How Medicare Handles Sexual Health Appointments
Medicare covers many sexual health appointments in Australia, including GP consultations and pathology tests for STIs. Bulk-billed visits cost nothing out of pocket. Coverage extends to STI screening, contraception consultations, PrEP prescriptions, cervical screenings and HIV testing. However, some services carry gap fees depending on your provider, and not all contraceptive procedures are fully covered.
Sexual health checkups are one of the most avoided medical appointments in Australia, and cost confusion is a major reason why. Many people assume they will face a hefty bill for STI testing or a contraception consultation, so they put it off entirely. In reality, Medicare covers a significant portion of sexual health care, and in many cases, the entire visit costs nothing. Understanding how Medicare handles sexual health appointments removes one of the biggest barriers to getting tested, treated and informed. This guide breaks down what is covered, where the gaps are and how to access care affordably.
What Medicare Covers for Sexual Health
If you hold a Medicare card, a large portion of your sexual health care is already covered. GP consultations can be bulk-billed, meaning the doctor bills Medicare directly and you pay nothing. Pathology tests for STIs — including blood and urine samples — are also typically bulk-billed through Services Australia. Even when a GP charges a gap fee, the pathology itself usually remains free.
Specifically, Medicare covers the following sexual health services:
- STI screening for chlamydia, gonorrhoea, syphilis, HIV and hepatitis B and C through standard pathology referrals.
- Contraception consultations with your GP, including prescriptions for the pill, implants and IUDs.
- Cervical screening tests every five years for eligible patients, fully bulk-billed.
- PrEP and PEP consultations and ongoing monitoring for HIV prevention, with medications subsidised through the PBS.
- Mental health support related to sexual wellbeing under a GP Mental Health Treatment Plan.
Where the Gaps Are
Medicare does not cover everything. The most common surprise is the gap fee at non-bulk-billing GPs. While pathology tests are usually free, the consultation itself may cost anywhere from $40 to $90 out of pocket, with a partial Medicare rebate. This varies widely between practices, so it pays to ask upfront. Additionally, some contraceptive procedures carry costs that Medicare only partially offsets. An IUD insertion, for instance, may involve out-of-pocket expenses for both the device and the procedure, depending on your provider and whether you hold a concession card.
Specialist referrals add another layer. If your GP refers you to a sexual health specialist, dermatologist or gynaecologist, the specialist’s fee is rarely fully covered by Medicare. You may receive a rebate, but the gap can be significant. Similarly, some newer telehealth services offer bulk-billed STI consultations, though eligibility can depend on whether you are an existing patient of that practice. The NSW Health sexual health guide provides a useful overview of what to expect cost-wise across different service types. For a broader look at reproductive health rights in Australia, our detailed guide covers the wider picture.
I have put off sexual health appointments before purely because I did not know what the bill would look like. That uncertainty is enough to keep people away, and it should not be this confusing. Once I actually called a clinic and asked directly about bulk billing, the whole process took less than an hour and cost me nothing. The hardest part was making the phone call.
Free and Low-Cost Alternatives
If your regular GP does not bulk-bill, several alternatives offer free or low-cost sexual health care. Dedicated sexual health clinics operate in every state and territory, often providing walk-in appointments with no out-of-pocket costs for Medicare cardholders. Many also offer free services to people without Medicare, including international students and visitors from countries with reciprocal health agreements. Medicare Urgent Care Clinics are another bulk-billed option that now includes STI testing and treatment. For a practical companion to clinical care, our guide to sexual health products covers what to keep on hand between appointments.
Telehealth has also expanded access significantly. Several online services now offer bulk-billed STI consultations with registered GPs, followed by pathology referrals you can take to any collection centre. This is particularly useful for people in regional areas or anyone who prefers not to discuss sexual health face-to-face. However, recent changes to Medicare telehealth rules mean some services now require an established patient relationship, so check eligibility before booking.
Confidentiality and What to Expect
Confidentiality is one of the most common concerns people have about sexual health appointments. By law, your GP and any health professional you see must keep your consultation confidential. Medicare statements sent to the primary cardholder will show that a service was claimed, but they do not include details about the type of appointment or tests performed. For young people still on a family Medicare card, this means a parent may see that a doctor visit occurred but not what it was for. Anyone aged 15 or older can apply for their own separate Medicare card to remove even that visibility.
The appointment itself is straightforward. Your doctor will ask a few questions about your sexual activity, number of partners and any symptoms. From there, most STI testing involves a simple blood draw and urine sample, sometimes with a self-collected swab. Results typically take a few days. If anything comes back positive, your doctor will discuss treatment options and may recommend contacting recent partners. The entire process is routine, non-judgmental and far quicker than most people expect.
Key Takeaways
- Medicare covers GP consultations, STI pathology tests, contraception consultations, cervical screenings and PrEP monitoring for cardholders.
- Bulk-billed visits cost nothing out of pocket, though non-bulk-billing GPs may charge a gap fee for the consultation itself.
- Contraceptive procedures like IUD insertion may carry partial out-of-pocket costs depending on your provider and concession status.
- Free sexual health clinics, Medicare Urgent Care Clinics and bulk-billed telehealth services offer accessible alternatives when your regular GP charges a gap.
- Medicare statements show that a service was claimed but do not reveal the type of appointment, and anyone aged 15 or older can apply for their own card.
Frequently Asked Questions
Is STI testing free under Medicare?
In most cases, yes. Pathology tests for STIs are typically bulk-billed, meaning no cost to you. However, the GP consultation to request those tests may carry a gap fee if your doctor does not bulk-bill. Sexual health clinics and Medicare Urgent Care Clinics usually offer both the consultation and testing at no charge.
Does Medicare cover contraception?
Medicare covers GP consultations for contraception advice and prescriptions. The Pharmaceutical Benefits Scheme subsidises many contraceptive medications, reducing their cost significantly. However, procedures like IUD or implant insertion may involve out-of-pocket expenses depending on your provider and whether you hold a concession card.
Will my parents see my sexual health appointment on Medicare?
If you are on a family Medicare card, the primary cardholder may see that a doctor visit was claimed. They will not see details about the type of appointment or tests conducted. To remove this visibility entirely, anyone aged 15 or older can apply for their own Medicare card through Services Australia.
Can I get sexual health care without a Medicare card?
Yes. Many dedicated sexual health clinics offer free or low-cost services to people without Medicare, including international students and visitors from reciprocal health agreement countries. Some online testing services also provide paid options for those without a card. Contact your nearest clinic directly to confirm availability.
How often should I get tested for STIs?
Frequency depends on your level of sexual activity and risk factors. As a general guide, anyone sexually active should test at least once a year. If you have multiple partners or engage in higher-risk activity, testing every three months is recommended. Your GP or sexual health nurse can advise on the right schedule for you.
Meet Bronte, our sexpert at the Adultsmart blog. A pansexual cis woman, she dives into LGBTQ+ topics, fetish exploration, sex work, and sex toy reviews!
