How the UK, Australia and the US pay for treatment
The rules each country sets for what a patient pays, quoted from each government’s own pages, with the date every page was read. Below them: what each country publishes about waiting times.
Each amount is shown in its own country’s currency and is not converted. The three systems use different mechanisms — a charge per item, a co-payment per script, a deductible and a share of each bill — so no figure here is set against another as the same thing, and nothing is ranked. Where a rule has not been read, the table says “Not tracked”.
Australia
Amounts in Australian dollars (A$).
Medicare (the Medicare Benefits Schedule)
Medicare pays a benefit per MBS item, calculated from that item’s schedule fee. The schedule fee is not what a doctor charges, and items are never added together here into a total for a course of treatment.
| Rule or parameter | What the source says | Source and date read |
|---|---|---|
| Medicare benefit percentages and item benefits | Not trackedRead from the MBS data file but not shown here until the terms for reusing it are confirmed. Each item’s schedule fee and benefit are published on MBS Online.MBS Online | None |
Medicines on the PBS
The generic PBS rule: what a patient pays per subsidised script, and the yearly Safety Net. No medicine is named.
| Rule or parameter | What the source says | Source and date read |
|---|---|---|
| PBS co-payment per script, general patient | A$25.00From 1 January 2026. The most a general patient pays for a PBS-subsidised script. | Australian Government Department of Health and Aged Care: Fees, Patient Contributions and Safety Net Thresholds, applies as at 1 July 2026. Read 26 October 2026. |
| PBS co-payment per script, concession card holder | A$7.70From 1 January 2026. The most a concession card holder pays for a PBS-subsidised script. | Australian Government Department of Health and Aged Care: Fees, Patient Contributions and Safety Net Thresholds, applies as at 1 July 2026. Read 26 October 2026. |
| PBS Safety Net threshold, general | A$1,748.20Calendar year. Once reached, each further PBS script that year costs A$7.70. | Australian Government Department of Health and Aged Care: Fees, Patient Contributions and Safety Net Thresholds, applies as at 1 July 2026. Read 26 October 2026. |
| PBS Safety Net threshold, concessional | A$277.20Calendar year. Once reached, further PBS scripts that year cost: nil. | Australian Government Department of Health and Aged Care: Fees, Patient Contributions and Safety Net Thresholds, applies as at 1 July 2026. Read 26 October 2026. |
How each route pays for a named treatment in Australia: paying for treatment in Australia.
United Kingdom
Amounts in Pounds sterling (GBP).
NHS prescriptions
Each UK nation sets its own prescription rule. England charges per item and sells prepayment certificates; the other three nations’ rules are quoted from their own pages.
| Rule or parameter | What the source says | Source and date read |
|---|---|---|
| England: NHS prescription charge | £9.90 per itemThe charge is per item on the prescription, not per prescription form. | NHS Business Services Authority: KA-03997: What are the current costs of NHS treatment in England?. Read 26 October 2026. |
| England: prescription prepayment certificate, 3 months | £32.05 per certificateA PPC covers all of the holder’s NHS prescriptions in England for its period for one set price. | NHS Business Services Authority: NHS Prescription Prepayment Certificate (PPC). Read 26 October 2026. |
| England: prescription prepayment certificate, 12 months | £114.50 per certificate | NHS Business Services Authority: NHS Prescription Prepayment Certificate (PPC). Read 26 October 2026. |
| England: HRT prescription prepayment certificate, 12 months | £19.80 per certificateThe HRT PPC covers only the HRT medicines on NHSBSA’s list, for 12 months. Other prescription items are still charged unless a full PPC or an exemption applies. | NHS Business Services Authority: NHS Hormone Replacement Therapy Prescription Prepayment Certificate (HRT PPC). Read 26 October 2026. |
| Wales: prescriptions | Prescriptions are free in Wales for patients registered with a GP in Wales, dispensed by a pharmacist in Wales. | Welsh Government (gov.wales): Free prescriptions. Read 26 October 2026. |
| Scotland: prescriptions | Prescriptions are free in Scotland. A prescription form issued in England is charged at the English rate when dispensed in Scotland. | NHS inform (Scottish Government): Prescription charges and exemptions. Read 26 October 2026. |
| Northern Ireland: prescriptions | All prescriptions dispensed in Northern Ireland are free for everyone. No application is needed. | nidirect (Northern Ireland Government): Help with health costs. Read 26 October 2026. |
NHS dental treatment
The four nations use different mechanisms, not different prices for one thing: England charges by band, Wales by care package, and Scotland a share of each item’s fee. A Welsh package is not an English band.
