medicare for Australian citizens overseas

Medicare for Australian citizens overseas

28th Nov 2019 – UPDATE:

Firstly, thank you to David W who let us know via Facebook, that the Department of Human Services website has recently been changed to omit a key statement about the ability for non-residents to continue to use Medicare for a period of up to 5 years after departing Australia.

In my original article under the heading “Can I still use Medicare when I am a non-resident?” (below), I referred to the Department of Human Services website and provided a link to the relevant page on that site. To maintain the integrity of the original article, I have retained the link as it was originally written in my original article.

Please note note that the information on the Medicare site has now changed and that the following original statement (in italics) has now been omitted:

If you’re an Australian citizen and you live overseas
If you’ve moved overseas, you continue to be eligible for Medicare for 5 years. The 5 years starts from the date you first left Australia.

You can’t access Medicare services from outside of Australia. If we have a Reciprocal Health Care Agreement with the country you’re in, you may get access to medically necessary care. You’ll need a Medicare card to do this.

If you live overseas for more than 5 years you’ll no longer be eligible for Medicare. You will need to re-enrol in Medicare when you move back to Australia to live.

If you wish to see the original webpage before the statement was omitted you can view a historical snapshot of Medicare’s website from the internet archive website (the “Wayback Machine”) – see below:

The original Medicare webpage (referred to in our article below)

The Takeaway

Notwithstanding that the statement (in italics) above has been removed from the Department of Human Services’ website, in researching this issue extensively, we did not find any reference to any change in policy. As such, we are not aware of any changes to the original policy. We will seek clarification from Medicare and will update this article as we learn more.

We do however, highly recommend that if you are unsure about your circumstances at all, please be sure to call Medicare and check your entitlements based on your own personal circumstances.


Shane Macfarlane
28 Nov 2019

Original post below


Am I entitled to use Medicare when I return home to Australia for short visits?

Moving overseas is daunting. There is new work, trying to find a decent place to live, new maps to scrutinise, new cities to get used to and a whole new set of rules when it comes to the country’s you’ve moved to.

But learning about your new country isn’t all, there’s a lot of things that you’ll need to learn about Australia and how things work when you’re an Australian expat living and working overseas.

And so in this article, I want to take you through a question about Medicare for Australian citizens overseas, that’s very commonly asked by many of our expat clients – are you entitled to use Medicare when you return home for short visits (e.g. for work or to visit family and friends)?

Medicare for Australian citizens overseas – clearing up the confusion

For any Australian expat who is confused about the Medicare for Australian citizens overseas, take a look below.

An Australian resident (i.e. a resident of Australia for Australian tax purposes), living and working overseas as an expat will remain liable for a 2% Medicare Levy (i.e. 2% of their taxable income), if their taxable income exceeds $27,475 (for singles) and $46,361 (for couples) plus $4,257 for each dependent child for 2017-18.

In addition to the Medicare Levy, if the income of an Australian tax resident exceeds $90,000 (singles) or $180,000 (couples) a further Medicare Levy Surcharge of between 1 – 2% applies if they do not maintain private health cover for all their dependents, even when they are not living in Australia.

Note that the Australian Taxation Office (ATO) uses a special definition of income called “Income for Medicare Levy Surcharge purposes” in determining who is required to pay the surcharge. For the purposes of this email I won’t run through every element of income that is included in that definition as too much detail is required, but you might be surprised to learn that tax losses (e.g. losses made on negatively geared rental properties) are added back in as income, as are any tax exempt income that you may have earned (e.g. income earned from government approved foreign aid projects where you’ve worked overseas for 91 days or more).

So what are the implications if I am an Australian tax resident whilst living and working overseas?

In short, if you’re working overseas, you’ll remain liable for the Medicare Levy. And since you are liable for the levy, it also means that you remain eligible to use Medicare as and when you need it, whenever you are present in Australia.

What about the Medicare Levy Surcharge? Do I have to pay that too?

If you’re a relatively high income earner, earning above $90,000 as a single or $180,000 combined as a couple, then it’s highly recommended that you maintain an appropriate level of Australian private health insurance.

The key word to note here is the word “Australian”, because in order to qualify as appropriate private health insurance your health cover MUST be provided by a health fund registered under the Private Health Insurance Act 2007 – to check your fund, take a look at the list of registered funds on the Private Health Insurance Ombudsman’s website.

If you do maintain an appropriate level of Australian private health insurance, although you will still be required to pay the Medicare Levy, you’ll be exempt from paying the Medicare Levy Surcharge.

Take Care: – Don’t assume that just because your overseas employer provides you with health insurance that you are exempt from paying the Medicare Levy Surcharge. Most, if not all overseas health funds ARE NOT registered funds under the Private Health Insurance Act 2007. So if that’s the case, then you should consider taking out some basic Australian health insurance cover in addition to your overseas health cover.

