thread: Medicare Benefit Question....

  1. #1
    Registered User

    Jan 2007
    7,197

    Medicare Benefit Question....

    I have just realised that I might be able to claim my sessions for anxiety I have been having. A wee bit exciting!

    Anyhoo on the Medicare website under the item number is says this....


    Fee: $135.30 Benefit: 85% = $115.05
    I am thinking it means I am out of pocket $115 and will get back $20 - does that sound right!?

    I have had 5 sessions so $100 is great!

  2. #2
    Registered User

    Nov 2008
    727

    I'm pretty sure the benefit is the amount you get back and the gap is the difference between the fee and the benefit which is your out of pocket cost. There might be a limit for how much you can get back, did it say anything about that?

  3. #3
    Registered User

    Jan 2007
    7,197

    Oh my gosh that would be ace!

    It says this

    These therapies are time limited, being deliverable, in general, in up to 12 planned sessions in a calendar year

    I have had 5.

  4. #4
    Registered User

    Jan 2007
    7,197

    Bah read the wrong number but the one for mine says the same thing about calendar year, but this about fee


    Fee: $92.20 Benefit: 85% = $78.40
    I paid $140 though but even so - better than nada! Off to Medicare!

  5. #5
    Registered User

    Nov 2008
    727

    Yay!!! Buy yourself something nice

  6. #6
    Registered User

    Mar 2011
    queensland
    696

    Tanstar - i work for a psychiatrist. To explain the:
    Fee Amount is what medicare say is an "acceptable" amount to charge for a consultation and the 85% is what you get back from medicare. There is usually a 75% amount which is usually the rebate for an outpatient consultation and the 85% is the rebate if it was an in hospital consultation. Obviously there is no psychology sessions in hospital normally so that may be why there is only the 85% on your item number.

    and like a PP there is usually a certain number of consultation in a calender year you can claim back.

    but i agree, any money back from the government is better than nothing!!!

    mv

  7. #7
    Registered User

    Jan 2007
    7,197

    Booo I got zero because I am not on a mental health plan (my choice) **Sob** Ah well, my new $5 tangerine splash lip gloss will cheer me up!

    thanks for your help!!!

  8. #8
    Registered User

    Aug 2006
    On the other side of this screen!!!
    11,129

    Tanstar, I see you've already caught up with the mental health plan thing. I guess you could use this as an opportunity to reconsider applying for one. It really just involves making an appt with yoru GP, gong through a bit of a history and filling out straight forward questionnaire to rate your stress, anxiety, depression levels.

    If you are thinking about doing this, better to get in sooner rather than later as the number of sessions is shrinking (next year?) due to changes in the last budget.

  9. #9
    Registered User

    Jan 2007
    7,197

    Thanks MD. I am just worried because they said it goes on my record for all eternity as having a mental illness. Yes I have one, and I know I have one and will always have one but am concerned about the affect of it being "on record" with a Government department. The GP and psych said the only thing it would affect would be my life insurance (am assuming if I took my own life, they wouldn't pay out?) Not sure if I am being silly and reading too much into it.