Australia and Canada both have universal healthcare systems designed to make essential medical services accessible to all citizens and permanent residents. However, despite offering similar principles of care, there are important differences in what is covered, what costs patients must bear out of pocket, and how private insurance factors into each system. Understanding these differences is crucial, especially for newcomers or those planning to move between the two countries. Here’s a detailed look at healthcare costs in Australia and Canada — and what’s included under each country’s healthcare umbrella.
1. Core Healthcare Coverage
Australia: Medicare Coverage
Australia’s Medicare covers a wide range of medical services, including:
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Free treatment as a public patient in public hospitals
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Subsidized visits to general practitioners (GPs)
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Subsidized specialist consultations
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Some diagnostic tests like x-rays and blood tests
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Certain surgical procedures
Medicare also partially covers prescription medications under the Pharmaceutical Benefits Scheme (PBS), which reduces the cost of many drugs for eligible patients. However, dental care, physiotherapy, optical care (glasses and eye exams), and ambulance services are generally not fully covered and may require private insurance or direct payment.
Canada: Medicare Coverage
In Canada, Medicare (administered at the provincial level) provides:
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Free hospital care
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Free physician visits
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Essential surgical procedures
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Diagnostic services such as lab tests and imaging
However, like Australia, Canadian Medicare does not cover:
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Most prescription drugs (outside hospitals)
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Dental care
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Vision care (glasses and routine eye exams for adults)
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Mental health services like therapy (unless hospital-based)
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Ambulance services (depending on the province)
Each province and territory may offer additional coverage or subsidies for certain groups like seniors, low-income families, or children.
2. Prescription Medication Costs
Australia: Subsidized Through PBS
Australia’s Pharmaceutical Benefits Scheme (PBS) significantly lowers the cost of hundreds of common medications. Under the PBS, patients pay a capped co-payment (around AUD $31.60 per prescription as of 2025, or less for concession cardholders), with the government covering the rest.
Canada: Limited Public Coverage
In Canada, outpatient prescription medications are not covered by universal healthcare. Some provinces offer public drug plans for specific populations, such as seniors or people on social assistance. Otherwise, individuals must rely on private insurance (often through employers) or pay out of pocket for medications.
3. Private Health Insurance
Australia: Encouraged for Additional Services
In Australia, private health insurance is widely encouraged. It helps cover:
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Private hospital care
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Choice of doctor in hospitals
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Shorter wait times for elective surgeries
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Dental, optical, and physiotherapy services
The government even offers rebates to make private insurance more affordable and imposes a Medicare Levy Surcharge on higher-income earners who don’t hold private coverage.
Canada: Limited to Non-Core Services
In Canada, private insurance is used mainly to cover services not included in Medicare, such as:
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Dental care
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Prescription drugs
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Vision care
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Private hospital rooms
Private insurance cannot cover core healthcare services like doctor visits or hospital care, maintaining the equity of the public system but leaving fewer options for bypassing wait times.
4. Out-of-Pocket Costs
Both systems aim to minimize patient costs for essential services, but some expenses are unavoidable:
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In Australia, out-of-pocket fees may apply for GP visits (if doctors charge above the Medicare rebate) and for services outside Medicare coverage.
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In Canada, patients often face out-of-pocket costs for medications, dental, and vision care if they lack supplementary insurance.
Conclusion
Both Australia and Canada offer strong healthcare protections, but neither system covers everything. Australians benefit from subsidized medicines and a more robust private system, while Canadians enjoy free access to essential medical services but must navigate more out-of-pocket costs for drugs and other services. Understanding what’s covered — and what’s not — is essential for managing your healthcare expenses in either country.
