Australia has Reciprocal Health Care Agreements (RHCAs) with 11 countries, and for anyone planning travel to one of them, it’s worth understanding exactly what that covers, because the coverage is narrower than most people assume, and it is not a substitute for travel insurance.
This guide explains which countries are covered, what the agreements actually provide, and the specific gaps that catch people out, most importantly, medical evacuation.
A note on what this is: Practical travel guidance, not medical or insurance advice. Confirm your specific circumstances and any current changes to these agreements with Services Australia or Smartraveller before you travel.
Which Countries Have an RHCA With Australia
Australia currently has Reciprocal Health Care Agreements with 11 countries:
- United Kingdom
- Republic of Ireland
- New Zealand
- Sweden
- Netherlands
- Finland
- Norway
- Belgium
- Slovenia
- Malta
- Italy
That’s the complete list. Countries people commonly assume are included but are not: Canada, the United States, Germany, France, Spain, Japan, South Korea, and most of Asia. If you’re travelling somewhere not on this list, there is no reciprocal arrangement at all, and you or your insurer are responsible for the full cost of any care.
What the Agreements Actually Cover
The general pattern, though details vary by country
Most RHCAs cover medically necessary care that cannot reasonably wait until you return home, typically as a public patient in a public hospital, some out-of-hospital medical treatment, and some subsidised prescription medicines. A treating doctor decides whether care meets the “medically necessary” threshold, not you.
What’s generally not covered
Private hospital treatment, treatment as a private patient, dental care, optical care, and ambulance transport are typically excluded across most agreements. Co-payments are common even for care that is covered.
New Zealand is a partial exception
New Zealanders visiting Australia don’t need to enrol in Medicare or carry a Medicare card. Coverage applies automatically for the length of their stay on presentation of a New Zealand passport. Coverage for Australians visiting New Zealand works differently again, so check the specific arrangement for your destination rather than assuming it mirrors what applies elsewhere.
What the Agreements Do Not Cover
This is the part that causes genuine problems.
Medical evacuation is never included
No RHCA covers medical evacuation, and evacuation costs can run into tens of thousands of dollars. If you need evacuation from an RHCA country, you or your travel insurer pay the full cost.
Pre-existing conditions are often excluded or limited
Coverage for a condition you already had before travelling varies by agreement and is frequently more restricted than coverage for a new illness or injury that arises during the trip.
Cover typically ends when your reason for being there ends
Most agreements cover you only while in the country for tourism, business, or a similar temporary purpose, generally up to a set number of months. Longer stays, working holidays, or relocating can change your eligibility.
There’s no cover at all outside the 11 countries
Worth repeating, since it’s the most common misunderstanding: if your destination isn’t on the list, there is no reciprocal arrangement, regardless of how developed the local healthcare system is.
Why an RHCA Is Not a Substitute for Travel Insurance
Even in a country with a full RHCA, you’re still exposed to the gaps above, most significantly medical evacuation, which is often the single largest cost in a serious overseas medical event. Smartraveller and Services Australia both explicitly recommend travel insurance regardless of whether your destination has an RHCA with Australia. Read our Travel Insurance and Pre-Existing Conditions guide for what to check before you buy, particularly around evacuation cover and your specific medical history.
How to Access Care Under an RHCA While Overseas
Bring your passport
This is generally the primary proof of eligibility, alongside evidence of your Australian citizenship or residency where required. Check the specific requirements for your destination before you travel, since documentation requirements vary by country.
Present at a public facility
RHCA coverage generally applies to public hospitals and, in some countries, specific public health providers, not private clinics or hospitals. Ask specifically to be treated under the reciprocal agreement.
Expect a co-payment
Most agreements involve some out-of-pocket cost even for covered care. Budget for this rather than assuming treatment will be entirely free.
Before You Book
Check the current details for your specific destination
Agreements and their terms can change. Confirm the current position on the Services Australia website before you travel, rather than relying on general information, including this guide.
Get travel insurance regardless of destination
An RHCA reduces some risk in 11 specific countries. It does not replace the protection travel insurance provides, particularly for evacuation.
Understand your coverage if managing a health condition
If you have a pre-existing condition, check both how your destination’s RHCA treats pre-existing conditions and how your travel insurance policy treats them, since the two are assessed separately.
FAQs
Which countries have a Reciprocal Health Care Agreement with Australia?
Eleven: the United Kingdom, Republic of Ireland, New Zealand, Sweden, the Netherlands, Finland, Norway, Belgium, Slovenia, Malta, and Italy.
Does a Reciprocal Health Care Agreement cover medical evacuation?
No. No RHCA covers medical evacuation. This needs to come from travel insurance.
Do I still need travel insurance if I’m travelling to an RHCA country?
Yes. Services Australia and Smartraveller both recommend travel insurance for all overseas travel, including to RHCA countries, because of gaps like evacuation, private treatment, dental, and optical care.
Does an RHCA cover pre-existing conditions?
This varies by country and is often more limited than cover for a new illness or injury. Check the specific terms for your destination and confirm separately with your travel insurer.
Is Canada covered by an Australian Reciprocal Health Care Agreement?
No. Canada, the United States, and most of Asia are not included in Australia’s 11 RHCA countries, despite this being a common assumption.
How do I access care under an RHCA while overseas?
Generally by presenting your passport at a public hospital or public health provider in the relevant country and requesting treatment under the reciprocal agreement. Requirements vary by country, so check before you travel.
Final Thoughts
Reciprocal Health Care Agreements provide a genuine safety net in 11 specific countries, but the coverage is narrower than most travellers assume, particularly around medical evacuation, private treatment, and pre-existing conditions. The details that matter most are knowing whether your destination is actually on the list, understanding that evacuation is never covered, and treating an RHCA as a supplement to travel insurance rather than a replacement for it.
A note on what this is: Practical travel guidance, not medical or insurance advice. Confirm current details for your specific destination with Services Australia or Smartraveller before you travel.
For more on planning around your health while travelling, read our guides on travel insurance and pre-existing conditions and what to do in a medical emergency overseas.
