Introduction
Medicare is Australia’s publicly-funded universal health insurance scheme and is designed to provide Australians (and eligible overseas visitors) access to a wide range of health and hospital services at reduced or no cost. GPs determine how they charge for the service they provide and may choose to:
- bill the Australian Government and accept the Medicare benefit as the full payment of the service. This is known as bulk billing and the patient does not pay anything for the service.
- bill the patient directly (where they do not bulk bill). If the fee charged is higher than the scheduled Medicare fee (that is, the Medicare benefit), the gap is known as the 'out-of-pocket' cost and this is paid by the patient.
This report examines trends in both the GP bulk billing rate and out-of-pocket costs across the last 40 years, as the financial cost of a GP visit has been identified as a potential barrier to Australians seeing a GP (other factors being service availability and waiting times). During 2023–24, 8.8% of people aged 15 and over cited cost as a reason for delaying or putting off care from a GP when needed in the last 12 months (ABS 2024).
This report is a companion to the AIHW’s Medicare GP bulk billing dashboard and adds to reporting conducted by the Australian Government Department of Health and Aged Care on Medicare statistics.
Note that reported figures may differ slightly:
- The Department of Health and Aged Care’s Medicare statistics are based on the date the service was processed by Services Australia.
- Statistics in this report are based on the date the service (GP attendance) was delivered.
These differences may result in minor variations between the 2 reported bulk billing rates.
See Technical notes for more information about the data used in this report.
This report focuses on 2 key measures (calculated monthly and annually):
- the bulk billing rate (%) for GP attendances (referred to as the GP bulk billing rate). This is the number of bulk billed GP attendances divided by the total number of all GP attendances x 100.
- the average out-of-pocket costs that patients paid for GP attendances (non-hospital services) when they were not bulk billed. This is calculated by dividing the out-of-pocket costs for (non-hospital) GP attendances by the number of (non-hospital) GP attendances delivered to patients.