Note: ‘Extras Cover’ also known as ‘General Cover’ (including items such as optical, dental, chiropractic treatment and physiotherapy etc) is not private patient hospital cover. So there’s no need to purchase ‘Extras Cover’ as this will just increase your costs unnecessarily. Similarly, travel insurance is not private patient hospital cover for the purposes of the Medicare Levy Surcharge.

What is an appropriate level of health cover?

As stated on the ATO website, for singles, an appropriate level of cover must have an excess of $500 or less. Couples or families must have an excess of $1,000 or less.

What if I am a non-resident?

If you are a non-resident for Australian taxation purposes, then you will NOT be required to pay the Medicare Levy, and neither will you be liable to pay the Medicare Levy Surcharge.

Can I still use Medicare when I am a non-resident?

There are so many misconceptions about a non-resident’s entitlement to Medicare, particularly from the Australian accounting profession, but also among expat circles generally.

In fact most expats and their accountants will emphatically state that if you are a non-resident and you’re not required to pay the Medicare Levy then, under no circumstances will you be eligible to claim Medicare benefits.

However, that advice is nonsense. In fact, if you’ve ever received that advice, then your advisor has done you a great disservice as that advice it is INCORRECT.

So let’s lay this question to rest once and for all.

If you are an Australian citizen who is a non-resident expat, living and working overseas, although you can’t use Medicare forever, you CAN use Medicare and claim Medicare benefits for a period of up to 5 years from the date that you first left Australia.

So let me just reiterate that again . . . the bottom line is, that non-resident Australians who are living abroad, are eligible to use Medicare and claim Medicare services on trips back to Australia for a period of up to 5 years after departing Australia originally. For further information, take a look at the Department of Human Services website where you can confirm this fact.

Note though that if your Medicare card has an expiry date of less than the 5 years, practically speaking you won’t be able to renew your Medicare card whilst living overseas and so in that instance, you will be limited in claiming Medicare benefits to the date of expiry of your card.

Can I access Medicare services outside of Australia?

Typically you won’t be able to access Medicare services from outside of Australia unless you live in (or a visiting) a country that has a Reciprocal Health Care Agreement with Australia.

In that case, you may be able to access to medically necessary care however you’ll need to check the eligibility rules of that specific Reciprocal Health Care Agreement. If seeking access to medical care under a reciprocal Health Care Agreement, you’ll also need to take with you, your passport and your Medicare card.

Additionally, if you live overseas for longer than 5 years you’ll no longer be eligible for Medicare and you’ll need to re-enrol in Medicare when you eventually move back to Australia to live.

What countries does Australia have a Reciprocal Health Care Agreement with?

As at the date of writing, Australia has Reciprocal Health Care Agreements with 11 countries around the globe – take a look below:

I’ve heard that if I claim Medicare benefits whilst I am a non-resident, this may affect my residency status. Is that true?

As much as I’d truly love to give a definitive answer, the only answer that I can give is “possibly”.

Unfortunately, residency is a very complex topic that hinges around the facts and circumstances of a your life, along with constantly evolving principles laid down in precedential court cases, court ruling and ATO tax rulings. So unfortunately the answer is not as easy as it seems.

But, let me try and answer it this way.

Non-residents who claim Medicare benefits whilst visiting Australia, will show a stronger connection, or durability of association with Australia than those that don’t. The durability of association that a person has with Australia is a key factor in determining a person’s residency status and so claiming Medicare benefits will be a stronger indicator for residency.

However, it should be noted that this factor alone will not mean that you are a resident for Australian taxation purposes. Combined with a bunch of other factors that also support lean towards the residency side of the equation, claiming Medicare benefits could tip you over the edge, in which case you could be found to be a resident of Australia.

However, just because you’ve claimed Medicare benefits whilst in Australia it doesn’t necessarily mean that you will lose your non-residency status.

If you want to learn more about how these rules affect you, or if you are nervous about your losing your non-residency status by claiming Medicare benefits, I highly recommend that you book in for a tax consultation (below) so that we can run through all the issues for you and set your mind at ease:

Book an Appointment

One last thing

If you feel that the information in this article was useful, please feel free to share this with any other expat Australians that you feel my benefit from this information.

Thanks for reading.

