Medicare Overhaul: What It Really Means for Everyday Aussies in 2025

G’day, mates. If you’ve been to the GP lately and walked out with a lighter wallet than expected, you’re not alone. Out-of-pocket costs for doctor visits have been creeping up for years, and bulk billing – that glorious system where Medicare covers the lot – has been harder to find than a parking spot at Bondi on a sunny Saturday. But hold onto your Vegemite toast, because the biggest shake-up to Medicare since 1984 is kicking off tomorrow, November 1, 2025, and it could save you hundreds of dollars a year.

Let’s break it down in plain English – no jargon, no spin – just the facts you need to know before you book your next appointment.

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The Big One: Bulk Billing Is Back – For Everyone

From tomorrow, 1 November 2025, every Australian with a Medicare card can walk into a participating GP clinic and be bulk-billed — no gap fee, no wallet needed. That’s right: kids, pensioners, workers, tradies — everyone.

This is the largest Medicare investment since 1984 — a $7.9 billion, 10-year plan to triple the number of 100% bulk-billing practices from ~1,600 today to 4,800 by 2030. The goal? 90% of all GP visits free within five years.

“This is a big expansion of bulk billing as a result of our record investment,” Health Minister Mark Butler said last week. “It’s good for patients — millions of Aussies will be able to see their doctor without extra costs.”

But it won’t happen overnight. Clinics must opt in to the new incentives. The government says ~900 practices have already committed to 100% bulk billing from Day 1, but many will take months or years to join.

The Data: Where Bulk Billing Stands Today

According to the Australian Institute of Health and Welfare (AIHW) — using Medicare claims data — here’s how bulk billing has changed over the last three years (rolling 12-month periods):

State	Nov 2021–Oct 2022	Nov 2022–Oct 2023	Nov 2023–Oct 2024
NSW	88.8%	82.4%	82.2%
VIC	86.3%	78.9%	78.5%
QLD	85.0%	76.1%	75.8%
WA	83.5%	72.6%	70.5%
SA	84.5%	73.5%	74.6%
TAS	75.8%	68.4%	71.9%
ACT	65.5%	53.3%	53.2%
NT	83.3%	72.0%	74.7%
National	86.0%	78.0%	77.7%

Source: AIHW analysis of MBS data, Department of Health and Aged Care

What this means for you:

• National bulk billing is down from 86% in 2021–22 to 77.7% in 2023–24 — a drop of 8.3 percentage points.
• Working-age adults (16–64) are hit hardest: only ~57–60% of their GP visits are bulk-billed — and in some states (like WA), it’s still falling.
• A decade ago, the national rate peaked at over 86% — so we’ve lost ground, especially for everyday workers.

This reform fixes that. From tomorrow, GPs get higher payments to bulk bill everyone — not just kids and pensioners.

To see the bigger picture, check this chart from AIHW data: GP bulk billing rates across states and territories, by age group, 2003 to October 2024. It shows national trends over time, highlighting how rates for kids (0–15) and seniors (65+) have stayed high (~85–95%), while working-age adults (16–64) have lagged behind, dropping from ~75% in 2003 to ~57% in 2024.

Chart source: AIHW analysis of MBS data.

Pro Tip: Call your clinic today and ask:

“Will you bulk-bill all Medicare card holders from 1 November?”

If yes — book in. If no — ask when they plan to join.

How Does the New System Actually Work?

Under the old rules, GPs got a small “incentive payment” from Medicare only if they bulk-billed kids under 16, pensioners, or concession card holders. Everyone else? Full price or gap fees.

Now, according to Services Australia, GPs will get a higher incentive for bulk billing anyone – and the more patients they register under MyMedicare, the bigger the bonus.

Think of MyMedicare like joining a loyalty program at your local café. You nominate your preferred GP, and in return:

• Your doctor gets extra funding to keep costs down
• You get priority access and better care coordination
• Bulk billing becomes more likely

As of October 2025, over 2.5 million Aussies have already signed up to MyMedicare. If you haven’t, it takes 2 minutes online via myGov.

