Medical Treatment Overseas Program

The Medical Treatment Overseas Program (MTOP) provides financial assistance for Australians with a life-threatening medical condition to receive proven life saving medical treatment overseas where effective treatment is not available in Australia.

Page last updated: 09 December 2016

Introduction

The Australian Government may assist persons suffering from a life threatening condition who require overseas medical treatment, following advice from a Panel of Departmental Medical Advisers that the medical evidence submitted by or in relation to the applicant meets the mandatory medical eligibility criteria set out below.


Program Eligibility

To qualify for assessment under the MTOP, the applicant must be an Australian citizen or an ‘Australian resident’, as defined in subsection 3(1) of the Health Insurance Act 1973 (i.e., the applicant must be eligible to receive Medicare benefits), must reside in Australia and must be suffering from a life-threatening condition.

To be eligible to receive financial assistance under the MTOP, the applicant will need to provide evidence addressing each of the four (4) mandatory medical eligibility criteria set out below. That evidence will be assessed by a Panel of Departmental Medical Advisers as to whether those four medical criteria are met.

Note: Applications for Proton Beam Radiation Therapy must be submitted with comparative proton versus photon plans. Photon therapy is available in Australia and may be an effective treatment for applicants requiring radiotherapy.

Mandatory Medical Criteria

(a) The proposed overseas treatment or an effective alternative treatment must not be available in Australian in time to benefit the applicant

Treatment will be regarded as being ‘available in Australian in time’ if the capacity, knowledge, skills and/or specialist facilities required to deliver the treatment are available in Australia, or are likely to be available in Australia within a period of time that is likely to be of benefit to the applicant.

The MTOP is not available for overseas travel for the purposes of obtaining medical advice or a medical assessment prior to a definitive treatment plan. The application must be for a specific treatment of a specified life-threatening condition.

Note: Applications for Proton Beam Radiation Therapy must be submitted with comparative proton versus photon plans. Photon therapy is available in Australia and may be an effective treatment for applicants requiring radiotherapy.

(b) The treatment must be significantly life extending and potentially curative

An application must contain evidence, including the results of medical examinations or assessments, which indicate that:
  • the condition is life-threatening; and
  • the applicant has a realistic prospect of a cure and significant extension of life expectancy from the proposed treatment.
(c) There must be a real prospect of success for the applicant

Clinical evidence must be provided to demonstrate that the proposed treatment has a strong probability of success for the individual applicant.

(d) The treatment must be accepted by the Australian medical profession as a standard form of treatment for the applicant’s condition

The applicant must provide evidence that this treatment is accepted by the Australian medical profession as a standard form of treatment.

The MTOP has been established to assist patients to gain access to treatments accepted as effective by the medical profession but is not available to support individuals wishing to receive experimental treatments or to participate in a clinical trial.

Administrative Eligibility

Applicants will not qualify for an assessment against the four mandatory medical eligibility criteria under the Program where:
  • the applicant is not eligible for Medicare; or
  • the application has not been supported by the applicant’s Australian treating medical specialist; or
  • there is no treatment plan presented; or
  • the proposed treatment is not for a life-threatening condition; or
  • the treatment is palliative in nature and not with a curative intent; or
  • there is insufficient medical and clinical information presented to undertake an assessment; or
  • the application is for participation in a clinical trial or to receive experimental treatment; or
  • an application has not submitted a proton versus photon comparison plan with an application for proton beam therapy.
For further information please refer to the Guidelines for Applicants.

Method of Application

Applications must be submitted on the;
PDF version: MTOP Application Form (PDF 184 KB)
Word version: MTOP Application Form (Word 533 KB)

Applicants must seek the assistance of the specialist(s) from whom they are receiving treatment in Australia to complete the application and provide supporting medical documentation.

The application will not be accepted unless the specialist who has supported the completion of the application has signed where specified on the application form.

Please allow a minimum of 6 weeks to process an application.

For further information please refer to the Guidelines for Applicants.

Confidentiality

Details of all applications will be treated in accordance with the requirements of the Privacy Act 1988. The Department will not discuss the details of a specific application with anyone, on behalf of an applicant, unless the Department has written authorisation from the applicant, specifically naming those persons to whom information can be provided. This includes parents or guardians of applicants over 18 years of age.

During the assessment process the Medical Adviser may need to discuss the application with the applicant’s supporting Australian and overseas specialists. Authorisation for these discussions is assumed, unless the applicant specifically advises the MTOP Administrator otherwise.

Confidentiality of all applicant information is maintained at all times. ALL relevant information should be disclosed when completing the application form and during the ongoing treatment process. Failure to disclose all information may affect the final assessment of your application or ongoing financial support.

The Commonwealth requests that applicants keep the MTOP Administrator fully informed if there is any media involvement in their circumstance.

If an applicant’s case is the subject of a media report or inquiry, the Department or the Minister may respond, including publicly, to correct or to confirm the content of such a report or inquiry.

Contacting the Department
The MTOP Administrator
Medical Treatment Overseas Program
Medical Benefits Division
MDP 951
Department of Health
GPO Box 9848
Canberra ACT 2601

Email enquiries should be directed to the MTOP inbox.

Telephone enquiries should be directed to: (02) 6289 7496 (from overseas: 0011-61-2-6289 7496).

The documents linked to this page are in PDF format. If you are unable to view them, please contact the Medical Treatment Overseas Program Administrator and a copy will be sent to you.