Shane Macfarlane CA
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Comments 42

  1. This is such an informative post – thank you for sharing. I wish I had found your team earlier!
    I have a question in regard to Medicare Levy Surcharge and the possibility of waiving it. I am an Australian resident for tax purpose and working for an Australian company. In Jan 2020, I went home to Malaysia for a vacation and was stuck overseas when the pandemic hit. I ended up working remotely from Malaysia for 2 years. During that 2 years, I suspended my private health insurance. When filing for tax returns FY2021, I realised that I have been hit by Medicare Levy Surcharge that was much higher than my insurance premium so I think I shouldn’t have suspended my insurance despite not being in Australia for 2 years. Is there a way to request for waiver on the MLS because I did not use any Medicare benefits since I was overseas? I supposed working remotely for the Australian company for 2 years still qualifies me as a tax resident because I am still earning my salary in Australia. Please advise. Thank you.

    1. Post

      Hi Cherrie,

      Firstly thanks for your message. So sorry to hear that you’ve been slugged with Medicare Levy Surcharge (MLS) when you least expected that.

      Although there’s some exemptions from the surcharge, it’s unlikely that any of those will apply to you unfortunately.

      However, I can think of a couple of other potential ways the surcharge may be able to be avoided, but it would depend very much upon how you structured your stay in Malaysia once you were stuck there, and the decisions you took relating to Australia. Depending upon those and other factors, there may be one or two other solutions available to you however I’d really need to learn more about your circumstances to be sure.

      What I’d recommend is that you book a free 30min ‘General Enquiry’ appointment with me via our Book an Appointment page so that you and I can connect to discuss your circumstances and any potential solutions that may or may not be available.



  2. Hi, I am a 32-year old Australian citizen. When I was 11 I went to boarding school in the UK, then went to a UK university and now work in the UK.

    When I turned 18 and was visiting my parents in Australia, they told me to register for my own Medicare card. I did mention to the staff member at the Medicare centre that I wasn’t living in Australia, and they said as I am a citizen was still eligible. After reading this I believe that advice was incorrect.

    When I was 23 my parents received a new card for me, I called Medicare and said I wasn’t living in Australia, they said they noted it and I didn’t need to do anything else.

    I haven’t been to Australia for a while because of covid, but I’ve just returned for another short visit. My parents no longer live in Australia but I visited my old house which was sold to my uncle, and not only have Medicare sent me another card, they also sent my parents a new card which still has my name on it.

    Any idea what I should do now? The only thing I have ever used the Medicare card for is as ID to get an Australian SIM card.

    Also complicating the issue is that I intend to move back to Australia in 3-4 years time, and I don’t want to have to pay the private health fee for not taking it out before 30, but obviously there is no point taking out health insurance until I actually am living in Australia

    1. Hi John,

      The advise that you were given by Medicare was incorrect you shouldn’t be renewing your card if you are not residing in Australia. I’d recommend contacting them to cancel your card.

      When you move back to Australia, once you can prove you have an Australian address you will be able to get a new Medicare card.

      The good news is that even though you have had a medicare card that won’t impact your ability to avoid the lifetime hospital cover loading, if you meet all the other conditions.



  3. Excellent article, thank you. As a non-resident for tax purposes living in UK for over 5 years with expired Medicare card – am I eligible to access Medicare on visits home through the AU/UK reciprocal healthcare agreement? The only information I can find speaks to non-Australian citizens accessing Medicare though reciprocal health care agreements but not Australian citizens.

    1. Post

      Hi Jayne,

      Although you would not be eligible to access Medicare via your Medicare card/historical Medicare account, if you are registered with the NHS in the UK, then you should be able to avail yourself of the reciprocal health care agreement that Australia has with the UK.

      The issue isn’t your citizenship status, it’s simply that of whether you are genuinely living in the UK and registered with the NHS or not. Perhaps take a look at the following page from the Services Australia website as this may help:

      Reciprocal Health Care Agreements – Visiting from the United Kingdom

      When reading the above page, please note that although the page explains that you must enrol in Medicare and provide evidence of your NHS registration (ie. by presenting your UK National Health Insurance card and 2 documents to prove that you live in the UK), this only applies to long stay visits. If you are visiting Australia for a short stay only, then there is no need to enrol.

      Having said that however, the exact mechanism by which a short-stay visitor to Australia can claim Medicare Benefits via a Reciprocal Health Care Agreement is particularly unclear from the Services Australia website. My gut feel is that it’s probably best to register for Medicare (using your National Health Insurance card and proof of UK address details) if you wish to avail yourself of Medicare whilst in Australia. It might be prudent to give Medicare a call to confirm however.

      I’m sorry I can’t be more helpful than that – unfortunately information about this and the Medicare website itself is unnecessarily vague, and ultimately, it’s poorly explained.



  4. Hi Shane

    Thank you for this. I found this extremely helpful.

