Medicare Safety Net, EMSN and obstetrics fees ~ I am confused can anyone help?

[*Beema*]

We are about to hit the Medicare Safety Net, but when it comes to Obstetrics Fees I know they have changed the rules, and there is a constant referral to the EMSN and a benefit cap that it has to be reached before you get more back but I can't find this anywhere and am getting completely confused

Because I don't know it we will acutally get anymore back on the obstetrics side once we pass the MSN Threshold or not. I am pretty sure that for the "big fee" for us it is ar 24 weeks, we pay $1060.40 and we get back $260.40, leaving up OOP by $800. Which we have to accept as we have chosen to go private, but we will be very close to hitting the MSN prior to that appointment, if we did would it make any difference, or is that the rebate and nothing will change?

[hannahfroodoo]

I know when I had my girls 2 years ago, that management fee counted towards the MSN. I was just under the MSN prior to paying the fee so a small amount of the fee went towards meeting the safety net and then I got 80% back on the remainder. My total OOP expense for that fee was not much in the end - maybe $200-$300.
But if things have changed since then, I have NO idea and would be interested to hear what you find out!
Sorry can't be of more help.

[black_rose]

Can't help either! I am just as confused as it has all changed since last year. Hope someone can help.

[*Beema*]

I am glad i am not the only one who doesn't understand it If someone had been seen by their OB prior to January 1st are under the "old" system, so get all the extra rebates.

[crumpet]

so from what i understand ( which is VERY limited i might add ) the max u can claim is around the $500 mark......
and i think thats when u have hit the safety net, BUT if ur management fee goes towards it u might get say $300 ish....

thats if what i indertsand is right, so i prob wouldnt rely on it to much!

[Loula]

I dont even think you can claim up to $500

My ob fees have cost me over $6000 and so far i have got back about $250! eek.

[Loula]

I dont even think you can claim up to $500

My ob fees have cost me over $6000 and so far i have got back about $250! eek.

[black_rose]

I saw my ob the first week in Jan, bugger should have gone a week earlier. I have paid the management fee but they said to wait to claim it until next month, so maybe they do combine it? Last time we got half back about $1300, it's a big difference but I love my ob. Will have to check and see how much we have spent this year, I have had extra ultrasounds and dd has had a few appointments so I must be almost there.

[*Beema*]

I dont even think you can claim up to $500

My ob fees have cost me over $6000 and so far i have got back about $250! eek.

Woah that is huge!

I have paid out $1320.85, received back $750.85 (that covers OB appointments, scans, bucket loads of blood tests, scans through the High Risk Clinic), so atm $570 OOP. I would be talking to your OB's office because you should have received back more than that !!

[*Beema*]

I saw my ob the first week in Jan, bugger should have gone a week earlier. I have paid the management fee but they said to wait to claim it until next month, so maybe they do combine it? Last time we got half back about $1300, it's a big difference but I love my ob. Will have to check and see how much we have spent this year, I have had extra ultrasounds and dd has had a few appointments so I must be almost there.

I wonder why they said to wait until next month... it would make it a new financial year, but I thought the Medicare Safety Net ran over the calendar year.....
Oh what a bugger about being a few days out

[crumpet]

I dont even think you can claim up to $500

My ob fees have cost me over $6000 and so far i have got back about $250! eek.

i think the $500 ive herd about is the max if u have reached ur saftey net, or so i was told...

$6000??? is he gold plated?!?! crikey!!! but im all for seeing a OB and if thats what it costs then id be paying it too, thankfully mine is only about $3500 before rebates

[Loula]

Oh wow

i do have a fee sheet from his office with amendments due to the new madicare changes

Fee ////// Medicare pay /////// You pay ////// Total cost to me!

1st appointment $175.00 ///// $68.75 ///////// $ 106.25 ///////// $ 106.25

4 antenatal visits $1537.90 ////// 68.35 ////// 1469.55 ///////////// 5878.20

Mid pg visit $463.4 /////////// 463.40 /////////////// 0 //////////////// 0

all other visits are covered cost free from medicare

[Janie]

Lou's Ob is high risk, they tend to charge more His fees are not a heap more than alot of average Melbourne Obs

[Loula]

hehe Janie, you know we are having the million dollor baby! lol what with all our added IVF cost!

[Loula]

Woah that is huge!

I have paid out $1320.85, received back $750.85 (that covers OB appointments, scans, bucket loads of blood tests, scans through the High Risk Clinic), so atm $570 OOP. I would be talking to your OB's office because you should have received back more than that !!

OOps and im not included BT and US!

[*Beema*]

Oh wow

i do have a fee sheet from his office with amendments due to the new madicare changes

Fee ////// Medicare pay /////// You pay ////// Total cost to me!

1st appointment $175.00 ///// $68.75 ///////// $ 106.25 ///////// $ 106.25

4 antenatal visits $1537.90 ////// 68.35 ////// 1469.55 ///////////// 5878.20

Mid pg visit $463.4 /////////// 463.40 /////////////// 0 //////////////// 0

all other visits are covered cost free from medicare

WOAH, how long do the antenatal visits last?

Our Initial Visit was ~ $218.75, get back $68.75 so $150 OOP
Antenatal Visits are ~ $82.90 get back $37.90 so $45 OOP (I've had 7 plus two extra scans through her which were Bulk Billed) Depends on how far I get I am going fortnightly and after 30 weeks weekly.
Management Fee is ~ $1060.40 get back $260.40 so $800 OOP (@ 24 weeks)

My OB is quite cheap in comparrison to others..... My OB is also a High Risk OB and is very highly recommended as one of the top OB is in the state.

[crumpet]

Lou's Ob is high risk, they tend to charge more His fees are not a heap more than alot of average Melbourne Obs

ok that makes a bit more sense....

we are in melb but my OB is in the suburbs so that prob helps with his costings as well....

our fees are

180 at first appt, we got 60 back
then every appt is $90 with $30 something back till we hit safety net then its $60 something back
at 20weeks we pay $1800 and get some piddly amount back
then at 30weeks $700 nothing back...

plus the monthly scans i have and the extra costs of being addmitted for a stitch and what not....

[black_rose]

Mine are similar to crumpets but I fi shared care with my gp so save a little there, I skip half the visits.