| Rule or parameter | What the source says | Source and date read |
|---|---|---|
| England: Band 1 | £27.90 per course of treatmentFrom 1 April 2026. | NHS (nhs.uk): How much NHS dental treatment costs. Read 26 October 2026. |
| England: Band 2 | £76.60 per course of treatmentFrom 1 April 2026. | NHS (nhs.uk): How much NHS dental treatment costs. Read 26 October 2026. |
| England: Band 3 | £332.10 per course of treatmentFrom 1 April 2026. | NHS (nhs.uk): How much NHS dental treatment costs. Read 26 October 2026. |
| England: how bands combine | One charge per course of treatment: where a course mixes bands, the patient pays the highest band once. | NHS (nhs.uk): How much NHS dental treatment costs. Read 26 October 2026. |
| Wales: maximum charge for a course of treatment | £384 per course of treatmentWales charges by care package; 12 package and appointment charges are published on the same page. | Welsh Government (gov.wales): NHS dental charges and exemptions. Read 26 October 2026. |
| Wales: examinations | Dental examinations are free in Wales for people aged under 25 or 60 and over. | Welsh Government (gov.wales): NHS dental charges and exemptions. Read 26 October 2026. |
| Scotland: how the charge is set | NHS patients in Scotland who pay for treatment pay 80% of the fee for each item of treatment, capped per course of treatment. There are no charge bands; the cost depends on the treatment plan. | NHS inform (Scottish Government): Receiving NHS dental treatment in Scotland. Read 26 October 2026. |
| Scotland: maximum charge for a course of treatment | £384 per course of treatment | NHS inform (Scottish Government): Receiving NHS dental treatment in Scotland. Read 26 October 2026. |
| Scotland: who pays nothing | NHS dental treatment in Scotland is free for everyone aged under 26, and for people who are pregnant or gave birth in the last 12 months. | NHS inform (Scottish Government): Receiving NHS dental treatment in Scotland. Read 26 October 2026. |
| Northern Ireland: NHS dental charges | Not trackedNorthern Ireland’s dental charges have not been read by this site.nidirect: help with health costs | None |
NHS-funded nursing care in a care home (England)
A weekly rate the NHS pays to the nursing home. It is not a charge to the resident.
| Rule or parameter | What the source says | Source and date read |
|---|---|---|
| England: who the payment goes to | The NHS pays a flat weekly rate directly to the nursing home towards the nursing part of the fee. It is not a charge to the resident. | NHS (nhs.uk): NHS-funded nursing care. Read 26 October 2026. |
| England: NHS-funded nursing care, higher rate (previous high band, care home entry before 1 October 2007) | £368.24 per weekFrom 1 April 2026. | NHS (nhs.uk): NHS-funded nursing care. Read 26 October 2026. |
| England: NHS-funded nursing care, standard rate | £267.68 per weekFrom 1 April 2026. | NHS (nhs.uk): NHS-funded nursing care. Read 26 October 2026. |
How each route pays for a named treatment in the UK, with NHS waits and hospital prices: paying for treatment in the UK.
United States
Amounts in US dollars ($).
Original Medicare
Federal cost-sharing for people enrolled in Original Medicare, as CMS and Medicare.gov state it for the period shown.
| Rule or parameter | What the source says | Source and date read |
|---|---|---|
| Part B annual deductible | $283Original Medicare Part B has an annual deductible, paid once a year before Medicare starts to pay. | CMS: 2026 Medicare Parts A & B Premiums and Deductibles, Calendar year 2026. Read 26 October 2026. |
| Part B coinsurance | 20%After the Part B deductible, the patient usually pays 20% of the Medicare-approved amount for each covered service, where the provider accepts that amount as full payment. | Medicare.gov: Medicare costs, In force (statutory share; not set annually). Read 26 October 2026. |
| Part A inpatient hospital deductible | $1,736Original Medicare Part A has an inpatient hospital deductible per benefit period, covering the patient’s share for the first 60 days of a covered inpatient stay. | CMS: 2026 Medicare Parts A & B Premiums and Deductibles, Calendar year 2026, per benefit period. Read 26 October 2026. |
Marketplace plans
The federal cap on what a Marketplace plan can require a person to pay in a plan year. It excludes premiums.