    I have a question around tax residency. My husband and I normally reside in Indonesia where he works (I am unable to work due to visa restrictions). Due to Covid-19 and the Indonesian government’s management of the pandemic, we came back to Australia where we felt we could access quality health care in case something happens. We didn’t quite expect the pandemic to last this long, however, we are still in Australia almost 6 months later with no expected date of return to Indonesia (due to the handling of Covid-19 and the quality of the healthcare there). Our home is in Indonesia together with all our belongings, my husband works for an Indonesian company remotely and will continue doing so until it is safe to return. Would you think we would be considered Australian residents from the date we returned? Have you seen cases where the residency of husband and wife are different?

    Thank you in advance!

    1. Hi Lauren,

      Thanks for your question, it is a really good question and I’m sorry to hear the position that you are currently in, it must be very difficult for you and your husband.

      Covid has brought about some unusual tax questions for many expats who have been forced to stay in Australia and are uncertain when they can return.

      Your Australian tax residency status needs to be considered for both the 2020 and 2021 financial years by applying the Australian tax residency laws to your personal circumstances. The ATO has provided some non-binding guidance on their website but it doesn’t give a lot of certainty and hasn’t been updated in light of how long the restrictions have been in place.

      The fact that you still have your home in Indonesia is a factor that needs to be considered along with all of your personal circumstance and applied to the law to determine your Australian tax residency status. Residency is a complex area and with the current circumstances is even more complicated so it’s not possible to say from the limited information what your residency will be.

      I’d highly recommend booking a ‘Residency’ consultation on the appointments page of our website and we can provide you with advice for your current circumstances.

      Australia and Indonesia have a double tax agreement so it should be reviewed to see if it can assist in a situation where you are resident in both countries.

      It is uncommon for spouses to have different residency status’ under Australia tax law however it is possible and there are cases that have set court precent where this has been demonstrated, however there were specific reasons why they could come to that conclusion.



  5. Hello,

    Any updates on a definitive answer from Medicare re the 5 year entitlement for expat use?


    1. Post

      Hi Craig,

      As you’ve probably learned, it is particularly difficult to get a clear answer on this topic, however the following I think should provide the clarity that you’re seeking:

      The Health Insurance (Eligible persons and citizens absent from Australia for five years) Order 2017 outlines that where a person is an Australian citizen, who was a resident for the purposes of the Act (refer s. 3 of the Private Health Insurance Act 1973.), who have been absent from Australia for a period of no longer than five (5) years from the date of last departure, will be treated as an ‘eligible person’, meaning that they will be eligible to use Medicare.

      Thus, if you were an Australian citizen who was a resident of Australia, you will be eligible to use Medicare for a period of up to 5 years from the date that you ceased residency and departed Australia.

      Hopefully that helps.



  6. Hi there,

    thanks for this article, it’s been a real eye opener. I think we should be given info packs when we leave the country, advising us of these issues.

    My sister had been living outside of australia for approx 8 years and is a non-resident for tax purposes.
    When she moved overseas, she only had 2 years left on her Medicare card, so when she went to Oz for a visit, she was informed that she is still eligible for Medicare so she renewed her card. She has an investment property in Oz so she still pays taxes. She’s told me that she used her Medicare card last year (year 7 of living overseas) as the card still hasn’t expired. I’ve told her about this article and now she’s quite concerned. What can she do to fix this issue? Should she inform her account? Can she pay the bill or Medicare Levy for the year she used the card? Is there any way she can find out what the ATO consider to be her status?


    1. Hi Reema,

      Thanks, it is a worry for us that incorrect information is often provided to expats when they leave Australia.

      For your sisters situation there probably isn’t a lot that can be done to fix the past if she has incorrectly been given a replacement Medicare card.

      Going forward she should ensure that Medicare has her correct residential address and advise Medicare that she is a non-resident.

      Residency is complex and based on all of the circumstances of a taxpayer, so using Medicare won’t necessarily mean that she is a tax resident, this is just one of many factors that would be considered.

      A taxpayers residency status with the ATO is self assessed by the way that the tax return has been prepared. As long as the return each year has been completed correctly as a non-resident then that will be what the ATO records have. Your residency status is a question on the return. The ATO could decide to audit her return and could come to the conclusion that she was a resident. If she did ever get audited it would be important to have a tax agent who specialises in Australian taxes for expats assist her in dealing with the ATO.

      If you or your sister want to discuss further you can contact us and one of our team will get back to you.



  7. Pingback: Expats Moving Overseas - Top 5 Tips | Expat Tax Services Australia

  8. Hi Shane,

    I have two questions:

    1. We have moved with Family to overseas for long term and for year 2019-2020 We only remained in Australia for 3 months (July2019 to Spetember 2019) so considering 180 days rule I believe I will be non-resident for tax purposes. We dont own any asset in Australia nor we have any family there so there is no connection what so ever apart from the fact the me and kids are Australian ciizens. Please advise if my understanding is right that I will only be considered Resident for Tax purposes partially for 3 months that w0e lived in Australia? and for remaining 9 months we will be non-residents for tax purpose?

