Are online telehealth and after-hours doctors still free in 2025?

We unpack what “bulk billed” really means in 2025 for online telehealth brands like Abby Health, Hola Health and 13SICK under new Medicare rules.

Dr. Louis J Sisk

BSc(Hons) MBChB MRCS(Glasg) MTrauma

December 9, 2025

16 min read

If you’ve landed here from Abby or Hola Health wondering “wait, are these still free?”, you’re not alone. A lot of Australians got used to tap-and-go telehealth during COVID, with big brands advertising “100% bulk billed” for almost everyone.

From late 2024 into 2025, however, Medicare (MBS) telehealth rules have tightened. The “eligible telehealth practitioner” rules and the closing of nurse-practitioner telehealth loopholes now mean that Abby, Hola Health and similar startups can only bulk bill in narrower, rule-bound situations.

TL;DR: if you’re using Abby or Hola Health in 2025 and beyond, you might still be bulk billed, but you should no longer assume your consult will be truly free. For many new or one-off patients, a gap fee is now likely. The rest of this article walks through why, and what it means for each provider:

In 2025 and beyond, is this service still free for me?

Affected Providers

The following telehealth providers may be affected by Medicare's 2024-2025 rule changes. Status indicators reflect current bulk billing reliability:

Bulk billing eligibility not guaranteed

Abby Health

Previously offered 100% bulk billing to all patients. Now requires existing patient relationship or MyMedicare registration for telehealth rebates.

Bulk billing eligibility not guaranteed

Hola Health

Similar to Abby, bulk billing is no longer guaranteed for new patients without an established clinical relationship.

After-hours service largely unaffected

13Sick

Primarily an after-hours home visit service with established GP relationships. Less impacted by telehealth-specific rule changes.

May require gap payment for new patients Bulk billing largely unchanged

Key Medicare changes that affect “free” telehealth

Eligible telehealth practitioner: the 12-month rule

For most Medicare-rebated GP telehealth consultations, the law now says your provider must be an “eligible telehealth practitioner”. In practice, that usually means: ¹

• a GP or practice that has seen you face-to-face in the past 12 months, or
• your MyMedicare-registered practice, or
• you fall under a specific exemption (for example:
  • babies under 12 months
  • people experiencing homelessness
  • some rural/remote situations
  • certain disaster/COVID arrangements).

This used to be called an “established clinical relationship”. AskMBS now uses the “eligible telehealth practitioner” language and has clarified the exemptions in dedicated telehealth advisories.¹

What this means for you

• Random one-off telehealth clinics can’t just bulk bill everyone anymore.
• If the doctor (or their practice) doesn’t know you, Medicare usually won’t pay a rebate for standard GP telehealth items unless an exemption applies.

Nurse practitioner telehealth: loophole closed

Until 2025, nurse practitioners had more flexible telehealth rules:

• NP telehealth items did not require the same 12-month existing relationship, which allowed NP-only telehealth clinics to bulk bill lots of new patients they’d never met.²

From 1 November 2025:

• NP telehealth items must also be billed by an eligible telehealth practitioner — i.e. an NP who has seen you in person in the last 12 months or is working in your usual practice, unless an exemption applies.²³

That closes the business model of “new patient, NP telehealth, always bulk billed” for most scenarios.

GP vs NP now

• Billing rules: From late 2025, GPs and NPs both need an existing relationship or exemption for standard MBS-funded telehealth.
• Care scope:
  • GPs can generally order a wider range of tests, make more types of referrals, and manage more complex chronic disease under GP-specific item numbers.
  • NPs can diagnose, prescribe and refer within a defined scope under NP regulations.

NP-only telehealth can still be useful, but it’s no longer a magical shortcut to “free for all”.

Bulk Billing Practice Incentive Program (BBPIP)

From 1 November 2025, the government rolled out the Bulk Billing Practice Incentive Program (BBPIP) and expanded bulk-billing incentives:

• Around $7.9 billion is being invested so GP clinics get extra payments when they bulk bill all Medicare-eligible patients for eligible services.⁴
• Practices that opt in and bulk bill everything under the program can significantly boost the effective rebate they receive, especially in regional and remote areas.⁴

Early data suggests a large proportion of practices have moved to “we bulk bill everyone” models to access BBPIP, with more expected over time.⁴

Key point for patients

Your usual GP clinic is now more likely to bulk bill you, especially if they’ve joined BBPIP — but telehealth-only startups don’t get the same structural support, so they’re more likely to charge a gap.

