Eye examinations provided by optometrists are subsidised Medicare for all permanent residents of Australia. All Australians qualify for optometric benefits without having to take out private health insurance.
You will receive Medicare benefits for eye examinations, except for some contact lens fitting consultations and some examinations that test your visual fitness to drive, fly or be employed by organisations such as the Australian Defence Forces.
Optometrists can direct bill the government on your behalf. This is also known as 'bulk-billing'. Many optometrists direct bill on behalf of pensioners, children and those with limited financial means. This means that all Australians can easily access quality eyecare without having to contribute from their own pockets.
Claiming from Medicare
If your optometrist bulk bills Medicare for your eye examination you pay nothing for the examination. Medicare pays the optometrist 85 per cent of the examination fee and that is accepted by the optometrist as full payment.
Sometimes your optometrist may recommend additional testing, such as digital retinal photography, that is not eligible for a Medicare rebate but is recommended in the best interests of your eye health.
If your optometrist does not bulk bill you can claim Medicare benefits by submitting a claim to Medicare just like you would when you see the doctor. You will have to pay the difference between the account and the Medicare refund, usually 15%, but this can be higher. However if you have already had an eye examination in the last two years Medicare will pay you a reduced benefit.
So that you receive your Medicare benefits you should always take your Medicare card to the Optometrist and when you claim from Medicare. The card has your Medicare number on it and is proof that you are eligible for Medicare benefits.
You do not need a referral from a medical practitioner to see an optometrist. Simply contact your local optometrist and they will be happy to arrange an appointment time.
Private Health Insurance
You do not need private health insurance in order to receive a Medicare benefit for an eye examination performed by an optometrist. If you do have private health insurance with extras cover you may be eligible for subsidised prescription glasses and contact lenses. If you are unsure of your private health rebate you should contact your private health insurer.