    2. My wife has to visit Australia for 10 days only to attend her citizenship ceremony. We requested the Immigration office to organize her Citizenship ceremony at Australian counsolate overseas but they advised that she must come to Australia to attend the ceremony so she is traveling for 10 days only. While in Australia is it OK for her to use medicare facility for doctor/lab visits? Will it affect my residensy for tax purposes status? please note that she does not work and she only files zero income tax return every year but she is my dependant.

    1. Post

      Hi Ahmed,

      Thanks for your message and for your questions.

      Firstly, if you’ve moved overseas with your family to live in a particular country (as opposed to travelling around), if you intend to remain there long term for at least 2 or more years and assuming that you have cut most, if not all ties to Australia, then you will most likely have become a non-resident for Australian tax purposes.

      Bear in mind however, that it’s not just the 183 day test that you need to fail in order to be a non-resident. There are three other residency tests for Australian tax purposes, each of which you must also fail. In other words, if you pass any one of the following 4 residency tests, then you will remain as a tax resident of Australia:

      • Resides Test
      • Domicile Test
      • 183 Day Test
      • Commonwealth Superannuation Test

      Now although that I stated above that it is likely that you are a non-resident, unfortunately, neither I nor any body else can categorically confirm for sure that you are a non-resident or not. The reason why we cannot is because residency hinges around ALL of the facts and circumstances of your life and upon your intentions, none of which we know at this point. As residency is extremely complex, we highly recommend that you seek advice from an appropriately qualified expatriate tax firm like ours or any similar firm.

      Regarding your wife travelling to Australia, if you have met the criteria for being a non-resident this is not likely to change as a result of your wife’s visit to Australia. In relation to Medicare although technically your wife could continue to use Medicare during her trip to Australia, we would strongly, strongly advise against that as it does risk your residency status significantly.

      Thanks again for your message. Please contact our team if you seek further advice that is specific to your circumstances.



  9. I have been traveling between Australia and SE Asia for 8 years spending most of my time in Thailand. This last trip out was one year and one day. I usually come back to Aus 2 times per year and I have always paid tax in Australia. Medicare had refused me a new card and right now I am extremely ill and was even turned away at a hospital unless I pay for all treatment up front. I receive a ComSuper pension which equals the minimum wage in Australia and I do not work OS. Medicare have stated unless I can produce property ownership title deeds or lease agreements there is no way I will get a Medicare card. I can not afford property and have returned to Aus looking for a home to rent prior to bringing my wife and son to Aus to live. I need to do this as bridging visas for my wife and he son are $6,000 each which I have to save if and when I get employment. I have been called a non resident even though I do not stay out of the country for very long periods of time. I am Australian born, an ex- service person and I have always paid tax in Australia! Why can’t I get a new Medicare card because my old one expired unless I OWN property or lease property in Australia. 5,800 homeless ex – service persons live on the streets in Australia, I will have to ad well now so how do I overcome extreme poverty in the country I was born in, in which I served in the ADF and where I do pay tax every year.

    1. Post

      Hi Graeme,

      Thanks for your message and your comments. Firstly, I’m sorry to hear about your situation as you’re definitely in a tough spot.

      I come from a military family myself so I understand and empathise with what you say.

      Unfortunately however, Australia’s rules in relation to Medicare are not that flexible and sadly they don’t reflect the years of service, and years that a person may have contributed to Australian society (or to Medicare itself) via the payment of taxes and the Medicare Levy itself.

      Where an Australian citizen has been living overseas for greater than five years, or if they live overseas beyond the expiry of their Medicare card, the person’s enrolment in Medicare drops off and ceases. Tho be eligible for Medicare again after this, the person MUST re-enrol in Medicare and obtain a new Medicare Card.

      But here’s the rub (this highlights the inflexibility of the Medicare rules), the legislation states that in order for an Australian citizen to be eligible to re-enrol in Medicare, that person MUST be living in Australia and must provide evidence of that fact (2 separate pieces of evidence in fact). The requirement to be actively living in Australia (in either your own home or in rented or some other accommodation) is a non-negotiable.

      The reason why this is so is essentially because if a person is not a resident of Australia, they do not have an obligation to pay the Medicare Levy. As they don’t pay the Medicare Levy they generally have no right to use Medicare. Hence the reason why the government requires a person to be a resident for Medicare eligibility purposes.

      The unfair aspect of this, as you say though, is that the rules do not reflect the fact that until more recently you have been a contributing tax-payer to the Australian economy who has already paid the Medicare Levy for years and years previously. In my opinion it is unfair that a person’s long history of paying for Medicare during their life, is not recognised here.