| Rule or parameter | What the source says | Source and date read |
|---|---|---|
| Marketplace out-of-pocket limit, individual | $10,600A Marketplace plan’s out-of-pocket limit for an individual is capped by federal rule; it excludes premiums, uncovered services and out-of-network care. | HealthCare.gov glossary: out-of-pocket maximum/limit, Plan year 2026. Read 26 October 2026. |
| Marketplace out-of-pocket limit, family | $21,200The family out-of-pocket limit for a Marketplace plan is capped by the same federal rule. | HealthCare.gov glossary: out-of-pocket maximum/limit, Plan year 2026. Read 26 October 2026. |
| Marketplace out-of-pocket limit, individual (Plan year 2027) | $12,000A Marketplace plan’s out-of-pocket limit for an individual is capped by federal rule; it excludes premiums, uncovered services and out-of-network care. | HealthCare.gov glossary: out-of-pocket maximum/limit, Plan year 2027. Read 26 October 2026. |
| Marketplace out-of-pocket limit, family (Plan year 2027) | $24,000The family out-of-pocket limit for a Marketplace plan is capped by the same federal rule. | HealthCare.gov glossary: out-of-pocket maximum/limit, Plan year 2027. Read 26 October 2026. |
Employer plans
Whether a state insurance mandate applies depends on how an employer plan is funded. State mandates are set out state by state on the US insurance pages.
| Rule or parameter | What the source says | Source and date read |
|---|---|---|
| Covered workers in self-funded employer plans | 71%Most workers with employer coverage are enrolled in self-funded plans, where the employer pays for enrollees’ health services from its own funds rather than buying health insurance. CC BY-NC-ND 4.0: cited with a link only; no KFF table or chart is reproduced. | KFF: 2026 Employer Health Benefits Survey, KFF Employer Health Benefits Survey 2026. Read 26 October 2026. |
Paying without insurance
A federal rule on what an uninsured or self-pay patient must be told before treatment.
| Rule or parameter | What the source says | Source and date read |
|---|---|---|
| Good Faith Estimate | Providers and facilities must give uninsured and self-pay patients a Good Faith Estimate of expected charges when a service is scheduled or on request. | eCFR: 45 CFR 149.610, In force (45 CFR 149.610, text as of 2026-10-01). Read 26 October 2026. |
State fertility insurance laws, state by state: US fertility insurance mandates.
What each country publishes about waits
What is published, by whom, and for which period. The measures differ — time waited so far on a list, time from listing to admission, a standard reported against — so the countries’ figures do not describe the same thing and are not shown side by side.
