11 December, 2017
Updated information available here.
Medicare offer rebates on the Chronic Disease Management (CDM) plan / Enhanced Primary Care (EPC).This entitles the patient to significantly discounted healthcare services. It’s a potential saving of over $250 each year.
Who is Eligible?
You may qualify if you suffer a chronic or ongoing condition. For example, diabetes, heart disease, back pain lasting longer than 6 months or arthritis.
It is ultimately up to your GP so please speak to your doctor to see if you are eligible.
How many visits?
Your GP may give you up to five consultations each calendar year. That means come January, you may be able to use a further five consultations each year.
What services are included in Medicare’s EPC / CDM Program?
We offer both Chiropractic & Dietetic/Nutrition consultations which may be covered by Medicare rebates.
What details do I need to provide my GP?
If your GP deems it appropriate, they will require the name, profession and address of your preferred practitioner. You don't have to have a name on the form but can instead use the profession - eg: Chiropractor or Dietitian.
To make it easy for you, we have attached below forms which you can print off or email your GP pre-filled.
Please note that your form must be completed including the correct profession and address in order to be valid.
I have a referral but it has someone else’s name on it, can I use it?
Maybe. If you have a referral which has the same address and service then you can use it.
For example, if your referral lists one chiropractor at Body & Brain but you’d like to see another at the Centre, then you can. It’s the same profession and address.
What do I need to bring along to my appointment?
You must have been to your GP prior and provide the written referral and plan at your consultation. Without that form, your claim cannot be made and you'll have to pay upfront for your appointment. That's a Medicare rule which cannot be broken.
For Dietetics, to make things simple, we have created a separate appointment for you. Please select the EPC / CDM initial or standard consultation on the online bookings or verbalise it when making your booking.
For Chiropractic, to ensure that we can accommodate your claim, please inform us that you have a EPC / CDM at the time of booking the appointment. This can be done online in the Extra Information / Comments section after you’ve filled in your personal details such as your name and contact number or by verbalising over the phone / email.
Please be aware that there will be a small out of pocket expense. This varies according to the appointment type & duration but may be as low as $5.
Can I use private health insurance with the Medicare rebate?
No. You can only use one at a time. Once you have complete your five visits, you may then use your private health insurance.
Please bring in your card so that we can process your claim on the spot.
This will leave you with only the gap to pay. The amount will vary according to your policy.
Can I use Medicare rebates for online telehealth consultations?
Find out more about telehealth consultations.
I've finished my 5 sessions. Can I get another referral?
Again this is up to your GP. Generally yes you can but it must be 12 months after your original referral or in the new calendar year.
If you have a referral for 5 sessions from March 5 2020 and you use all 5 sessions in 2020. Then from January 1 2021, you'll potentially be eligible for another 5 sessions.
If you have a referral for 5 sessions from March 5 2020 and you use 4 sessions in 2020 and one session in 2021 then you might be eligible for another 4 sessions for 2021.
You can use a maximum of 5 sessions per calendar year.
Medicare Forms for GPs
Appointments available in Moonee Ponds or online.
Summary
- Speak to your GP to determine your eligibility and to write your referral
- Entitles you up to five consultations per calendar year (January to December)
- Can be utilised on Chiropractic & Dietetic / Nutrition consultations
- You must bring along your form to your consultation to get the rebate
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