      Graeme, again I’m sorry to hear of your illness and from all of the team we wish you a speedy recovery. I’m sorry that I don’t have a lot of good news for you on this front but I sincerely wish you all the best going forward.

      If you have any questions or need further advice, please feel free to contact us any time.



  10. This is a great article, I have already passed it onto my Australian expat friends. I have a quick question regarding a non-resident for tax purposes using medicare for a period of 5 years after you initially leave. I have worked and lived overseas for about 10 years but moved home and worked from January 2018 – June 2018 then returned overseas. Would the 5 years start again from June 2018?

    1. Post

      Hi Pia,

      thanks for your message and kind remarks.

      Regarding your question, assuming that you regained your Australian residency after living abroad for greater than five years, and assuming that you re-enrolled in Medicare and obtained an new Medicare card during that time, then we are of the opinion that you will remain eligible for Medicare for a further 5 years if you subsequently return overseas.

      The information is hard to find but the following Medicare form Application for a Medicare Entitlement Statement contains instructions that detail a person’s continued eligibility for Medicare and it confirms that Australian citizens living overseas for greater than 5 years lose their eligibility for Medicare. Thus in our opinion, returning overseas would effectively after a stint of Australian residency should buy you a further 5 years.



  11. That is truely an informative article for anyone who is just starting to look into this topic. I wish I found this article before we moved to Singapore, would’ve saved me a lot of time and effort determining our eligibility to use Medicare once we become non-residents for tax.

    1. Post
  12. Hello, May be a little off topic, but I’ve been o/s for more than 5 years and plan to head back to OZ. I’ll be a low income earner. Do you know if there is a waiting period to get the low income health care card? Wanting to use it to avoid stamp duty on a small property. thanks!

    1. Post

      Hi Luna,

      Thanks for your message. Unfortunately I’m not sure whether there is a waiting period or not as I don’t know enough about your circumstances. Having said that I have found some information that should assist you – take a look at the links below as this is where you should be able to find your answer:

      If you take a look at that last link, under the heading of “Periods of Qualifying Residence” it states:

      “The qualifying residence period begins from the date the person starts residing in Australia as a permanent visa holder. Time spent in Australia on a temporary visa is not counted towards the qualifying residence period.”

      Accordingly, as a citizen and former resident of Australia, I think that for waiting period purposes will probably have been satisfied because it appears that your earlier periods of residence are likely to count towards the qualifying residence period. Thus, as an Australian citizen, all that remains is that you must ensure that you are residing permanently in Australia, and not just for some temporary period.

      Whilst I think I’m on the right track with all of the above, there’s a good chance that I may be wrong! Accordingly, I highly recommend that you reach out and contact the Department of Human Services to confirm the above and/or to learn more.

      Sorry that I couldn’t be much more help.



  13. HI Shane,
    Great article, thanks very much. However, I’m not sure I’ve seen (or understood) the answer to my particular situation. I have recently become a non-resident for tax purposes. Do I need to continue paying for private health insurance in Australia to avoid the 2% annual increase for lack of cover if/when I return to live in Australia? (I’m definitely over 30!) Or is this unnecessary if you have a period of non-residency for tax? Would it be worth continuing private health insurance for the first five years of non residency while you are still eligible to claim on Medicare or are you unable to use private health insurance in Australia as a non resident for taxation purposes.
    Many thanks.

    1. Post

      Hi Susan,

      Perhaps it’s best if you drop us an email or message via our contact us page and book a short appointment with me so that I can explain how this all works for you as the answers really depend upon your circumstances (most of which I don’t yet know) plus I think it will be easier to explain that way.

      To help though, take a look at as this should help explain things for you. Without knowing your circumstances fully, I suspect that the short answer will likely be, that you do not need to continue paying for private health insurance to avoid the 2% Lifetime Health Cover premium loading.

      The main reason to keep private health cover in Australia is generally just so that you have some cover somewhere, in the event that you do not have an overseas health cover policy. In that instance it may make sense to keep your Australian health cover if you are in a location that is relatively quick and easy to travel from (back to Australia should the need arise to utilise your health cover, such as in the event of an accident or emergency).

      Just bear in mind though that maintaining your policy is a factor for residency so the decision really needs to be made by bearing in mind all the other facts and circumstances of your life to ensure that maintaining an Australian heath cover policy does not tip you over the edge and thus change your residency status.

      As to whether you are able/unable to use private health insurance in Australia when you are a non-resident for Australian taxation purposes, ultimately the answer will depend upon the terms, conditions of the particular health insurance policy that you take out. I can[t really answer that question beyond that because each company’s policies terms and conditions are different.

      Hopefully that helps?



