What Does OSHC Cover?

What OSHC covers

OSHC covers a range of core healthcare services. GP visits (bulk-billed or with a gap payment) are covered. Public hospital treatment — including emergency, inpatient, and day surgery — is included. Ambulance services are covered if medically necessary. Most OSHC plans also cover prescription medicines on the Pharmaceutical Benefits Scheme (PBS), usually with a patient contribution.

The exact level of cover varies between providers (Allianz Care, ahm, Bupa, Medibank, nib) and between different tiers of each provider's plans. Mid-tier and higher plans typically offer better coverage of these services, including lower gap payments at the GP, higher hospital benefit limits, and wider medicine cover. Basic plans cover the essentials but with tighter limits.

What OSHC does NOT cover

OSHC does not cover dental treatment — not emergency dentistry, not routine checkups, not fillings or extractions. Optical services (eye tests, glasses, contact lenses) are also excluded. Physiotherapy, chiropractic, osteopathy, and most other allied health services are not covered by standard OSHC.

Mental health and psychological counselling are usually covered only up to a limited number of visits per year (check your policy), and often require a referral from a GP. Orthotics and prosthetics (like hearing aids or shoe inserts) are typically not covered.

Elective (planned) procedures and cosmetic treatments are excluded. Pre-existing conditions are usually subject to a 12-month waiting period. Overseas medical treatment is not covered — OSHC only applies to care received in Australia.

The gap between OSHC and OSHC Extras

The distinction between OSHC and OSHC Extras is important. OSHC is the core cover (hospital, emergency, GP, prescriptions). OSHC Extras is a separate optional policy that covers services OSHC doesn't: dental, optical, physiotherapy, chiropractic, naturopathy, and other services. Many providers sell OSHC and OSHC Extras as a combined package, but you can also buy OSHC alone.

If you need dental or optical care while on a student visa, you must buy OSHC Extras — OSHC alone won't cover it. Budget accordingly: dental work and new glasses can be expensive out of pocket.

Hospital treatment in detail

Public hospital treatment under OSHC covers emergency department visits, inpatient hospital stays, and day procedures. You do not get a choice of hospital or doctor — the benefit applies to public facilities and to doctors working in the public system. Private hospitals and private doctors are not covered by OSHC; private health insurance would be needed for those.

OSHC covers the cost of hospital treatment, medicines administered in hospital, and basic hospital accommodation. Extras like private or semi-private rooms are not covered. Hospital meals, phone calls, and other accommodation extras are your responsibility.

GP and doctor visits

GP visits are usually covered by OSHC, either fully bulk-billed or with a gap payment (the amount you pay and OSHC reimburses the rest). The gap varies by doctor and OSHC plan. Some doctors bulk-bill all OSHC students; others charge a gap. Check with your GP before your visit to avoid surprises.

Specialist doctor visits (cardiologist, dermatologist, etc.) are usually covered only if referred by your GP, and may have higher gap payments. Overseas telehealth consultations are not covered.

Prescription medicines

OSHC covers prescription medicines listed on the Pharmaceutical Benefits Scheme (PBS). You'll pay a patient contribution (the co-payment), and OSHC covers the rest. The co-payment amount changes each year — check the current amount at pbs.gov.au. Medicines not on the PBS (very new medicines, or medicines not approved in Australia) are not covered.

Over-the-counter medicines (paracetamol, antihistamines, etc.) are your responsibility.

Mental health services

Mental health support under OSHC is usually limited. OSHC typically covers GP consultations for mental health (bulk-billed or with a gap), and a limited number of psychology or counselling sessions per year if referred by a GP. The number of sessions and the gap payment vary by plan.

If you need ongoing mental health support, check your policy details and consider whether OSHC Extras (if it covers psychology) or private psychology insurance would be useful.

Pregnancy and maternity

OSHC covers pregnancy and maternity only if you've held your policy for 12 months before giving birth, and only on mid-tier and higher plans. Cover is usually limited to inpatient (hospital) care. Antenatal checkups, scans, and postnatal GP visits are usually not covered by OSHC maternity benefits.

Does OSHC cover dental treatment?

No. OSHC does not cover any dental work — not emergency, not routine care, not fillings or extractions. You'll need to pay out of pocket or buy a separate OSHC Extras policy that includes dental cover.

Do I need to buy OSHC Extras?

Not necessarily. You only need OSHC Extras if you expect to use services it covers: dental, optical, physiotherapy, chiropractic, or other allied health. Basic OSHC covers hospital, GP, emergency, and prescriptions. Decide based on your health needs and budget.

Is private hospital treatment covered by OSHC?

No. OSHC covers treatment in public hospitals and public emergency departments only. Private hospital treatment is not covered. If you want to use private hospitals or private doctors, you'd need private health insurance.

Does OSHC cover psychology or counselling?

OSHC usually covers a limited number of psychology or counselling sessions per year if referred by a GP. The number varies by plan. Check your policy for the exact limit and whether there are gap payments.

Are telehealth or online doctor visits covered by OSHC?

Telehealth services within Australia are usually covered if provided by a bulk-billing or OSHC-approved provider. Overseas telehealth is not covered. Check with your OSHC provider or the doctor before booking.

What medicines does OSHC cover?

OSHC covers prescription medicines listed on the Pharmaceutical Benefits Scheme (PBS). You'll pay a co-payment and OSHC covers the rest. Medicines not on the PBS and over-the-counter medicines are not covered. Check pbs.gov.au for the current list of covered medicines.