Who is eligible?
You may be able to claim Medicare rebates for allied health services if you have a chronic medical condition that is being managed by your GP under an Enhanced Primary Care (EPC) plan.
Chronic medical conditions
A chronic medical condition is one that has been (or is likely to be) present for six months or longer. It includes conditions such as asthma, cancer, cardiovascular disease, diabetes, musculoskeletal conditions and stroke.
Care plans can help you and your GP manage your chronic medical condition by identifying your needs and planning what should be done. An EPC plan involves your GP preparing a GP Management Plan and Team Care Arrangements.
If you have a chronic medical condition, a GP Management Plan provides an organised approach to your care. It is a plan of action that you have agreed with your GP.
If you have complex care needs, Team Care Arrangements help coordinate your care. Your GP will collaborate with at least two other care providers involved in your treatment.
Individual allied health services
Once you have an EPC plan, you can be referred for up to five allied health services each calendar year. Your GP will decide whether you would benefit from these services and make the referrals.
The five services can be provided by a single allied health professional or shared across different professionals.
You can request that the GP refer you to an allied health professional you already know, or your GP can recommend one.
Allied health professionals need to meet specific eligibility criteria and be registered with Medicare Australia.
For more information, read this brochure, and talk to your GP.
With an EPC plan, we can process the rebate for you on site. This means that you only have to pay the gap payment, which is quite small, thanks to the great rebates from Medicare.
The prices are as follows:
EPC Cost: $70.05
EPC Cost: $65.00
Unfortunately, we can only put the rebate back onto a savings or cheque card, so for your EPC treatment, you will need to bring:
Your EPC referral note (only on your first time),
Some way for you to pay for the treatment in full,
Your medicare card, so we can process the rebate, and
A savings or cheque card, so we can give you back the refund!