What is a 19AB exemption and how does it work?

Deciding to follow a medical career path often involves a lot of legal requirements that need to be carefully considered. Sections 19AA and 19AB impact doctors who decide to transition from hospital medicine across to GP work, and also those who come into Australia from overseas.

Below are all the facts you need to know about section 19AB, simplified to clarify the requirements expected. 

What is Section 19AB?

Section 19AB is part of the Health Insurance Act of 1973 that has reference to overseas trained doctors (OTDs) or foreign graduates of accredited medical schools (FGAMS) who have received their first medical registration on or after 1 January 1997 OR became and permanent resident or citizen in Australia on or after 1 January 1997.

This section restricts access to a Medicare provider number for these doctors, requiring them to work in a district of workforce shortage (DWS) for their medical speciality. For these doctors, working in these DWS areas then allows them access to Medicare benefits arrangements. 

Generally, these doctors are required to work under these requirements for a minimum of 10 years from the date of first Australian medical registration, although there are exceptions which are explained below.

What is a DWS?

A district of workforce shortage (DWS) is an area where the general population’s need for medical services is deemed to be unmet. To classify as a DWS location, the access to medical services must be lower than the national average.

What does this all mean for doctors who fall into this section?

For those doctors that fall into any of the categories below, it is necessary to work in a DWS in order for your patients to collect a rebate from Medicare (or for these doctors to bulk bill).

• Doctors that completed their medical degree outside of Australia or New Zealand
• Medical professionals who weren’t an Australian Citizen or didn’t hold permanent residency prior to the end of their degree in Australia
• Those who registered with AMC after 1 January 1997
• Doctors that became Australian Citizens or Permanent Residents after 1 January 1997

What are the exemptions?

As previously mentioned, there are some exemptions. The following list is a general list of exemption types considered for section 19AB:

• Class Exemptions
  • If you have an academic appointment with an Australian Medical School and are seeking Medicare access for the purpose of discharging clinical teaching functions as part of your appointment
  • If you’re applying for a role with working hours considered as ‘after hours’ or if your location of practice is in the Northern Territory

• General Exemptions
  • If you’re replacing a doctor who held DWS (conditions apply) or you commenced negotiations with the practice prior to DWS being lost

• Spousal Exemptions
  • If your spouse is a doctor who holds a DWS exemption or they migrated to Australia on a skilled occupation visa

• ATSI Clinics
  • If the clinic you’ve applied to work at is an Aboriginal Medical Service that is Commonwealth funded

• Locum Service
  • If you’re a specialist GP or a non-VR GP on a temporary visa then you are eligible for a six month exemption from Medicare. It must be six continuous months from approval of the application – meaning you can’t pause the six month exemption and use your leftover balance at a later date. 

If you have any more questions about section 19AB or need any help beginning your medical journey, reach out to the team at Jon & Jon Medical today and we can help you navigate this process with ease.