Medicare Benefit Question....

[Beach Mama]

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!

[Fuzzywuzzy]

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?

[Beach Mama]

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.

[Beach Mama]

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!

[Fuzzywuzzy]

Yay!!! Buy yourself something nice

[AlligatorsMum]

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