Abby Health

TL;DR: Abby still bulk bills many patients, but it is no longer “100% bulk billed for everyone”. Whether it’s free depends on your Medicare status and whether Abby meets the eligible-practitioner rules for you.

Abby Health is an Australian online telehealth clinic offering GP and nurse practitioner appointments nationwide.

Abby markets:

• Telehealth GP and NP appointments via app and web
• Online prescriptions, medical certificates, pathology and imaging requests, referrals and chronic disease care
• “Bulk Billing Available – check your eligibility” (note the careful wording).

Some older directories and health listings still describe Abby as “bulk billing telehealth doctors”, but those are based on earlier marketing before the telehealth rules tightened.

When Abby is likely free

You’re more likely to be fully bulk billed when:

• You have a valid Medicare card, and
• Abby (or a related bricks-and-mortar partner) is effectively your usual practice, so they can meet the eligible telehealth practitioner requirement, or
• You fall into an exemption group (e.g. baby under 12 months, homelessness, particular rural/remote scenarios) as defined in the telehealth rules.¹

In those cases, Abby can bill GP or NP telehealth item numbers directly to Medicare, so you don’t pay a gap.

When you’ll probably pay a gap with Abby

Expect out-of-pocket costs if:

• You’re a brand-new patient with no in-person contact with Abby or a linked practice in the last 12 months, and you don’t meet an exemption.
• You’re requesting services that sit outside standard telehealth items, or Abby chooses to use private billing (e.g. some longer or complex consults).
• You don’t have Medicare (e.g. some temporary visa holders).

Abby is now more accurately described as:

“Bulk billed for eligible Medicare patients, private fees for others”,
not “free for everyone”.

Hola Health

TL;DR: Hola Health does still offer genuinely bulk-billed telehealth, but mainly for specific service types and when you meet Medicare’s eligibility rules.

Hola Health runs both standard GP telehealth and a dedicated bulk-billing stream.

Their information highlights:

• Bulk-billed telehealth for:
  • After-hours GP consults
  • Urgent care
  • Scripts and repeats
  • Mental health care plans
• For these services, there’s no upfront fee; your Medicare rebate is paid straight to Hola if you’re eligible.

Where Hola’s bulk billing is strongest

You’re most likely to be fully bulk billed when:

• You have a valid Medicare card, and
• You’re using an eligible GP telehealth item, such as:
  • a brief or standard telehealth consult
  • a mental health care plan or review (some mental health items remain exempt from the 12-month rule)³
• Hola meets the eligible telehealth practitioner or exemption criteria in your case.¹

Hola explicitly states that mental health care plans are fully bulk billed for eligible patients, which matches broader policy goals around improving access to mental health care.

When a gap fee may apply with Hola

You may be charged a gap or private fee if:

• You’re a new patient without an eligible existing relationship (and no exemption) using a standard, non-mental-health GP telehealth item.
• You’re outside the defined bulk-billed service types or time windows (for example, wanting a long non-urgent consult that the clinic decides to privately bill).
• You don’t have Medicare, or you’re using a non-MBS service.

Hola is one of the few big brands still offering a strong bulk-billed telehealth stream, but it is targeted and rules-based, not unlimited free care.

13SICK (One3Sick)

TL;DR: For most Medicare card holders using it the way their GP intends, 13SICK is still genuinely bulk billed after hours, especially for home visits and many telehealth calls, because it operates as an after-hours deputising service.

13SICK – National Home Doctor provides:⁵

• After-hours GP home visits
• Telehealth
• Aged care facility visits

across much of metropolitan Australia.

