What is bulk billing and how does it work?

Australia’s publicly funded healthcare system, Medicare, is designed to make essential health services affordable and accessible to all Australians. In fact, there are many healthcare services you can access for free, thanks to bulk billing health practitioners and general practice clinics.  

According to the latest Australian Seniors Cost of Health Report 2023 (which surveyed over 1,200 Australians over 50), 49% of respondents always use bulk billing GPs, and a further 34% are completely reliant on Medicare (including bulk billing) to afford essential health treatments. 

Are you curious about how bulk billing works? In this practical guide, we’ll explain how bulk billing compares to other healthcare payment methods, its benefits, and how to find your nearest bulk billing GP.   

The state of healthcare services in Australia 

Medicare is Australia's universal health care scheme and was introduced to help Australians pay for the cost of medical services. Its goal is simple: to help ensure Australians can access the care they need, regardless of their location or income. 

As a key part of Medicare, bulk billing means certain healthcare services are available to you at no out-of-pocket cost. However, finding bulk billing GPs is becoming increasingly challenging, with certain electorates experiencing an almost 30% decline in bulk billing clinics over the past 12 months, according to analysis of Australia’s Healthdirect GP finder database. 

The Australian Seniors Cost of Health Report 2023 echoes this sentiment, with around 7 in 10 (71%) of respondents agreeing it’s getting harder to find doctors who provide sufficient bulk billing services.    

Around 58% of respondents say the cost of appointments and the inability to find a bulk billing GP are among the greatest challenges currently facing the Australian healthcare system.  

Plus, 2 in 5 (39%) agree they have to travel some distance to find a bulk billing GP that offers affordable healthcare services with an acceptable wait time.  

How to access healthcare services: exploring your options 

There are two ways to pay for the costs of seeing a GP in Australia:  

• Bulk billing: Under the Medicare Benefits Schedule (MBS), a number of medical and hospital services (including some tests and scans) are subsidised. By presenting your Medicare card and booking with a bulk billing doctor, you can access some services and appointments at no out-of-pocket cost.  
• Private billing: If your GP doesn’t offer bulk billing, you’ll either need to pay the full out-of-pocket cost of your visit or the difference between what the GP charges and what Medicare covers (known as a gap payment).  

By visiting a bulk billing GP, you won’t need to pay any fees. Instead, your doctor will bill Medicare directly for the costs of your visit, and your doctor accepts the Medicare benefit as full payment for this service. 

If you need to make a gap payment, the easiest way to claim Medicare benefits on any out-of-pocket costs is at your GP’s office right after you pay. This means you should receive a rebate on the spot. However, you can also make a claim online using your Medicare account or using the Medicare Express Plus app.  

What’s covered by bulk billing? 

In general terms, the healthcare services typically that bulk billing can cover include: 

• A visit to your GP or even a specialist health professional 
• Some tests and scans like X-rays and pathology tests  
• Certain eye tests performed by optometrists 

Australian Seniors Tip: On 1 November 2023, the Australian Government increased the Medicare Benefits Schedule (MBS) bulk billing incentive payment for Commonwealth concession card holders for a range of services. This increase is designed to help GPs continue to offer bulk billing appointments to Australians most impacted by rising cost-of-living pressures.  

On the flip side, Medicare typically doesn’t cover the costs of: 

• Ambulance services 
• The majority of dental services  
• Glasses and contact lenses 
• Hearing devices 
• Elective and cosmetic surgeries  
• Services not listed on the MBS 
• Other services provided through the private health system (if you have private health insurance, your policy may cover some of these costs instead)  

Who’s eligible for bulk billing in Australia?  

To be eligible for a bulk billing arrangement, you need to be registered with Medicare and hold a valid Medicare card. Not all medical practitioners may offer it, so be sure to check with your healthcare provider to see if they offer bulk billing for the services you need. 

The benefits of bulk billing healthcare services  

Bulk billing makes healthcare services more accessible to everyday Australians, offering a range of benefits, including: 

• Financial savings: With no out-of-pocket costs, bulk billed appointments can help ensure you can receive the care and medical service you need without worrying about the final bill.  
• Simplified payment process: Bulk billed appointments are free of charge to patients, meaning your fees are charged directly to Medicare. 
• Accessible healthcare without the upfront costs: Simply by showing your Medicare card and Commonwealth Concession Card and finding a bulk billed GP, you can access the services you need at no cost.  

How to find bulk billing GPs and clinics near you  

The easiest way to find your nearest bulk billing GP or health clinic is to use the ‘find a health service’ tool on the Australian Government’s Healthdirect website. Search by the service you need and your suburb or postcode to find a bulk-billed doctor in your area.  

Prior to booking, always make sure to check with your GP that your specific appointment type or healthcare service is eligible for bulk billing. Some clinics may only offer bulk billed appointments during certain times or days of the week. 

Plus, always bring your Medicare card and Commonwealth Concession Card to your appointment, and ensure these documents are up to date.  

Ultimately, bulk billing is designed to make essential health services affordable and accessible to Australians. By offering essential healthcare services free of charge (like a visit to your GP), bulk billing helps to lower the barriers to accessing crucial health services in Australia.  

Download the Australian Seniors Cost of Health Report 2023, exploring the challenges Australians over 50 are facing with the rising cost of living and the growing cost of healthcare.