Medicare has been forced to send its staff a reminder of its requirements under Ireland’s reciprocal healthcare agreement with Australia, after a pregnant Irishwoman on a 457 visa was provided with the wrong information about the level of public health cover she could access.
In an email sent on November 17, and seen by the Irish Echo, Medicare told Deirdre O’Rourke, 36, that any decision to give her maternity care would lie with an individual hospital.
“The individual public hospital would make the decision as to whether the treatment they are willing to provide as a public patient under the reciprocal agreement is due to ill health or immediately medically necessary,” the email states.
This ran contrary to the federal Department of Health position, which says that it has had the final say on the provision of pregnancy cover to expectant mothers on 457 visas.
“Women from Ireland who are in Australia are entitled to free public hospital care including pregnancy care,” a spokesperson for Health said.
The situation has been causing confusion among pregnant temporary workers and their spouses.
Ms O’Rourke, who is three months pregnant, said her GP was unsure of what medical costs were covered during the pregnancy.
It took the woman from Kildare several attempts to get a clear response to questions she had asked Medicare.
Irish citizens become entitled to Medicare benefits for non-hospital medical care when they become permanent residents in Australia.
However, the Irish and Australian governments are signed up to a reciprocal healthcare agreement (RHCA), which covers treatment deemed to be ‘medically necessary’. Irish visitors are also entitled to subsidised medicines under the Pharmaceutical Benefits Scheme.
Eventually the Royal Women’s Hospital (RWH) in Melbourne settled the matter and told the woman she would be covered as a ‘reciprocal rights patient’.
“Trying to get a straight answer from Department of Human Services and from Medicare, was a nightmare,” Ms O’Rourke told the Irish Echo.
Medicare has now apologised.
“Medicare acknowledges that a staff member provided incomplete information to a customer, and sincerely apologises for any inconvenience caused,” a spokesperson for the Department of Human Services said.
“A message will be sent to all relevant staff this week reminding them of the requirements of the RHCA with the Republic of Ireland,” he added.
He stressed that the government considers that maternity services can constitute immediate ‘medically necessary’ treatment under the RHCA.
Meanwhile, a separate woman on a 457 visa who has given birth in a public hospital said her experience went very well. The Irish Echo previously reported this woman’s experience in April, as she had learned that her private health insurer would not cover pregnancy.
“All ante natal and post natal care was covered and all follow-up appointments have also been covered for example, home visits by community nurses, follow-up baby appointments, ultrasounds,” the woman said. She did not wish to be named.
“All vaccinations post-baby are also free. If you go to the GP you have to pay but if you go to your local area health centre they will inform you of times that they do vaccinations, but you must donate $4.40 towards them,” she added.

