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

[crumpet]

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

can u do that when u go private??
i didint knoe that....

mind u my OB is a bit of a security blanket so i prob wouldnt but thats handy to know

[black_rose]

I trust my gp, he used to deliver babies until the insurance was too high so maybe that's why he can? I love that I can see him if issues come up without forking out more money and he calls my ob if need be.

With dd he convinced my ob to take me off the insulin for my gd as my levels weren't high enough to be on it and I was feeling like crap, I managed fine with my diet after that.

[Hollybolly]

It doesn't make any difference as to whether you had seen your FS previous to Jan 1st or not, unfortunately

After asking the girl at medicare when we claimed everything, she explained it to me like this...

By law, you are not allowed to claim back the $$ from medicare for your management fee until 20 weeks - we missed out by a week as I was 20 weeks in the 2nd week of Jan.... grrrr!
(Some OB's have let you pay/claim early, but they can lose the medical licence if caught).

If we had been 20 weeks before the change, we would have gotten back 80% of our OB's management fees (saying we had reached the safetynet, which we had as we had done 2 rounds of IVF within the calendar year).
With the changes now, though - its just a set amount no matter what your OB charges (the governments attempts to make OB's have to be more competitive with their fees)
So no matter if your fees are around the $1500 mark (like Beemas) or the $6000 mark (like Lou), you still only get the same amount back - which is approx $470.

Our OB's management fee was $4500 - and $100 per visit.
We got back $470 from the $4500 (ouch!) and about $80 from the $100.
If baby had been concieved 9 days earlier we would've gotten $3600 back instead of the crummy $470
(Although I'm counting my lucky stars, though, as we were lucky enough to get 80% back on the 2 IVF cycles we'd done that year, so you can't have everything I guess )

After having bub, we just got the last account from our OB - which was $1300 for the c/s.
I'm yet to claim that back to see what percentage we get from medicare - but I'm not expecting to get much, as I know my OB is pretty exxy compared to most.... bummer, but we wouldn't have gone with anyone else, & for what we've been through to get our little man, any price was worth it for us... like Lou, he's our million dollar baby

Hoping all of my natter makes sense

[~me~]

Hollybolly has explained well! Just another thing to remember, keep all your receipts. As with out of pocket expenses you may be able to claim through tax. As in when you hit the $1500 out of pocket threshold (medical) for ATO you can get back 20c in the dollar? after that $1500 threshold. So keep all receipts and remember to request Tax statements from Medicare, your private health fund, Pharmacy (scripts).

HTH

[*Beema*]

Thankyou everyone for posting and helping to clarify the issue as you can see there were quite a few of us feeling very confused

If you register online for Medicare you cna also access all your statements there, I will definitely keep the OOP expenses in mind when it comes to tax time as well. I don't know if we have kept al our pharmacy receipts, but gee they add up to a lot with the amount of Meds that DD and DH are on!

[Hansie]

Just looking at my little medicare slip I had already reached the saftey net and my 20wk fee was $2526.40 charge / 306.30 (sch fee) / 463.40 benefit 511 code EMSN threshold reached -cap applied to benefit. so it does look like you may get a bit more back after reaching the safety net but not much. I also paid another $1134 which was all OOP.

[~me~]

Hey Beema, go to your Pharmacy or Pharmacies and request a Tax Receipt. They can print off one for you when it comes to scripts as they keep records on their system. Ask for all the family, your DH may have to request his own.

[feeb]

Crikey I am glad I have allready had my boys as those costs are crazy!

I went private with both and go pretty good refunds.

[nickle730]

I'm in Melbourne too, Loula, and my OB charges about the same as yours. Total OOP cost just for the OB is slightly more than $6000. As Janie said, that's perhaps slightly more than the Melbourne average... but only slightly!! I did ring around when I discovered that I was pregnant this time and found out how much it would cost us OOP to return to my previous OB. The least expensive OB I called (I only called those whom I had personal recommendations for) was still $3500 OOP.

First appt was... mmm... something around $200 and I got back 60 something bucks. I will pay $3500 at 20 weeks, rebate is about $400, then pay $1500 at 30 weeks no rebate from Medicare. I have been told by my OB's receptionist that Medicare have capped OB rebates and the total I will get back is somewhere between $400 and $500. Is VERY expensive!!! But we have chosen to go back to the same OB who delivered our last two kiddies, so we have no choice but to suck it up... and pay up!!!

[*Beema*]

Hey Beema, go to your Pharmacy or Pharmacies and request a Tax Receipt. They can print off one for you when it comes to scripts as they keep records on their system. Ask for all the family, your DH may have to request his own.

Really! that is brilliant, thankyou so much for that I will definitely be doing it, I go to the same pharmacy every time, DH accassionally goes to a different one, but he knows where to go now

[*Beema*]

I had an OB appointment yesterday and asked there and they had trouble finding the info, but another mum waiting said that she spoke with Medicare and if she passed the Safety Net prior to the large payment of 24 weeks, she was then able to got the standard $260 back, PLUS an extra $200, but if she hadn't passed it priro to that payment she would have received only the $260 back.

We are with $100 of passing it and I have another OB appointment between now and then so we will be close.... might have to see the GP in the meantime.....

[black_rose]

Thanks beema, not much back is it. The govt really thought ob's would drop their fees??? I will have to see how close I am, will get the bill to claim next week.

[*Beema*]

No it isn't and the fact that you have to be past the SN it before you get the extra, it is worth paying for an extra Dr's appointment or so to get the extra $200 back!

I have online registration, it is so good as you can see it really quickly I am almost checking daily atm to see how we are tracking

There was no way OB's were going to drop their fees, I am just lucky that mine are so cheap in comparrison to others, and that my OB spreads her fees out so that we can get the best value

[Loula]

well i went over the SN in March! still doesnt mean i get much back IMO.

just getting DH's appointments done this year now lol, just the skin Dr to go! woohoo lol

[black_rose]

I have an online registration have forgotten the password though so I have to get it reset. Arrrgh!

[Razzberry]

Can ia ask a question relating to the money you can get back in tax when you spend over $1500 - Does my daughter reipts go on my tax return or my husbands?

[*Beema*]

well i went over the SN in March! still doesnt mean i get much back IMO.

just getting DH's appointments done this year now lol, just the skin Dr to go! woohoo lol

When it comes to OB and IVF, nope you get stuff all, very dissappointing how much you have to pay out and get so little back

I have an online registration have forgotten the password though so I have to get it reset. Arrrgh!

is there an email option for resetting the password?

Can ia ask a question relating to the money you can get back in tax when you spend over $1500 - Does my daughter reipts go on my tax return or my husbands?

I assume if you are all on the same Medicare Card, that it can go to either, who ever needs the better Tax deductions, I would check with your accountant or maybe post the question in the Bills and Financing section

[black_rose]

Can ia ask a question relating to the money you can get back in tax when you spend over $1500 - Does my daughter reipts go on my tax return or my husbands?

I have included dd1s receipts on mine hers alone was $1500+ because of her hips, but it needs to be the out if pocket stuff any rebate from Medicare or phi comes off the total. You can also include dental too. You just work out whoever has the highest income and apply it to that return. In our case it was the same but the bills were in mine and dd's names.