Did you know your Medicare card can help pay for your chiropractor, dentist or midwife?
We all know Medicare will cover costs such as GP visits, public hospital stays and annual eye tests, but did you know you may be able to use your Medicare card to help pay for your chiropractor. dentist or midwife?
If you suffer from a condition that has lasted, or is predicted to last, for six months or longer, you may be eligible for Medicare assistance under the Chronic Disease Management (CDM) scheme.
Chronic conditions covered include:
According to the Department of Health and Ageing, eligible patients must have a chronic (or terminal) medical condition, which requires complex care that is being managed by a GP under strategies known as GP Management Plans and Team Care Arrangements. These strategies allow most patients to be referred by their GP for up to five Medicare rebateable allied health services a year.
The Medicare rebate for the allied health services is currently $50.95 per visit to each of the practitioners a patient is referred to, with out-of-pocket costs counting towards the patient’s Extended Medicare Safety Net.
This means that although the amount you can claim on the spot is limited, once you’ve spent $1157.50 ($578.60 if you have a concession card) of your own money within a calendar year, Medicare will cover 80 per cent of any further costs for the rest of the year.What can you claim?
1. Exercise physiology
"Your doctor may send you to an exercise physiologist if he wants you to increase your physical activity and there may be some risks involved. These may include diabetes,heart problems or stroke [risks]," explains Dr Ronald McCoy from the Royal Australian College of General Practitioners.
Moderate exercise is always okay, he adds, but some people require a more intense level of activity. An exercise physiologist can determine the risks and devise an exercise plan to suit your needs.
Medicare’s Chronic Disease Dental Scheme (CDDS) provides up to $4250 in benefits over two calendar years for people with a chronic medical condition and complex care needs whose oral health is impacting on their general wellbeing. To be eligible for the CDDS, patients must have a GP Management Plan and Team Care Arrangements in place and must be referred to a dentist by their GP.
The government has recently announced it intends to close the CDDS at the end of the year in order to
make more funding available for the Commonwealth Dental Health Program, so these rebates may be changing next year. However, the Senate has twice prevented closure of the CDDS.
3. Musculoskeletal treatments
People who suffer from conditions that affect mobility may benefit from musculoskeletal therapies, Dr McCoy says. Medicare will cover physiotherapy, chiropractic and osteopathy if your doctor and healthcare team add it to your CDM treatment plan.
If you have a chronic condition that affects the health of your feet, Medicare offers a rebate for podiatrists' fees as part of the CDM scheme. "This is especially important for people with diabetes, who should see a podiatrist regularly," Dr McCoy advises.
5. Pyschological treatment
Eligible patients requiring psychological therapy can take advantage of the Better Access to Psychiatrists, Psychologists and General Practitioners plan through the Medicare Benefits Schedule initiative.
Currently, patients with a mental health condition, which has been diagnosed by a medical practitioner, may be eligible to receive up to 12 individual allied health services and 12 group therapy allied health services per calendar year. Psychologists, occupational therapists and social workers are accredited to deliver such services. From November 1, eligible patients will be able to receive up to 10 individual allied health services and 10 allied group therapy services per calendar year.
Medicare does offer a rebate for such fees and your doctor may advise seeing a dietitian if you have a condition that is affected by nutrition. "This may include diabetes, heart disease or weight issues," Dr McCoy says.
The government provides Medicare funding for a range of assisted reproductive technologies, including in vitro fertilisation (IVF). Services for infertility treatment include planning and management, and a range of treatment options, such as super-ovulated and natural cycles.
9. Weight-loss surgery
Medicare benefits are payable for clinically relevant professional services rendered by approved practitioners. There are Medicare items that provide benefits for gastric-banding procedures, performed laparoscopically or by open surgery, on patients considered to be morbidly obese.
Medicare does not cover the cost of the gastric band itself, only the specialist and anaesthetist fees.
10. Occupational therapy
"An occupational therapist can help with any condition that impacts on activities in daily life and requires learning self-management,"
Dr McCoy says. "Recipients might include people who have had a stroke or carers of people with dementia"
For more information call 132 011 or visit www.medicareaustralia.gov.au