| Where | Wait for | What is published | Source and date read |
|---|---|---|---|
| England | Waits for planned hospital treatment | NHS England publishes monthly, by provider and specialty, how long people still on the waiting list have waited so far since referral (incomplete pathways). It does not publish a wait per procedure.Latest period read: August 2026.NHS England RTT statistics | NHS England Referral to Treatment (RTT) waiting times, incomplete pathways, provider extract, August 2026. Read 26 October 2026. |
| England | Waits for diagnostic tests | Patients waiting at month end for a diagnostic test, and how long they have waited so far for that test. Not a wait for treatment.Latest period read: August 2026.NHS England diagnostic waiting times | NHS England, Monthly Diagnostic Waiting Times and Activity (DM01), provider file, August 2026. Read 26 October 2026. |
| Scotland | Waits for planned hospital treatment | Public Health Scotland publishes monthly waits by health board and specialty for new outpatients and for inpatient or day-case treatment, reported against Scottish Government standards.Standard reported against: Following the decision to treat, all eligible patients should wait no longer than 12 weeks for treatment as an inpatient or day case (the Treatment Time Guarantee). Latest month read: August 2026. Scotland and England measure waits differently. NHS England reports referral to treatment as one wait per treatment function; Public Health Scotland reports the wait for a first outpatient appointment and the wait from decision to treat to admission separately, per specialty. The figures are not comparable and are not combined here.Public Health Scotland release | Public Health Scotland: stage of treatment waiting times, month ending 31 August 2026. Read 26 October 2026. |
| Scotland | Waits for diagnostic tests | Public Health Scotland publishes waits for key diagnostic tests by health board, reported against this standard: Patients should wait no longer than six weeks (42 days) for the eight key diagnostic tests.The standard is a target, not a measured wait. Latest month read: June 2026.Public Health Scotland release | Public Health Scotland: diagnostic waiting times, month ending 30 June 2026. Read 26 October 2026. |
| Wales and Northern Ireland | Waits for planned hospital treatment | Not trackedBoth governments publish waiting statistics; this site has not read their data files. | None |
| Australia | Waits for elective surgery in public hospitals | Australian Institute of Health and Welfare (AIHW), MyHospitals publishes median waits by procedure, state and hospital from the National Elective Surgery Waiting Times Data Collection (public hospitals). Public hospitals only. Time from being added to the surgical waiting list to admission; excludes the wait to see a specialist.Latest period read: 2024-25.AIHW MyHospitals: elective surgery | Australian Institute of Health and Welfare (AIHW), MyHospitals, 2024-25. Read 26 October 2026. |
| Australia | Waits in private hospitals | Not trackedNo private-hospital wait has been read. | None |
| United States | Waits for planned treatment | Not publishedNo official US source publishing an elective treatment waiting time has been found. This site does not estimate one. | None |
| All three countries | Waits when paying privately | Not trackedNo provider’s self-pay waiting time has been read in any country. | None |
Sources
- Australian Government Department of Health and Aged Care: Fees, Patient Contributions and Safety Net Thresholds, applies as at 1 July 2026. Read 26 October 2026.
- NHS Business Services Authority: KA-03997: What are the current costs of NHS treatment in England?. Read 26 October 2026.
- NHS Business Services Authority: NHS Prescription Prepayment Certificate (PPC). Read 26 October 2026.
- NHS Business Services Authority: NHS Hormone Replacement Therapy Prescription Prepayment Certificate (HRT PPC). Read 26 October 2026.
- Welsh Government (gov.wales): Free prescriptions. Read 26 October 2026.
- NHS inform (Scottish Government): Prescription charges and exemptions. Read 26 October 2026.
- nidirect (Northern Ireland Government): Help with health costs. Read 26 October 2026.
- NHS (nhs.uk): How much NHS dental treatment costs. Read 26 October 2026.
- Welsh Government (gov.wales): NHS dental charges and exemptions. Read 26 October 2026.
- NHS inform (Scottish Government): Receiving NHS dental treatment in Scotland. Read 26 October 2026.
- NHS (nhs.uk): NHS-funded nursing care. Read 26 October 2026.
- CMS: 2026 Medicare Parts A & B Premiums and Deductibles, Calendar year 2026. Read 26 October 2026.
- Medicare.gov: Medicare costs, In force (statutory share; not set annually). Read 26 October 2026.
- HealthCare.gov glossary: out-of-pocket maximum/limit, Plan year 2026. Read 26 October 2026.
- KFF: 2026 Employer Health Benefits Survey, KFF Employer Health Benefits Survey 2026. Read 26 October 2026.
- eCFR: 45 CFR 149.610, In force (45 CFR 149.610, text as of 2026-10-01). Read 26 October 2026.
- NHS England Referral to Treatment (RTT) waiting times, incomplete pathways, provider extract, August 2026. Read 26 October 2026.
- NHS England, Monthly Diagnostic Waiting Times and Activity (DM01), provider file, August 2026. Read 26 October 2026.
- Public Health Scotland: stage of treatment waiting times, month ending 31 August 2026. Read 26 October 2026.
- Public Health Scotland: diagnostic waiting times, month ending 30 June 2026. Read 26 October 2026.
- Australian Institute of Health and Welfare (AIHW), MyHospitals, 2024-25. Read 26 October 2026.
This page presents published rules and figures. It does not recommend a country, a route, a provider or an insurer.