An Australian Medicare Card is a green-coloured plastic card (or light blue for interim cards) that is issued to individuals or families who are eligible to receive a rebate of medical expenses under the Australian Medicare system when they are treated privately by a doctor with a provider number. All permanent residents of Australia are eligible for a Medicare Card, except for those resident on Norfolk Island or those who are not deemed to be residing in Australia, where the Medicare system does not apply; eligibility is not based on Australian citizenship. The card lists an individual as well as any members of his or her family he or she chooses to add who are also permanent residents and meet the Medicare definition of dependent. The card must be produced or the Medicare number provided if the Medicare rebate is paid directly to the doctor under the bulk billing system. It is also necessary to provide a Medicare number (although not necessarily show the card) to gain access to the public hospital system to be treated at no cost as a public patient. For non-elective treatment (e.g. emergency), public hospitals will admit patients without a number or card and resolve Medicare eligibility issues after treatment.
Use of the card
Australian Medicare is administered by Medicare Australia (until late 2005 known as the Health Insurance Commission (HIC)) which also has responsibility for supplying Medicare cards and numbers. Almost every eligible person has a card: in June 2002 there were 20.4 million Medicare cardholders, and the Australian population was less than 20 million at the time (cardholders includes overseas Australians who still have a card).
However, the use of the card is relevant only to consultations with medical practitioners who are eligible for Medicare provider numbers. Such access has been made subject to increasing requirements since the mid-1990s.
The widespread use of the Medicare card means a distinction needs to be drawn between the card and failed proposals for an Australia Card. The Medicare card is used for health care purposes only and cannot be used to track in a database a number of activities. It contains a name and number, and no visible photograph (however, the Tasmanian "Smartcard" version has an electronic image of the cardholder on an embedded chip). Individuals are not legally required to have a Medicare card, to carry it with them, or to produce it on request.
The primary purpose of the Medicare card is to prove eligibility when seeking Australian Medicare-subsidised care from a medical practitioner or hospital. Legally, the card need not be produced and an Australian Medicare number is sufficient. In practice, most Australian Medicare providers will have policies requiring the card be presented to prevent fraud.
From 2002, a Medicare card must now be shown at a pharmacy when collecting Pharmaceutical Benefits Scheme (PBS) medication.
The Medicare card is used as a recognised form of ID in opening bank accounts or obtaining a driver's license. On the ‘100 point scale’, on which 100 points of ID are required for proof of identity, a Medicare card is generally 30 points.
The Medicare scheme entitles most Australian residents to a rebate of medical and some other expenses paid for consultations with a medical practitioner who holds a current provider number. The medical practitioner will usually apply for, maintain and quote a provider number on their tax invoices. Without quoting a valid provider number, a practitioner's patients will not be entitled to a rebate of their medical expenses.
A practitioner who is in breach of a contract with the Commonwealth may face a 12 year prohibition on access to a provider number. This means that a Medicare cardholder cannot obtain a rebate of expenses paid to a prohibited practitioner regardless of the practitioner's registration at any (state) board or specialty for the period that the practitioner is without a provider number.
Issue of Medicare cards
Medicare cards can be issued to individuals or to families, with a maximum of five names per card. Families with more than five members will have additional names listed on additional cards, while retaining the same card number. Children are listed on their parent's card – a family may be all on one card, or a child may be listed on one parent's card, or both parents' cards, or even in some cases, alone on their own card if their name exceeds a specific number of letters. Children who are wards of the state will be listed on a card with the Department of Children's Services as cardholder. Medicare cards may be used to show a relationship when parents have different surnames to their children.
Individual Medicare cards are generally only issued to people over 15. This is a Medicare Australia policy (not legislation) and there are exceptions for people at boarding schools or away from home. Significantly, this policy may detract from the right of a mature minor to gain confidential medical care. Using their family's Medicare card (and presenting the card) could potentially notify their parents of the consultation, but only if the parents request information about their child's medical claims.
In Tasmania, an enhanced version of the Medicare card, called a "Smartcard", was introduced in 2004 and differs only in that it contains a chip that stores the same data found on the standard Medicare card, and also an optional digital photograph of the cardholder.
Proposed end of the Medicare card
In 2005, plans to expand the capabilities of the ubiquitous Medicare card were announced by then Howard Government Human Services Minister Joe Hockey. The new card, to be called the Health and social services access card, was intended to replace both the Medicare and up to 17 other similar cards (such as Centrelink benefit and concession cards), and to commence operation in 2008. However, the scheme was criticised by some sectors of the public and relevant interest groups as a step in the same direction of an Australia Card. The Howard government was unable to implement the scheme before the government's electoral defeat in 2007.