How can I effectively manage my Medicare funding?
Note: This information primarily relates to a Mental Health Treatment Plan (MHTP). For information on managing other applicable Medicare referral types, please consult with our admin team or your clinician.
We understand that managing your Medicare funding might feel a bit overwhelming. Here's a breakdown to help you navigate the process effectively:
Valid Referral: If you want to receive a Medicare rebate, ensure you have a valid referral from your GP, psychiatrist or paediatrician before attending your appointment. It is your responsibility to seek a referral when you need one.
Referral Renewal: You can expect that your clinician will write to the referrer after you have attended all available sessions on the referral. For a MHTP referral, this will be a maximum of 6 sessions unless the referrer has noted otherwise. If you want to continue to receive a Medicare rebate, you will need to request a re-referral from your GP, psychiatrist or paediatrician. Medicare allows a maximum of 10 rebates per calendar year under a MHTP.
Rebate Limitation: Even if your referral indicates more available sessions, you can only access 10 Medicare rebates per calendar year with your MHTP, and no further Medicare rebates can be claimed under a MTHP until the next calendar year. This is where private health insurance may help - if you have Extras Cover that includes Psychology or Social Work, your private health insurer may pay benefits towards the additional sessions you need, up to your annual limits. You can find more information about private health HERE.
Session Flexibility: The number of sessions required is not determined by the number of rebates you can access. Many clients will need more sessions than the number of rebates they can access in a given calendar year. Your clinician will tailor your therapy based on your unique needs and challenges. It is important that you talk with your clinician about any concerns regarding your financial commitment to therapy.
Open Communication: We encourage you to have regular and transparent discussions with your clinician about your therapy plan, progress, and any changes in your circumstances. This proactive approach not only helps you manage your Medicare funding and finances effectively but also enables clinicians to tailor your therapy plan to provide the most suitable and personalised care for your needs.
Planning Ahead: Scheduling multiple appointments ahead can assist you in knowing how many appointments are remaining on your referral. When speaking with admin, this is an opportunity for you to check how many appointments are remaining on your referral and how many rebates you may have access to for the remainder of the calendar year.
Record Keeping: You can request a copy of your referral from your GP for reference. Keeping a record of your referrals and appointments is useful for any questions or issues that may arise related to your funding.
Courtesy Reminders: We have set up automated reminders to let you know when you have only 1 session remaining on your current Medicare referral. Clinicians also do their best to remind you when you have attended all sessions on your current referral and when you have reached your 10-session limit for the calendar year. It is your responsibility to seek a referral when you need one.
Additional Support: If you require assistance in keeping track of the sessions remaining on your Medicare referral, please speak to our admin team at Reception after your next appointment or email us at admin@healthymindcentre.com.au
Medicare Safety Net: There’s something called a Medicare Safety Net that can help lower your out-of-pocket medical costs for out-of-hospital services. Once you have spent a certain amount in the calendar year, your Medicare rebate will increase. If you’re part of a family or couple, you can combine your costs by registering as a family. To find out more about the Medicare Safety Net, click HERE.