20 March, 2023
Outdated information - current information can now be found here.
With the cost of living going up dramatically, being money smart has never been so important. Medicare offer rebates on allied health such as Chiropractic and Dietetics. It's a potential saving of $280 a year!
Who is Eligible for Medicare Rebates?
The short answer - your GP will decide if you are eligible and write your referral.
If you suffer from an ongoing or likely ongoing condition, then you are likely eligible. Some conditions might include:
Hormonal Conditions
Diabetes
Endometriosis or Adenomyosis
Food & Gut Conditions
Allergies
Coeliac disease
Asthma
Cancer
Musculoskeletal
Migraines
Ongoing pain lasting longer than 6 months
Arthritis
Neurological Conditions
Multiple Sclerosis (MS)
Stroke
Parkinson's Disease
Organ Diseases
Heart disease
Kidney disease
Liver disease
Cancer
How many visits will Medicare rebate?
You can get up to five sessions a year. That means come January, you may be able to use a further five consultations each year.
It's up to your GP to determine how many sessions they think you need. Sometimes GPs will give you all five sessions straight up. Other times, they'll write a few sessions and then review you before writing a referral for the remainder.
Your five sessions are shared amongst all of allied health. This means you might have three sessions with your chiropractor and two with your dietitian.
What services are included in Medicare’s EPC Program?
Medicare will rebate the partial cost of:
What details do I need to provide my GP?
Your GP will require your practitioner's name (if you have a preference), 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.
FAQs
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 Centre but you’d like to see another at the Centre, then you can. It’s the same profession at the same address.
I have a referral for a practitioner but it has a different address. Can I use this referral?
Unfortunately, you'll need to get the referral re-written to include the correct address. The key bits of information on the referral are the correct address, number of sessions for each profession, GP's signature and date of the referral.
My GP hasn't signed my referral, can I still use it?
With telehealth consultations becoming more popular, many GPs are writing referrals and sending them straight off. Sometimes they will sign it electronically and this is ok - Medicare will still process the referral for you.
My referral has Chiropodist marked. Can I use this at your clinic?
Truthfully, I don't know what a chiropodist is! Do you?
We have registered chiropractors so the Chiropractor box needs to be selected with the number of rebatable sessions. We can't use Chiropodist referrals.
I've only been given a couple of sessions but I think I'll need more. What do I do?
Being a chronic and ongoing health condition, you might require more sessions than Medicare will rebate you for. You can continue your therapy paying privately. If you have private health insurance with extras, you might be able to use that towards your consultation costs. Sometimes, private health insurance give you a higher rebate than what Medicare does so it can turn out to be cheaper, particularly for initial consultations when the gap is larger.
What are all the acronyms?
There's a lot of abbreviations that might get thrown around. These might include:
EPC - Enhanced Primary Care
CDM - Chronic Disease Management Plan
GPMP - GP Management Plan
TCA - Team Care Arrangement
What do I need to bring along to my appointment?
We encourage you to email your referral through prior to your appointment. We frequently get referrals that are missing information or have incorrect information on there. We check the referrals as they come in so that they can be fixed up prior to your appointment if needed.
If we don't have your Medicare referral, then we are unable to process your rebate for you. As long as the date of the referral is prior to your appointment, we can process it after your appointment.
We do require that all appointments be paid in full at the time of your face to face appointment or 24 hours prior to your teleheath appointment.
We process the Medicare claim for you and you'll receive your rebate within a few days. Some patients report it can be in their bank account later that day but Medicare's official stance is that it can take up to 10 working days.
For Dietetics, we have created a separate appointment for you. Please select the Medicare 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 Medicare referral at the time of booking the appointment. This can be done online in the comments section after you’ve filled in your personal details or by verbalising over the phone / email. This means we can chase up your referral ahead of time if required - so you get your rebate shortly after your consultation.
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 $15.
Can I use private health insurance with the Medicare rebate?
No. You can only use one at a time. Once you have completed your five visits, you may then use your private health insurance.
Please bring in your private health insurance 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?
Yes! Find out more about telehealth consultations.
I've finished my 5 sessions. Can I get another referral?
Generally yes you can but it's up to your GP and 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 2022 and you use all 5 sessions in 2020. Then from January 1 2023, you'll potentially be eligible for another 5 sessions.
If you have a referral for 5 sessions from March 5 2022 and you use 4 sessions in 2022 and one session in 2023 then you might be eligible for another 4 sessions for 2023.
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 year (January to December)
- Can be utilised on Chiropractic and Dietetic / Nutrition consultations
- We need your Medicare referral to process your rebate and suggest emailing it ahead of your consultation