  14. HI Shane,
    i have found your website extremely helpful. thanks for the posting. Just some clarification if i may ask. We are currently living in Dubai as a non residents in Australia for less than 5 years. My husband has recently been diagnosed with some health issue in relation to brain, we will like to seek 2nd medical opinion in Australia before we seek any treatment in Dubai.

    As a measure of that, we have recently reactivated our private health insurance in Australia (while living oversea) in hope of seeking private medical consultation and treatment. Will this affect our tax residency status? In event if we have to, can we claim claim from both medicare and private health insurance as non resident?

    Would appreciate your advice on this. Many thanks.

    1. Post

      Hi Sherry,

      Firstly, we’re so sorry to hear of your husband’s health issues and from all of the team here at Expat Tax Services, we hope for a successful outcome for him and a speedy recovery.

      Residency sadly is a complicated issue that is very much based around the facts and circumstance of your lives, most details of which, I simply don’t know. As such I really can’t say for sure that it won’t change your residency status as I don’t know all the facts and circumstance of your lives.

      Regarding taking out private health insurance however, unfortunately, the reality is that taking out an Australian policy shows a stronger durability of association with Australia (i.e. it shows that you have a stronger connection to Australia) and that is indeed a factor FOR tax residency of Australia.

      Having said that however, given the length of time that you and your household have remained in Dubai among other factors, it is unlikely that taking out Australian private hospital/health cover would tip you over the edge and change your residency status, particularly if you continue to intend to reside in Dubai on an ongoing basis.

      As I mentioned earlier however i can’t say for sure that it won’t affect your residency status because I don’t know all the facts of your lives.

      if you wanted to be sure, then I’d highly recommend booking in for an ‘Expat Already Overseas’ appointment via the Book an Appointment page on our website. In that appointment we’ll be able to run through everything and answer any and all questions that you have.

      Thanks again for your message. Hopefully my reply helps however.



  15. Good Day Shane,

    This has been my 5th year living outside Aus, and my medicare card has already expired. The question I have is for my foreign resident status for tax purposes only, if my child moves back to Aus as a domestic student by himself only, whilst rest all of the family members are still foreign residents. Also will he be able to enrol for medicare with no impact to my residency status. Thank you

    1. Post

      Hi Sherry,

      Thanks for your question. Firstly, children over the age of 15 can receive their own Medicare Card I believe so assuming that your child is over 15yo then this should not be a problem. A Medicare Enrolment form will need to be completed and various certified documents (passport etc) will need to be supplied. Additionally, you’ll need to provide documents and proof that your child is living in Australia.

      Regarding residency, the fact that your child will be living in Australia is a factor for your Australian tax residency status as it shows that you willl have a stronger durability of association with Australia, a fact that is weighed more heavily under Australia’s ‘Domicile Test’ of residency.

      Although I don’t know enough about your circumstances, I don’t think that fact would be likely to change your residency status, particularly if your child will stay with relatives, friends or school accommodation etc.

      If your child were to stay in your family home, that would have a greater bearing on your residency status. However that last scenario is probably unlikely so as I mentioned above, your residency status is unlikely to be affected.

      If you seek more clarity on that, feel free to book a “Residency – Am I a tax resident” consultation with us via our Book an Appointment page as we’d be more than happy to run you through all of the issues and provide you with an opinion.

      Thanks again for your message.



  16. Hi Shane

    I’m trying to find the reference for:

    ‘So let me just reiterate that again . . . the bottom line is, that non-resident Australians who are living abroad, are eligible to use Medicare and claim Medicare services on trips back to Australia for a period of up to 5 years after departing Australia originally. For further information, take a look at the Department of Human Services website where you can confirm this fact.’

    I’ve been trawling through the website and have had no luck. Can you help?


    1. Post

      Hi Andrew,

      Thanks for your message. Alas you are 100% correct – that information confirming the 5 year rule is extraordinarily difficult to find sadly.

      I am kicking myself now for not taking a screenshot of the webpage that the link we provided links to. In reviewing the link again recently I can see that Medicare have removed their original paragraph that stated that the 5 year rule applied.

      I’ve done a little more digging to find another reference and this link below is the best that I could find:

      So as stated above, the information is incredibly hard to find but the following Medicare form Application for a Medicare Entitlement Statement contains instructions that detail a person’s continued eligibility for Medicare and it confirms that Australian citizens living overseas lose their eligibility for Medicare after 5 years.



  17. Hi

    I have been living and working in dubai for 17 years. I have fixed term deposits back home and a I pay a % on my deposit as a non resident. I fly back home two times a year and I have been using Medicare… is this wrong? AM I not entitled to this? I also noticed this time when I was in melb that I wasn’t there on the electrol poll to vote.. So I take it that the government knows I’m not living back home. Am I wrong by using Medicare? I plan to move back to aus in a few years and I don’t want to have any issues.. Also I’m pregnant if I go home and give birth AM I covered by Medicare? Thank u so much for your assistance!

