REBATES/ COMPENSATION SCHEMES
How does Medicare apply to private psychology consultations?
From November 2006, the federal government made provision for the public to access rebates for private psychological consultations.
Clients with a mental health concern intending to claim a Medicare rebate need to obtain a referral from their GP before attending an appointment. The GP will assess your concerns and, if appropriate, develop a Mental Health Care Plan which will be either sent to the identified psychologist or you will be given the plan to bring with you on your first visit. This is essential as the GP (not the psychologist) has the responsibility for linking you up with the Medicare system. The plan entitles you to a maximum of 12 individual counselling sessions in a calendar year. You will receive a Medicare rebate of $78.40 for a 50 minute session. You can also receive a rebate of $20 in relation to a maximum of 12 group psychological consultations within one calendar year. This is in addition to the individual sessions.
Clients who have a chronic medical condition and complex care needs, referred by a GP under the Enhanced Primary Care Plan, are entitled to a maximum of five counselling sessions in a calendar year with a rebate of $48.95 for a 50 minute session . This rebate system also applies to other health care items under Medicare so if you have received a rebate for any other allied health care issue it is important to check with Medicare to see what your eligibility for rebates is at any point in time.
If you have a co-occurring chronic medical condition and a mental health concern, you can discuss with your GP which plan you will be referred under. In this situation, many GPs offer you the option of referral under a mental health plan with the higher rebate and more comprehensive service.
The amount you can claim under both schemes increases once you have reached the Medicare Safety Net threshold.
Our psychologists, Meg Debski and Bernadette Mc Sweeney, are registered Medicare providers. For further information you can visit the Medicare website: www.medicareaustralia.gov.au .
To claim your rebate you will need to take your receipt to a Medicare office. The closest office is at 22a Puckle St, Moonee Ponds.
Can I use my private health care to claim back money for consultations?
Yes. Many private health insurers allow for some refund for psychology services; however no two are the same. We advise you to check with your specific provider to see what your policy allows.
Please note that you cannot use your private health insurance in conjunction with claiming a Medicare rebate. However you may use your 12 Medicare rebates and then claim against your health insurance.
Can I access psychological services through Workcover, Transport Accident Commission, Comcare, Department of Veterans Affairs?
If you have been injured at work, or on the way to work, or in a motor vehicle accident, or as a result of defence service, you may be eligible to receive compensation and support services under the Workcover, Comcare, Transport Accident Commission or Department of Veterans' Affairs schemes.
As a part of these schemes, you could be entitled to medical and related treatment in relation to your injuries. Such treatment may, at your Doctors recommendation, include Psychologist services.
If you have obtained a Workcover, Comcare, Transport Accident Commission or Department of Veterans Affairs medical certificate from your Doctor, and this includes a recommendation that you see a Psychologist, you can contact us to obtain these services. We will seek approval from your third party provider, with your permission, before we begin treatment.
If your treatment is being paid for by a third party compensation scheme you should be aware that the information collected during your assessment and treatment will be able to be accessed by your insurer. We will also be required to report back to your insurer about our assessment of your condition as well as your progress in treatment.
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