management fee/medicare safety net

[Mrs McAwesome]

Hi ladies,

Just an update. I had my last app with my OB yesteday for 2009 and he let me pay the management fee then. I went into medicare and claimed it straight away and they put it in my bank account no worries no questions. The receipt I claimed with nowhere said I was 20 weeks preg.

My OB was $2000 and I got $1396 back from medicare so very happy with that. Otherwise the lady at medicare said the scheduled fee is only $122 and that is all I would have got back if I didn't have the safety net.

[JLeigh29]

Thanks for your update Mrs Hendo. Have been reading this thread with interest as I paid our management fee yesterday - $1850. Medicare gave us back just over $700. How does that work as I thought once you reach the safety net you get back 80% of oop expenses and by our calculations we've definitely reached the safety net? Am I right or is that baby brain? And will private health cover any of the rest of the expense, does anyone know?

[Mrs McAwesome]

Your OOP won't be covered by your private health... Well most won't I work for medibank and I know we definately won't.

The safety net is $1100 ish.. We had already reached $890 ourselves prior to paying the management fee which is why we have gotten more back. As the scheduled fee is only $122 you got back an extra $500-$600.

Prior to doing your tax next year make sure you get an annual statement of benefits from medicare and your private health fund as any OOP over $1500 for the financial year you will get back 20%

[berrme]

Private health cover doesn't cover anything that is not in a hospital, so none of the general ob fees before the birth are covered.

The medicare safety net only includes your out of pocket expenses, so maybe you are over estimating by including the total of the bills from the ob so far?
I found that it was the management fee that put me past the safety net limit so we only got the 80% back for about half of the management fee that was past the limit. I hope that made sense.

[starangelk]

Mrs Hendo - you are so lucky, I talked to my Ob about it and he basically said I should speak to his assistant. I did that and she said she'd talk to him, but then at my next appt she just said that because I won't be 20 weeks it's a no go. I am trying to be brave about it and just think in my head that "it's only money" but am still annoyed at the system. Jut one of those things really, no point being annoyed.

[JLeigh29]

Thanks Mrs Hendo. Yeah, I knew about the 20% on our tax, so I will definitely remember to do that.

And Berrme, I think you might be right that I was including total bills and not just oop expenses. And also my fs expenses, some of which weren't covered by Medicare at all.

Thanks for your help.

[~Phoenix~]

Update from me on this, got home last night to a nice cheque in the mail from Medicare. I paid my Ob fees in December which were $1864.00 and I got back $1105.00.

Was quite happy with that, since I was originally told I would be $1700+ OOP for the management fee since $122 was the scheduled fee.

[BlackRose]

Hi ladies,

Just an update. I had my last app with my OB yesteday for 2009 and he let me pay the management fee then. I went into medicare and claimed it straight away and they put it in my bank account no worries no questions. The receipt I claimed with nowhere said I was 20 weeks preg.

My OB was $2000 and I got $1396 back from medicare so very happy with that. Otherwise the lady at medicare said the scheduled fee is only $122 and that is all I would have got back if I didn't have the safety net.

That's really interesting Mrs Hendo, because I asked my OB if I could pay my 20 week fee early to claim the 80% back and he said no because I wasn't at 20 weeks by 31DEC. I noticed you weren't at 20 weeks either, so how did you claim this money back from Medicare? didn't your OB have to state you were at 20 weeks or over by 31st December 09?

Thanks!

[Mrs McAwesome]

I have heard most OB won't do it as they are worried about getting into trouble. Medicare just go off the the item no on the receipt. on it states nowhere that I was 20 weeks along. When i went into medicare i was only 15.5 weeks along and noone asked me how far along i was either.

[alexsandra]

hi all,

i too was concerned about the fees and i was able to pay my management fee which was 5k in December when i was 16 weeks, claimed the money not a problem at all like MrsHendo said no where does it say how far along you are or anything like that they don't check anything.

I guess we're just lucky my OB allowed this and im glad he did as he was bloody expensive!

But a friend of mine asked to do the same and her OB said no in case they check and he gets into trouble, so i suppose it very much depends on your OB