The success of Medicare in removing financial barriers to patients' access to basic medical care depends on whether or not families with pressing financial problems live in reasonable proximity to services that offer bulk billing. This raises the issue of whether residential location affects the chances of a free medical service for poor families. This article examines the level of success of Medicare in enabling low income families to receive free basic medical care. The analysis is based on data from the Australian Living Standards Study (ALSS) conducted by the Australian Institute of Family Studies. It focuses on reports of families in nine ALSS areas and in two rural areas - the Riverland and Roma/Bungil. The study found that Medicare discretionary system of fee setting failed to benefit low income families in the Riverland. In fact all families in the Riverland were unlikely to receive a free service. In some of the other areas a relatively high bulk billing rate applied to the socio-economically advantaged as well as the disadvantaged, while in other areas, low income families seemed more likely than other families to be bulk billed.