- The UK and Australia have a Reciprocal Health Care Agreement (RHCA) that gives UK visitors free essential and urgent hospital treatment through Medicare, according to the FCDO.
- The same FCDO guidance confirms the agreement does not cover ambulance services or medical evacuation, which it describes as "very expensive".
- A UK GHIC can be used in Australia, but the NHS states it does not cover repatriation back to the UK, private treatment, or ski or mountain rescue.
- ABI members paid out 262 million pounds in travel medical claims in 2024, with an average medical payout of 1,528 pounds.
- FCDO advice flags rip currents, bushfires, cyclones and diving as activity and hazard areas worth checking a policy against.
Australia is one of the few long-haul destinations where UK travellers have a reciprocal health agreement, which makes the relationship between state cover and private travel insurance unusually easy to misread. The protection is real, but it is also narrow, and the gaps it leaves are precisely the ones that produce the largest bills. This guide sets out what the Reciprocal Health Care Agreement does and does not do, what the FCDO advises UK travellers to insure against, and the cover features worth checking before buying a policy for a trip Down Under.
How cover for Australia differs from cover for Europe
For European trips, many UK travellers rely partly on a free Global Health Insurance Card (GHIC), which gives access to state healthcare across the European Economic Area. Australia is unusual among long-haul destinations because it is also on the GHIC list. The NHS confirms a UK GHIC can be used in Australia alongside the EEA, Montenegro, Switzerland and a handful of other territories.
That sits on top of the Reciprocal Health Care Agreement (RHCA) between the two countries. The FCDO states that under the agreement, "Essential and urgent hospital treatment is free," and that UK residents receive "limited subsidised health services from Medicare for medically necessary treatment while visiting Australia". For a destination as far from the UK as Australia, that is more state-backed cover than most long-haul travellers ever have.
The difference, and the reason a separate policy still matters, is what the agreement leaves out. The FCDO lists exclusions including "pharmaceuticals (unless you're in hospital)" and "use of ambulance services and medical evacuations, which are very expensive". The NHS makes the equivalent point about the GHIC, stating it does not cover "being flown back to the UK (medical repatriation)", "treatment in a private medical facility", or "ski or mountain rescue", and that it "is not a replacement for travel insurance". Reciprocal cover handles the hospital ward; it does not handle the flight home or the ambulance that gets you there.
What to look for in a policy for Australia
The FCDO advises travellers to "get appropriate travel insurance" covering "your itinerary, planned activities and expenses in an emergency", and specifically to have cover "for local treatment or unexpected medical evacuation". Its general foreign travel insurance guidance breaks this down further.
On medical cover, the FCDO lists "treatment in state or private hospitals (emergency treatment and hospital bills can be enormously expensive)" and "emergency transport, such as an ambulance: this is often charged separately to other medical expenses and emergency travel home on medical grounds can be very expensive". Because the RHCA explicitly excludes both ambulance use and evacuation, these two lines are the parts of a policy that do the work the reciprocal agreement cannot for an Australian trip.
The FCDO also advises declaring "existing conditions or pending treatment or tests so that you are covered if there are related complications during your trip". Its health page singles this out for Australia, noting that adequate cover is "particularly important if you have a health condition or are pregnant". Separately, the FCDO notes that "Some insurers may waive any excess on medical treatment if you use an EHIC or GHIC", which is a reason to carry a GHIC for Australia even though private insurance remains the primary safety net.
Cover limits and exclusions to check
Scale matters most on the medical line. The ABI reported that its members paid out 472 million pounds across more than 500,000 travel claims in 2024, with medical claims reaching 262 million pounds at an average payout of 1,528 pounds. Medical expenses were the most common reason to claim, making up 34 percent of claims, up from 29 percent in 2023. The ABI also recorded a single case in which a member "paid out more than 1 million pounds" for emergency hospital treatment abroad and repatriation. That figure related to the USA, but it illustrates why repatriation cover, the exact item the RHCA excludes, is the line that drives the largest claims.
Activities are the other common exclusion. The FCDO advises cover for "all activities you may undertake on holiday, such as sports or adventure tourism (you may need specialist insurance or an add-on for some activities)". Australia generates several of these. The FCDO notes that diving and snorkelling "accidents can happen and have sometimes been fatal" and that divers "must complete medical declarations". Standard policies frequently treat scuba diving, jet skiing and similar pursuits as add-ons rather than default inclusions, so the activity schedule is worth reading against the planned itinerary, whether that is the Great Barrier Reef or a campervan route through the outback.
Three further limits are worth confirming for an Australian trip. Trip length, because the FCDO notes "many policies have a maximum trip length" and long-haul holidays and working-holiday stays can run past it. Cruise cover, because the FCDO warns that "cruises generally require an additional level of cover", relevant for reef and coastal sailings. And natural hazards, because the FCDO records bushfires that can "become a risk to life very suddenly", tropical cyclones across Queensland, the Northern Territory and Western Australia, and flooding from heavy rain, all of which can disrupt travel and trigger curtailment or delay claims.
Providers offering worldwide cover including Australia
A worldwide policy that includes Australia is widely available from UK insurers, and the features worth comparing are medical limits, repatriation, age limits and how pre-existing conditions are handled. Two providers with publicly documented terms illustrate the range.
Staysure travel insurance is a trading name of TICORP Limited, registered in Gibraltar, operating in the UK with FCA reference number 663617. Its published terms include unlimited emergency medical and emergency expenses cover on its Comprehensive and Signature policies, cancellation cover up to 15,000 pounds on Signature, no upper age limit, and cover for more than 1,300 pre-existing medical conditions. Worldwide cover is offered, so Australia falls within scope where selected.
Saga travel insurance is arranged by Saga Services Limited (FCA number 311557), underwritten by Astrenska Insurance Limited with claims administered by Collinson Insurance Services Limited. Its published tiers range from emergency medical cover up to 2 million pounds on its Essential level to up to 20 million pounds on its Plus level, with cancellation up to 20,000 pounds per person on Plus and no upper age limit, though policyholders must be over 50. It covers most pre-existing conditions including high blood pressure, diabetes and heart disease.
These are illustrations of how published terms differ, not endorsements. The figures above are taken from each provider's own pages and should be reconfirmed at the point of purchase, since tiers, limits and definitions change. For travellers who struggle to find cover because of a medical condition, the categories to compare are insurers that specialise in pre-existing conditions, where the number of conditions covered and the medical screening process vary widely between policies.
Common pitfalls
The first pitfall is treating the reciprocal agreement as a substitute for insurance. The RHCA and the GHIC both cover hospital treatment but neither covers the flight home, and repatriation from Australia is among the most expensive in the world simply because of the distance. The second is non-disclosure: the FCDO warns that failing to declare a condition can leave a related claim unpaid, and for diving the medical declaration is a legal requirement as well as an insurance one.
The third is the activity gap, where a policy is bought but an add-on for diving, watersports or remote driving is not, leaving the most likely Australian accident uninsured. The fourth is trip length, where a long stay or a working holiday quietly exceeds a policy's maximum trip duration. None of these are exotic edge cases; each is a routine feature of an Australian itinerary that a standard worldwide policy may not cover by default.
Sources
- FCDO foreign travel advice: Australia, health (RHCA / Medicare)
- FCDO foreign travel advice: Australia, safety and security
- FCDO guidance: foreign travel insurance
- NHS: apply for a free UK Global Health Insurance Card (GHIC)
- ABI: travel insurance claims data 2024
- Staysure travel insurance
- Saga travel insurance
