Overseas Visitor Health Cover (OVHC)

Any Australian visa with an 8501 condition requires that you take out overseas visitor health cover. This includes many work and visitor visas, such as the 482 and 485 visas. Visa conditions are subject to change; to check the conditions of your visa, refer to your visa grant letter or the Department of Home Affairs website.

Not all providers offer OVHC that meets visa condition 8501, which specifically states you must maintain health insurance for the duration of your stay in Australia. Be sure to check with the provider that the policy they are recommending satisfies this requirement.

Here is a list of common working and visiting visas and if they require OVHC as a requirement for visa approval, Health Condition 8501.¹

An OVHC policy can cover yourself, your partner and any dependent children who join you on your visit to Australia. Check your policy for age limits on coverage for dependent children.

Things that OVHC does not cover include elective cosmetic surgeries, non-emergency ambulance transportation, assisted reproduction services (such as IVF) and any procedure not recognised by Medicare.

Australia’s healthcare system is a dual system split between public and private. The public system is provided by the government through Medicare, which covers the entire cost of public hospital care for Australian citizens and permanent residents. The private system is made up of private hospitals and clinics. While Medicare covers a portion of private hospital care and other out-of-hospital clinic appointments (like general practitioner consultations), private health insurance helps with cost of private services in hospital.

The Reciprocal Health Care Agreement is a special agreement Australia has with a few specific countries, where emergency health care for citizens of those countries visiting Australia is covered through Medicare. Australian citizens visiting those countries likewise can get medically necessary emergency care through those nations’ specific healthcare systems. The following nations have a Reciprocal Health Care Agreement with Australia:

• New Zealand
• United Kingdom
• Republic of Ireland
• Sweden
• The Netherlands
• Belgium
• Norway
• Slovenia
• Malta
• Italy
• Finland

If you already have an OVHC policy, you can switch policies at any time. Simply purchase new cover and inform the insurance provider you have an existing policy, and they will cancel your current OVHC policy for you by sending a transfer request to your previous provider.

After your old provider receives a transfer request, they must process it within 14 days, issue a transfer certificate and pay a refund on any premiums paid in advance (as long as you haven’t made any claims in that time).

When switching between Australian OVHC providers, any waiting periods you have completed won’t need to be served again unless your new policy has higher coverage or includes benefits you weren’t covered for before. If you’re switching from an overseas provider, you will most likely have to re-serve any waiting periods.

You will still have health insurance while you switch provided your payments are up to date, which helps you remain compliant with your visa.

A pre-existing condition is any health condition, ailment or illness you showed signs or symptoms for in a six-month period before starting your health insurance policy. This is evaluated by a doctor appointed by the health fund. Many OVHC policies cover pre-existing conditions and their related treatment, but it’s vital to check whether any waiting periods apply to treatment for your condition.

It’s likely you will still have some out-of-pocket expenses even with health insurance. This means that you may have to pay some portion of your medical bills yourself, as your insurance might not cover all of it. Your out-of-pocket costs will depend on your policy and the health services you use.

For in-hospital medical services through the public system, you will be covered up to the fee determined by the relevant state or territory authority. Public hospitals have one rate that includes all medical services while in hospital.

For out-of-hospital services like doctors and radiology, you will be covered for the Medicare Benefits Schedule (MBS) fee. However, your service provider may choose to charge over the MBS fee, in which case you will have to pay the difference out of pocket.

For private hospitals, your insurance may pay for your room and theatre fees; however, individual medical services such as your surgeon and anaesthetist are billed separately. Your insurance will only cover costs up to a percentage of their MBS item fee, so you will be charged the difference out-of-pocket.

If your policy includes extras, your insurer will have either a percentage limit that they pay per benefit claimed or a dollar limit that they are willing to pay up to. Policies with a dollar limit are subject to annual or sub-limits. This works the same for Australian residents who hold extras cover through private health insurance.

Many insurance policies will also require that you pay an excess, which is a lump sum payment usually made per hospital visit. Some providers will allow you to pay a higher excess in exchange for lower premiums or vice versa. It’s best to speak with your insurance provider directly to understand what out of pocket costs you may incur (if any) in your particular situation.