Medicare Questions

So what’s the deal with Medicare?

One of the most common questions our admin team receives is “what will I get back from Medicare”? This can be tricky to answer, because it often depends on individual circumstances. First, let’s go through the referral process step-by-step.

Step One: Get a referral

Before you can receive a rebate, your GP, Paediatrician or Psychiatrist have to assess you (or your child). So, make an appointment with a doctor you are comfortable with and chat about why you’d like to see a psychologist. The doctor will give you the most relevant referral (or referrals).

Step Two: Send us your referral

We love to receive your referral before you come in! That way we can check everything’s in order, so you don’t miss out on your rebate. We’ve put together information sheets on the different types of referrals we receive, which explain what’s required and where to find more information. Check them out here.

Step Three: Track your sessions

The trickiest thing about Medicare is that they track your rebates by calendar year. Let’s have a look at how it works:

  • You see your GP in November 2016 and they refer you under a “Mental Health Care Plan”, which allows us 6 sessions
  • You see us for three sessions before the New Year hits
  • You have three more sessions in 2017 before going back to your GP for review
  • According to Medicare, you have a total of 7 more sessions to use in 2017
  • A GP review gives us 4 more sessions, so you would need another review in 2017 to access the other 3 sessions

Confused yet? Don’t worry, you can always check in with us to see when you need another referral!

Step Four: Arrange referral reviews

Medicare place restrictions on how many sessions can be referred at one time. So, for example, a “Mental Health Care Plan” can give you up to 6 sessions at a time. Once you see us for 6 sessions, your psychologist sends a report back to the doctor. You then need to make an appointment for a “review”. We’ll let you know when this needs to happen!


So what will my rebate be?

This is the part where what you have already spent on medical appointments adds up! The Medicare Safety Net tracks all of your out-of-pocket expenses (not bulk billed) within a year. Once you hit the threshold for your particular situation, Medicare will give you a higher rebate for the rest of the calendar year. It resets each January 1st.

The standard rebate amount depends on the type of referral and the type of psychologist you see. Medicare also review their rebate amounts periodically. This is why we suggest calling them with the item number, which you can find in our information sheets (see Step Two). You can also go to www.mbsonline.gov.au and search the item number – the rebate (“benefit amount”) will be listed at the end of the description.



Hopefully we have helped explain the deal with Medicare! Have more questions? Comment below or jump onto our Facebook page and ask away! Alternatively, call (03) 9768 9990 or email info@lcpsych.com.au

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