Claim via Medicare or PHI

[surprised]

Hi all,

Just wondering if you find it better to claim through Medicare where you have a referral or through PHI? DS has to see an OT for his neck and I've been told the consultation is $150. I *think* I get about 50 back from Medicare. Not sure about PHI as I don't have an item number to find out.

Thanks!

[Liviam]

I have always been under the impression that you claim through both medicare and PHI (if it is one of your extras). Could be wrong though. Hopefully someone will know for sure.

[feeb]

Can claim both if your PHI covers it.

When I had boys got rebate from both for pead in hospital and anethatist.

[LizLemon]

Are you sure the OT is covered by medicare? I would have thought it wouldn't be - ie in the same group as physio, dental, chiro, psychology etc.

BUT assuming it is coverable by medicare then you theoretically should be able to claim both.

[LizLemon]

Are you sure the OT is covered by medicare? I would have thought it wouldn't be - ie in the same group as physio, dental, chiro, psychology etc.

BUT assuming it is coverable by medicare then you theoretically should be able to claim both.

[glenny_c]

If the OT is in the category that is covered by medicare then you can claim both. You send it to medicare using a 2 way claim form not the usual claim form and they forward the receipt ect onto your PHI agency. Here is the form
http://www.medicareaustralia.gov.au/...o_way_form.pdf

[surprised]

Thanks ladies. I thought I had a primary care plan but I don't think I do. Will have to talk to OT.

I believe (and I could be wrong) it's illegal to claim from both medicare and PHI for "extras" type things (obviously hospital stuff is different).

[AnyDream]

If the treatment is covered by a Medicare care plan you cannot claim any of the gap with your health fund. This is because the item numbers they use are different for a care plan. I always get the provider to give me 2 quotes with both sets of item numbers and then ring both Medicare and the ph insurer to find out which is the better rebate. 95% of the time, Medicare pays better than phi.