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.

[*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 !!

[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 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

[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.

[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

[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.

[*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.....

[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!!!