Medicare and Leaving Australia: What You Lose When You Retire to Thailand

Medicare doesn't cover you in Thailand. Australia has no reciprocal health care agreement with Thailand, so every doctor's visit, hospital stay and prescription there is paid by you or your insurer. If you leave Australia permanently, Services Australia's guidance is that you generally stay enrolled in Medicare for about 12 months, then need to re-enrol if you come back to live. This guide explains what changes and what to arrange before you go.

This is general information, not medical or financial advice. Contact Services Australia about your own situation.

Medicare overseas: the basics

• Medicare covers treatment in Australia only.
• Australia has Reciprocal Health Care Agreements (RHCAs) with a small number of countries (including the UK, New Zealand and several European countries). Thailand isn't one of them.
• Smartraveller repeatedly reminds Australians that they're responsible for their own medical costs overseas, and that medical evacuation can be very expensive.

What happens to your Medicare enrolment

Services Australia's guidance for people leaving permanently is that your Medicare enrolment generally lasts 12 months after you first leave. After that you're no longer enrolled, and you re-enrol when you return to live in Australia.

If you're only travelling (going and coming back), your Medicare stays, but it still doesn't cover you while you're in Thailand.

Coming back for treatment: to use Medicare on a visit home, you generally need to still be eligible. Retirees who have left permanently and been away a long time may not be. Check with Services Australia before you rely on flying home for treatment.

The PBS and your medicines

• Pharmaceutical Benefits Scheme (PBS) subsidies apply only to medicines dispensed in Australia.
• There are legal limits on taking PBS medicines overseas, and it's illegal to send PBS medicines abroad except in specific circumstances. Check the rules before stocking up.
• Most common medicines are available in Thailand, sometimes under different brand names. Check that yours is available and legal in Thailand, especially controlled medicines. Thailand regulates some prescription drugs strictly.
• Bring a letter from your doctor and your prescriptions (with generic names) when you travel.

A guide to buying prescription medicines in Thailand is planned.

Concession cards and other benefits

From Services Australia:

• Your Pensioner Concession Card is cancelled after you've been temporarily overseas for 6 weeks.
• The pension Energy Supplement stops after 6 weeks and the Pension Supplement after 12 weeks. After 26 weeks, your rate may become proportional. See our Age Pension guide.
• Benefits tied to living in Australia, such as state concessions, are generally lost when you move.

Private health insurance in Australia

• Australian private health insurance covers treatment in Australia. It generally doesn't cover treatment overseas.
• Some retirees suspend their Australian cover while overseas. Funds have their own rules on suspension periods and on waiting periods when you return.
• Lifetime Health Cover loading may be affected by time overseas. Check the government's privatehealth.gov.au information, and ask your fund.

What to arrange before you go

1. Health insurance for Thailand. International expat cover or a Thai policy. If you're on a Non-OA, insurance is compulsory. See our Non-OA insurance guide.
2. Medical evacuation and repatriation cover, if you'd want to come home for treatment.
3. Health checks and dental work in Australia while you're still covered.
4. Copies of your medical records, a list of medicines with generic names, and a doctor's letter.
5. Talk to Services Australia about Medicare, your pension and concession cards.
6. Decide on Australian private health insurance: keep it, suspend it or cancel it.
7. Register with Smartraveller and keep emergency contacts up to date.
8. Find your Thai hospital, and check whether your insurer pays it directly.

When you return to Australia

• If you come back to live, re-enrol in Medicare with proof that you've returned and of your residency.
• Your pension rate and supplements are reassessed when you return.
• Ask your fund about waiting periods if you take up Australian private health insurance again.

Summary

• Medicare doesn't cover treatment in Thailand, and there's no reciprocal agreement.
• If you leave permanently, your enrolment generally ends after about 12 months, and you re-enrol when you return.
• PBS subsidies and the Pensioner Concession Card don't follow you. The card is cancelled after 6 weeks.
• Insurance is essential. Arrange it before you go.

What we couldn't verify

• Medicare on a visit home after leaving permanently: eligibility depends on individual circumstances.
• The PBS overseas rules on quantities and exemptions: check the Department of Health's current guidance.
• Lifetime Health Cover effects of time overseas: check privatehealth.gov.au.