Can I get a Medicare Rebate for my Headache Treatment?
Our headache clinicians work as part of the multidisciplinary team of Allied Health Professionals that keep you healthy. Because of that, there are ways that you can access funding for your treatment through Medicare.
Unfortunately, it’s not as simple as just swiping your Medicare care for each session. You will need to ask your GP to create a Chronic Disease Management (CDM) plan, formally known as an Enhanced Primary Care (EPC) plan. This CDM plan will have to include a physiotherapy referral specifically to our clinic in order for your sessions with us to receive a rebate.
Talk to your headache clinician in your initial consultation, and they will be able to give you all the information you need to discuss your CDM plan with your GP. Your clinician can even contact your GP directly to help organise your referral.
Do I have to meet certain requirements?
In short, is yes.
You will require a Team Care Arrangement (TCA) to be arranged by your GP as part of your CDM. Your GP will decide whether you qualify for this or not.
A TCA is intended for people who suffer from chronic conditions. That is, that you have suffered from the condition for longer than 6 months, or you are likely to suffer from this condition for longer that 6 months.
Your TCA will need to involve at least 3 health professionals. This means that at least one other provider must be included in the arrangement, outside of your GP and your headache clinician. TCA’s are able to be used with any allied health service, such as; podiatry, dieticians and exercise physiologists.
Finally, your GP will need to create a referral that is addressed directly to our clinic, in order for you to be eligible to receive your Medicare rebate.
How many treatment sessions are covered by the Medicare rebate?
With your CDM plan, you are entitled to receive up to 5 rebates per calendar year (1 January – 31 December). These rebates are to cover all allied health referrals. The CDM is open to; physiotherapy, dietetics, podiatry, exercise physiology, speech pathology etc. and your GP may refer you for 3 physiotherapy sessions and 2 exercise physiology sessions, for example.
Your rebates will reset in the new calendar year, but you will have to receive a new referral each year.
How much does the Medicare rebate cover?
Currently, the Medicare rebate is set at $53.80 per consult, and this is standard across all services that you receive at our clinic. This means that the price is the same for an initial consult and any subsequent treatments. Unfortunately, we are not able to bulk bill Medicare at our clinic, so there will be a gap payment to make in order to cover the full cost.
How do I claim the Medicare rebate?
Once your CDM/TCA has been approved by all members of your health team, you will be eligible to claim your rebate.
We will charge you the full amount for your session when you are in clinic. Once we have received payment for your session, we can process the Medicare rebate using you Medicare card. This amount can be deposited right back into your account, providing your debit card is attached to either a cheque or savings account. Unfortunately, we are unable to process your rebate using a credit card.
This is the process:
- Pay the full fee for your session
- We will access your rebate by swiping your Medicare card
- We will then swipe your debit card again, and you will receive this rebate back into your cheque or savings account.
Alternatively, we can provide you with a receipt for your transaction, and you are able to claim your rebate through the Medicare website.
To wrap it all together:
- Yes, you can get a Medicare rebate for your headache treatment, using the CDM Program
- To be eligible you doctor needs to provide you with a specific referral, and your condition will be considered chronic
- You can get $53.80 rebate for up to 5 visits per year
- Once you have payed the full amount for the services that you received, we will use your Medicare and debit card to return the $53.80 rebate to you.
If you have any questions about the Medicare CDM process, feel free to Contact Us our friendly team to discuss the process with them. Further information regarding your CDM/ TCA can be found on the Department of Health website.
Otherwise, come in and see us and we can assist you by liaising with your GP to get the process started and get on top of your headaches and migraines!