    1. Post

      Hi – thanks for your message.

      Based on what you’ve written (i.e. that you have been living and working in Dubai for 17 years), you are not entitled to use Medicare. Unfortunately, Australia’s medical system under Medicare doesn’t reconcile with the electoral roll or the ATO unfortunately, so when you have used Medicare incorrectly, you’ve simply flown beneath the radar.

      Be careful though because given that Medicare is typically only available for up to 5 years (maximum) after becoming a non-resident, or until the expiry of your Medicare card, whichever is the earlier, by using Medicare, you are in effect declaring to the ATO that you are an Australian tax resident (as only Australian residents and non-residents within that 5 year window) are entitled to use Medicare.

      Additionally, you should also bear in mind that it is actually quite equitable that you are not entitled to use Medicare. Why? Because for the last 17 years you have not been paying the Medicare levy so that alone is a big reason why you are not entitled to use Medicare.

      Given that your income in Dubai is tax-free in the UAE, being treated as an Australian tax resident would be devastating because it would mean that ALL of your Dubai income (and any other income that you earn from anywhere in the world) would become subject to Australian taxes at extremely high Australian tax rates (potentially up to 47%). And it should also be noted that the Medicare Office cannot issue Medicare cards to non-residents, therefore to have updated your card 2 or 3 times during the last 17 years you have probably declared to Medicare that you are in fact a resident, because like I said, if my understanding is correct the Medicare office cannot issue cards to non-residents. That does not bode well for your Australian tax residency status.

      If I were in your shoes I would avoid using Medicare, I wouldn’t update my card until such time that I regained my Australian tax residency status and more generally I would avoid doing anything that may cause the ATO to have a stronger argument for treating you as an Australian tax resident. You may think that you are saving a few dollars by utilising Medicare, but it’s just not worth it.

      Regarding pregnancy or any other condition, in order to utilise Medicare you will need to regain your Australian tax residency status. That will entitle you to a new Medicare card, and you’d potentially be covered from the date that you regained your residency status, meaning that from that date, you’d be eligible to utilise Medicare.

      I hope that helps.



  18. Thanks for this site – brilliant and clear.
    On returning from an overseas posting of 4 years, do i face a penalty under the Medicare Surcharge if i haven’t maintained private health cover in Australia over the time away?
    I would organize private health insurance to commence prior to my return.

    1. Post

      Hi Darren,

      Thanks for your message – there’s not really any penalty as far as the Medicare Levy Surcharge goes if you haven’t maintained cover. There is however a penalty loading that gets added to the price of your private hospital cover premium, compared to other taxpayers (over the age of 30yo) who have been fully covered throughout that same period.

      I believe a loading of 2% is added per year that you are not covered. For example, if you are over the age of 30 and if you have been outside of Australia for say, 10 years and you have were not covered by an appropriate private hospital policy, then when you return and take out a new policy, your premiums would be 20% higher (2% x 10 yrs) than the next person’s (who had been covered the whole time).

      Hopefully that all makes sense?



      1. We previously lived overseas, and live OS again now. In our first stint overseas the loading for private health insurance was introduced. We didn’t need to pay this even though we were over 30, as we could prove that we were not in the country, and therefore not requiring private health cover in Australia. You will need to show proof to your insurer, such as a copy of re entry at immigration. Not sure if that is helpful.

  19. Hi Shame I am an Australian expat living and working in Thailand over 5 years. From my understand I will not be able to use medicare. I will need to apply when I come back to live in Australia. How long will it take to get cover. Is there a waiting perod?

    1. Post

      Hi John,

      There’s no waiting period as you will be able to re-apply for a Medicare card on day 1 of your return. The Medicare office should be able to let you know your Medicare number and theoretically you should be able to use services straight away. The main issue that you will need to satisfy is that you must be an Australian resident at the time of applying for the card, otherwise they will not issue one to you.

      Hope that helps.



  20. Great read and thanks for the clarification Shane – I now need to find out if registering my newly born son complicate my residency status determination more! Maybe I just wait until we come back in a few years…

    1. Post

      Thanks Gavin.

      Regarding your newly born son, firstly congratulations and secondly, it’s probably safer to simply register your son when you come back (as the alternative is likely to be a factor towards residency).



  21. Thanks Shane. This was very helpful reading after needing to go to emergency for my son over the Christmas holidays. I was of the impression I would get a huge tax bill.

    1. Post

      Hi Cam,

      Thanks so much for your positive comments. I hope that you son pulled through okay and that the emergency wasn’t too serious. I’m also glad you found our article to be helpful so thanks once again for your kind comments.



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