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Good News for Your Medicine Cabinet Too

It’s not just doctor visits getting a makeover. From 1 January 2026, the maximum you’ll pay for PBS-subsidised medicines drops from $31.60 to $25 per script — a 20% cut, locked in to shield you from inflation.

“Australians will save $6.60 on every PBS medicine from 1 January 2026,” Health Minister Mark Butler announced in the 2025 Budget.

That’s $6.60 back in your pocket every time you pick up a script. For a family filling four PBS scripts a month, that’s up to $316 saved per year — or $238 if you hit the Safety Net after 36 scripts.

Pensioners and concession card holders? Their co-payment stays frozen at $7.70 until 2030 — no cuts, just certainty.

And there’s more life-changing news:

• Lumasiran (Oxlumo) – a breakthrough treatment for a rare kidney disease – was added to the PBS on 1 October 2025. Without subsidy: over $500,000 per year. With PBS: just $31.60 (general co-pay) or $7.70 (concession).
• Selinexor (Xpovio) for multiple myeloma is now a Highly Specialised Drug — meaning free access in public hospitals.

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Tax Relief: You Might Not Pay the Medicare Levy Anymore

Remember that 2% Medicare levy on your tax? According to the Australian Taxation Office (ATO), over one million low-income Aussies got a break this year.

From July 1, 2024 (and still in effect), the income threshold for the levy went up by 4.7%. That means:

Who	Old Threshold	New Threshold (2024–25)
Singles	$24,276	$26,000
Couples/Families	$40,939	$43,846
Seniors/Pensioners	$38,365	$40,939

If you earn under these amounts, you pay zero Medicare levy. If you’re just over, you pay less. That’s $648 million back in pockets of everyday Aussies, according to Treasury.

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What’s Already Happening Behind the Scenes

The government isn’t waiting until November to act. According to the 2025 Federal Budget, they’ve already pumped $8.5 billion into “Strengthening Medicare” – the biggest single investment since Bob Hawke launched the system in 1984.

What’s that money buying?

• 50 new Urgent Care Clinics (walk-in, bulk-billed, no appointment needed) – bringing the total to 137 by mid-2026
• Training 1,500 extra doctors and nurses
• Better pay for GPs in rural and regional areas
• New consumer advisory committees so you can have a say

Plus, MyMedicare is getting smarter. From July 1, 2025, Chronic Disease Management plans were updated to give GPs more flexibility. And aged care patients? There’s a GP Aged Care Incentive (GPACI) payment – but only if your doctor sees you at least once every three months.

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The App Change You Need to Know About

Hate waiting on hold to Services Australia? You’re not alone. But here’s a heads-up: from November 1, 2025, you can’t use the old Express Plus Medicare app anymore.

According to Services Australia, all mobile Medicare services move to the myGov app. That means:

• View claims
• Update bank details
• Order a new card
• Link to MyMedicare

All in one place. If you haven’t downloaded myGov yet, do it now. It’s free, secure, and saves you from 20-minute hold music.

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Your Medicare Checklist: What to Do This Week

1. Call your GP – Confirm if they’re bulk billing all patients from November 1.
2. Register with MyMedicare – Lock in your doctor and boost their funding.
3. Download myGov app – Don’t get locked out of online services.
4. Check your scripts – Ask your chemist if your meds qualify for the $25 cap in 2026.
5. Review your tax – Use the ATO’s Medicare levy calculator if you’re near the threshold.

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The Bottom Line

This isn’t just another government promise before an election. According to the independent Grattan Institute, bulk billing incentives do work – but only when they’re high enough and simple enough. This reform ticks both boxes.

Will every clinic bulk bill tomorrow? No. Will you save money in 2026? Almost certainly.

For the first time in years, Medicare is moving towards being truly universal again – not just in name, but in your hip pocket.

So next time you’re at the doctor, ask the question. And if they say “bulk billed,” give ‘em a smile. You helped make it happen.