Understanding Medicare Rebates

A Medicare rebate is the amount the Australian Government pays back to you (or directly to your health provider) when you receive a medical service listed on the Medicare Benefits Schedule (MBS). The rebate doesn't always cover the full cost of a service — understanding how it works helps you budget smarter and avoid surprises.

What Is Bulk Billing?

Bulk billing means your doctor or health provider accepts the Medicare rebate as full payment for their service. This means no out-of-pocket cost to you. The provider bills Medicare directly, and you simply present your Medicare card.

Not all providers bulk bill, and some only bulk bill certain patients (e.g., pensioners, children, or concession card holders). It's always worth asking before your appointment.

What Is a Gap Payment?

If your provider charges more than the Medicare schedule fee, the difference is called a gap or out-of-pocket cost. For example:

  • MBS schedule fee for a standard GP consultation: $42.85
  • Medicare rebate (100% for GP): $42.85
  • Doctor's actual charge: $80.00
  • Your gap: $37.15

For specialist services, Medicare pays 85% of the MBS fee, and the gap can be considerably larger depending on the specialist's fees.

How to Claim a Medicare Rebate

Option 1: At the Point of Service (Easiest)

Many providers lodge your claim on the spot using EFTPOS-integrated Medicare claiming. You pay any gap, and the rebate is deposited directly into your bank account (usually within 1–2 business days), provided you have your bank details registered with Medicare.

Option 2: Through the Medicare App or myGov

  1. Open the Medicare app or log in to myGov
  2. Navigate to "Make a claim"
  3. Enter the date of service, provider details, and amount charged
  4. Upload or photograph your receipt
  5. Submit — rebates are typically paid within 3–5 business days

Option 3: At a Services Australia Service Centre

Bring your original receipt and Medicare card to your nearest service centre. Staff will process your claim in person and can arrange direct deposit or a cheque.