They describe themselves as a Medicare bulk-billed after-hours service, with home visits and telehealth bulk billed for eligible Medicare patients.⁵

Why 13SICK can still bulk bill most people

13SICK acts as an Approved Medical Deputising Service (AMDS) for many GP clinics:

• Under the AMDS program, deputising services provide care after hours on behalf of your usual GP.⁶
• AMDS guidelines and RACGP advice confirm that when you’ve been seen face-to-face by your regular practice in the last 12 months and that practice has a formal agreement with an AMDS provider, doctors working through that AMDS can use the standard telehealth and after-hours items with you.⁶

Typical scenario:

You’re unwell on Sunday, your GP is closed, and their voicemail or website says:
For after-hours care, call 13SICK.

In that situation, 13SICK is deputising for your usual GP, who has already seen you in person in the last year. That satisfies the eligible telehealth practitioner requirement via the AMDS arrangement, so 13SICK can usually bulk bill you.

When 13SICK might not be free

You may see a fee or different arrangements if:

• You don’t have Medicare (for example, overseas visitors).
• The visit doesn’t meet after-hours definitions or falls outside their coverage area.
• You request non-standard services that aren’t covered by regular GP items.

For most Australians with a Medicare card using 13SICK exactly as their GP intends, it remains one of the most reliably bulk-billed options in 2025.

Services That Remain Free/Bulk Billed

Even with the tighter "eligible telehealth practitioner" rules, several categories of care remain accessible via bulk-billed telehealth without needing a prior face-to-face visit:

1. Sexual & Reproductive Health and Blood-Borne Viruses (BBV)

The strongest exemptions. For specific BBV and sexual/reproductive health telehealth items (e.g. MBS Group A40 Subgroups 39 and 40):¹⁷

• No existing relationship required — you don't need to have seen the GP face-to-face in the last 12 months
• Covers STI testing/treatment, HIV & PrEP/PEP care, Hepatitis, and contraception advice
• Not included: IVF and antenatal care

2. Mental Health & Eating Disorder Telehealth

Nuanced exemptions apply here:¹³

• Still exempt: Focussed Psychological Strategies (FPS) by GPs, Eating Disorder Plans & Treatment (Subgroups 21, 25–28), and Allied health mental health under Better Access
• Now requires eligible practitioner: GP Mental Health Treatment Plans (from 1 Nov 2025 — must be your MyMedicare practice or a GP you've seen in person in the last 12 months)

3. Chronic Condition Management (CDM / Care Plans)

From 1 July 2025, chronic condition management telehealth items (Subgroup 13, A40) are exempt from the eligible-practitioner rule, but must be provided by:¹

• Your MyMedicare-registered practice, or
• Your usual medical practitioner

This keeps CDM accessible via telehealth from your regular GP, while still blocking random telehealth clinics from bulk billing care plans.

Practical cheat sheet: how to maximise “free” care in 2025

If your main question is “Is this still free?”, here’s a simple way to think about it:

Start with your usual GP / MyMedicare clinic

• Ask whether they’ve joined the Bulk Billing Practice Incentive Program and which services they’ll bulk bill.⁴
• Use their telehealth whenever possible: they’re almost always your eligible telehealth practitioner, so Medicare rebates (and bulk billing) are most reliable.

Use 13SICK as your GP directs

• If your clinic says “for after-hours, call 13SICK, those services are deputising under AMDS and are typically bulk billed for Medicare patients with after-hours needs.⁶⁵

Treat telehealth-only startups as “maybe free, maybe a gap”

• Abby Health, Hola Health, DoctorAI and similar brands will often bulk bill eligible patients, but:
  • You need Medicare, and
  • The consultation has to satisfy the eligible telehealth practitioner or exemption rules — especially now that NP telehealth has the same existing-relationship requirement as GPs.²¹

Consider low fixed-fee options

• If you mainly need a same-day medical certificate for work or study and prefer a predictable, low fee instead of navigating bulk-billing eligibility, you can skip Medicare altogether and use a service like Doccy’s online medical certificate doctors for a quick telehealth consult and emailed certificate. For a full breakdown of all your options, see our guide to free medical certificates in Australia.

Always read the fine print

• Look for phrases like “bulk billed for eligible Medicare patients” and “gap fees may apply”.
• Many booking systems now tell you before you confirm whether your appointment will be bulk billed or privately billed.

Frequently Asked Questions

References