medicare
Medicare is Australia’s government funded health insurance, providing free or low-cost health care services to eligible people – including medical services, treatments, tests, prescription medications, specialist services, and mental health services.
Many trans and gender diverse people are able to use Medicare when seeking gender‑affirming care to help reduce the cost of treatments and doctors’ appointments. Some people, even if they do have Medicare, may choose to go with a private doctor and pay private fees and/or use their private health insurance cover. It is your choice which doctor you prefer.
You can talk to your doctor about making sure you receive a Medicare rebate for any eligible treatments you seek. In some cases, hormone replacement therapies can be covered by Medicare.
Even if you do not have Medicare, there are some free or low‑cost health services that provide gender‑affirming care (see here).
Generally, all Australian and New Zealand citizens and Australian permanent residents are eligible to use Medicare. Some types of temporary visa holders are also eligible.
Reciprocal Health Care Agreements
People on temporary visas visiting Australia from certain countries can also access Medicare through Reciprocal Health Care Agreements. These are agreements between the Australian government and their home country’s government to ensure people can access affordable healthcare while visiting each other’s countries.
| Countries that currently have Reciprocal Health Care Agreements are: – Belgium – Finland – Ireland (public hospital care and PBS medicines only, not MBS services) – Italy (eligibility limited to six months from date of each arrival) – Malta (eligibility limited to six months from date of each arrival) – The Netherlands – New Zealand (public hospital care and PBS medicines only, not MBS services) – Norway – Sweden – Slovenia – United Kingdom (including Northern Ireland) |
The agreements vary in scope and are subject to change. For the latest information, visit the Services Australia website.
Medicare eligibility – Bridging visas and Family & domestic violence
If you are not from one of these countries, are in Australia on a temporary visa, and want to know if you are eligible for Medicare, there are a few ways to find out:
- Your visa type
- Your visa conditions
- Whether you have applied for a permanent visa
If you have applied for a Permanent Visa (other than a Parent visa) and have a bridging visa with work rights, in most cases you will also be eligible for Medicare.
If you have applied for a Permanent Visa and have a bridging visa without work rights, you are usually not Medicare eligible. However, you might be able to apply to change your bridging visa conditions to allow work rights – this may make you eligible for Medicare.
If you do not have a bridging visa that allows you to work and access Medicare, you may meet an exception if you have a family relationship (parent, de facto, spouse or child) that is an Australian permanent resident, or an Australian or New Zealand citizen.
You can check your bridging visa type and conditions on your Visa Grant Notice, or online through VEVO or ImmiAccount. You can check on this government website for guidance. If you don’t understand your conditions or would like to apply for work rights, seek immigration advice.
There are many exceptions to these rules. If you have applied for a Parent visa, a refugee or protection visa, have a regional work visa, a PALM scheme visa, or some other visas, we recommend getting immigration advice or talking directly to Medicare.
If you have experienced family or domestic violence while on a visa, you may also be eligible for Medicare. You should talk to an immigration lawyer (for example, at IARC).
If you believe you should be eligible for Medicare but encounter difficulties accessing it, seek advice from an immigration lawyer, as there can be errors in government systems.
Apply for a Medicare Card
If you are eligible, you need to apply for a Medicare card to use the benefits. You can apply online or using a paper form, and you will need to provide ID to verify your identity. If you are having problems with proving your identity, ICLC can help.
Accessing gender-affirming care using Health Insurance & non-Medicare services
If you are not Medicare eligible, you will need to either pay the full cost of gender‑affirming care, use private health insurance, or find a free service.
Many people on temporary visas have health insurance. For example, some student visa holders and their dependents are required to have Overseas Student Health Cover (OSHC). OSHC insurance providers must follow government rules about coverage for different treatments and services. Depending on the treatment, this may include some forms of gender‑affirming care if they are listed on the Pharmaceutical Benefits Scheme (PBS) and Medicare Benefits Schedule (MBS) (i.e., would be covered for someone on Medicare).
Different insurance providers offer different types of cover. Check the Product Disclosure Statement (PDS) and the schedule or certificate of insurance to see whether gender‑affirming care is covered. Your insurer must give you copies of these when you ask. If you are having difficulty understanding these documents, seek advice.
For example, ‘medically necessary breast surgery’ is often covered by such insurance. You should talk to your doctor, read the PDS, or seek legal advice to determine if your health insurance while in Australia will cover (or partially cover) the cost of breast surgery.
Private health insurance companies cannot cancel your visa or cancel your health insurance just because you try to use the insurance to access gender-affirming care.
Your health insurance provider must follow Australian privacy law. For example, they cannot tell your parents about what kind of healthcare you are receiving without your permission. Check your insurer has the correct contact details (e.g. the nominated email address is yours, not your parents’ or education agents’).
You should seek legal advice about your rights and options if:
- your health insurer is unfairly refusing to cover your gender-affirming care,
- if the policy in the PDS is unclear or unfair,
- your insurer is being very harsh or unfair,
- your insurer is breaching anti-discrimination laws
- your insurer is engaging in misleading advertising or deceptive conduct
You can make a free complaint about your health insurance provider to the Commonwealth Ombudsman or the Australian Financial Complaints Authority.
Visa health checks
When you apply for some kinds of visas, you and your family members may be asked to undergo health examinations. You will be told beforehand what kind of health tests are required. You can find out here what kind of health tests are requested for different types of visas.
At time of writing, these health examinations do not test for or ask specifically about gender-affirming care. You may be asked about any medications you are currently taking.
Some visas will have health criteria that look at the cost of treating a particular disease or condition while in Australia, or access to health services in high demand (such as a heart or kidney transplant). If you are concerned about a health condition like this, seek legal advice before applying for a visa, as some chronic health conditions can make people ineligible for certain visas.
Will accessing gender-affirming care affect my visa?
Being trans or gender diverse or accessing gender-affirming care (or not) is generally not considered relevant when applying for a visa in Australia.
You may want to choose to disclose that you are seeking gender-affirming care if this benefits you. For example, if you are seeking refugee status and a protection visa, you may want to explain that because you are seeking gender-affirming care you might face harm and transphobia in your country of origin.
Some visas (such as a tourist visa), have a ‘genuine temporary purpose’ criterion, meaning you intend a short‑term stay in Australia for a short‑term purpose (such as a holiday). If you tell Immigration something that suggests you do not intend to stay short‑term (for example, that you want to stay in Australia forever because you fear transphobia in your home country), you may no longer be found to meet the ‘genuine temporary purpose’ criterion.
We recommend seeking advice from an immigration lawyer if you think this may apply to you.
References & Links
Medicare – myGov
Enrolling in Medicare – Services Australia
About reciprocal health care agreements – Services Australia
Check visa details and conditions – The Department of Home Affairs
Overseas Student Health Cover (OSHC) – Study Australia
What health examinations you need – The Department of Home Affairs
