Costs and funding in Australia

Verify every figure and scheme detail against a current primary source before publishing. This page must not state or imply the cost of any specific medicine.

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Cost is one of the main practical barriers to weight management care in Australia, and it's poorly explained almost everywhere. Here's how the funding actually works.

Consultations

GP appointments are either bulk-billed (no out-of-pocket cost) or charged with a Medicare rebate leaving a gap. Longer appointments — often needed for this kind of care — attract higher fees and higher rebates.

Specialist appointments require a GP referral, which is what makes a Medicare rebate available. Fees are set by the practice and gaps vary considerably. Ask for the fee and expected gap when booking; you're entitled to that before the appointment.

Allied health

Dietetics, exercise physiology and psychology can be accessed privately without a referral, paying full fee.

Through a GP-initiated chronic disease management plan, Medicare rebates are available for a limited number of allied health visits per year for eligible conditions, including type 2 diabetes. Private health extras cover may also apply, though not for the same visit as a Medicare rebate.

Verify: current visit limits, eligible conditions and rebate amounts.

Investigations

Blood tests are commonly bulk-billed. Imaging varies — what Medicare covers depends on the specific test and how it's performed, which is why liver scan costs differ so much between providers. See *what a liver scan costs in Australia*.

Medical treatment

Whether a medicine is subsidised depends on PBS listing and the specific clinical criteria attached to it. Where those criteria aren't met, the full private cost applies. Your prescriber and pharmacist can tell you what applies in your case.

Verify: current PBS listing status and criteria for relevant indications — this has changed repeatedly and is the single most likely thing on this page to become inaccurate.

Surgery

Mostly accessed privately in Australia. Costs include the surgeon, anaesthetist, hospital and follow-up care. Health fund cover may apply depending on your policy and waiting periods; out-of-pocket costs are frequently substantial. Public access exists but waiting lists are long.

Get a written quote covering every component before committing.

Reducing what you pay

• Ask about bulk-billing when booking
• Ask for a full quote including gaps, in advance
• Ask your GP about a chronic disease management plan
• Check your private health extras before paying full fee
• Check whether the Medicare Safety Net applies if you have high annual costs
• If travel for specialist care is required, check your state's patient travel assistance scheme

Next: Your first consultation · Find a bulk-billing clinic →