Guidelines for obtaining Medicare benefits when practising as a GP in Australia vary based on several factors. The main factor is if you are an Australian citizen and have obtained an Australian accredited qualification in medicine. Foreign practitioners have a different set of guidelines as defined by the Australian government.

Sections 19AA and 19AB clearly defines the requirement specifications to gain Medicare benefits for each type of doctor. This is often confusing, especially for those who are new to the subject. However, it’s equally important to know what these are and their specifications.

So, let’s dive into the topic and identify the differences between 19AA and 19AB.

About Section 19AA

Sections 19AA of the Health Insurance Act 1973, defines the requirements for doctors who are citizens or residents of Australia to access Medicare benefits. It requires these doctors to hold vocational recognition or work actively towards it to access these benefits. There are no exemptions for these doctors, under section 19AA.

Doctors who are permanent residents of Australia should have a fellowship with the following;

·        The Royal Australian College of General Practitioners (RACGP)

·        The Australian College of Rural and Remote Medicine (ACRRM)

·        An Australian Medical Specialist College

If a doctor does not satisfy the above requirements, he needs to be on one of the below-approved training programs and should be working towards attaining a fellowship.

·        ACRRM Independent Pathway Program

·        Australian General Practice Training Program (AGPT)

·        Remote Vocational Training Scheme (RVTS)

·        RACGP Practice Experience Program (PEP)

·        Approved Medical Deputising Services Program

·        More Doctors for Rural Australia Program

If you gain permanent residency in Australia before obtaining vocational recognition and are not following an approved training, your Medicare access will cease. To obtain Medicare access you need to join any of the above-approved training programs.

Gaining fellowship is important as it ensures that you qualify for complete Medicare benefit access and well-qualified and experienced medical practitioners in Australia.

Processing Timeframe

Medicare provider number applications are mainly processed during the period starting December up until March. It takes approximately 6 weeks to completely process an application and issue a Medicare provider number.

About Section 19AB

Section 19AB of the Health Insurance Act 1973 is aimed at overseas-trained doctors and International Medical Graduates (IMGs). Foreign doctors should have an accredited qualification from a medical school approved by the Australian Government.

Processing Timeframe

Medicare provider number applications for section 19AB are mainly processed during the period starting November up until April. It takes approximately 6 weeks to completely process an application and issue a Medicare provider number.

All applications are processed and approved based on a strict order of receipt to ensure fairness in the entire procedure and approval of the Medicare number issuing process.

Location Restrictions

Overseas-trained doctors and medical graduates with an approved medical qualification from an accredited medical school, need to work in areas that need them the most. Section 19AB brings about this requirement to ensure that people living in every area have access to quality healthcare regardless of the location.

Foreign-trained doctors and IMGs must work for 10 years in the following areas, from the time they get their medical registrations in Australia.

·        For General Practitioners (GPs) - Distribution Priority Area (DPA)

·        For Non-GPs – District of Workforce Shortage (DWS)

This is called the “10-year moratorium”. You can reduce the timeframe for the above through a process called scaling. You can find more information on the 10-year moratorium and scaling via the official website of the Australian Health Department.

These restrictions do not apply to doctors who don’t attract Medicare benefits, such as salaried positions in public hospitals.

Following is a summary of who these restrictions apply. You are restricted from receiving a Medicare provider number if you are:

·        An overseas-trained doctor with a medical degree from a medical college outside of Australia or New Zealand

·        A temporary resident enrolled in a medical college in Australia or New Zealand (This is applicable for foreign graduates enrolled in an accredited medical school)

Section 19AB Exemptions

Gaining exemptions allows access to Medicare benefits before the end of the 10-year moratorium. The best method to obtain this is to work in a DPA or DWS based on if you’re a GP or Non-GP. Exemptions to work outside of these locations are very limited.

Before applying for an exemption, you need to have knowledge about who is eligible to apply for exemptions and the type of evidence you need to submit for this process. You can apply for all exemptions by including the supporting evidence you have along with your Medicare provider number application. However, the exception is on the spousal and discretionary exemptions, for which you need to take additional steps.

All applications are processed based on the order they are received. Exemptions are assessed within 28 working days of receiving them.

Spousal and Discretionary Exemption

The spousal and discretionary exemption follows a different procedure than any other exemption, which follows the above procedure. In this case, an initial assessment is done prior to applying for a Medicare provider number.

If you are applying for the spousal exemption, you need to complete and submit the application form which is given on the website of the Australian Health Department. If you are applying for the discretionary exemption, you need to send details of your situation and circumstances as outlined in the detailed fact sheet given on the same website.

Declined Applications

Declined applications for exemptions are allowed to be reviewed 90 days from the decision date. You can request a review of your declined application via an email with the below details.

·        Reasons you think for the decisions to be incorrect

·        Additional documents and evidence which you think may assist to assess your eligibility for an exemption

Obtaining Permanent Residency

If you obtain permanent residency, you must inform of this to Medicare because your exemption may prove to be invalid.

However, your exemption will not change if you have a fellowship qualification or are on one of the approved training programs given above.

In order to access Medicare benefits after becoming a permanent resident, (without a fellowship qualification) you need to do the following.

·        You need to join a 3GA-approved training program defined under Section 19AA

·        You will require an exemption under Section 19AB

Visit the official website of the Australian Health Department for more information on the requirements under section 19AA and sections 19AB of the Health Insurance Act 1973.

Conclusion

At Medfuture, we provide Australian and New Zealand doctors as well as Overseas-trained doctors and IMGs the assistance required to find a job and practice in Australia. We have a strong network that enables us to access the best doctor jobs in Australia.

Our longstanding efforts have enabled us to match the most-suited jobs for every candidate as well as assist in finding the best recruits for vacancies in the healthcare industry in Australia.

Visit our website to find out the latest list of doctor jobs in Australia and other vacancies in the healthcare industry.