Medicare Rebates: Does Medicare fund Osteopathy treatment?
Medicare funds Osteopathy treatment (in some circumstances)
Great news, Medicare does fund osteopathy treatment in some circumstances, this means there is a rebate. This program is referred to as the Chronic Disease Management Plan (CDMP).
Osteopathy is a vital treatment option to assist with pain management, improving movement, assisting balance and physical strengthening. People experiencing conditions including fibromyalgia, chronic pain, osteoporosis and arthritis (and many more) come for an appointment.
It should be really easy to get a medicare rebate for osteopathic treatment, but unfortunately this is not the case.
We are going to outline the medicare payment process for you a little more, so you can be well informed and get the support you need.
There are strict criteria
First and foremost, your current health is taken into consideration. Your condition needs to satisfy certain criteria. It’s great that there is government Medicare initiative, however patients must have a chronic condition in order to qualify.
This means the problem must be at least 3 month old
In addition, this problem that is being managed is unlikely to fully resolve in the near future or on its’ own.
Referral required
Your GP must write you a referral to undergo osteopathic treatment via this program.
This essentially states the osteopathic referral is medically beneficial.
The referral is not only to the osteopath, a second referral for another health professional is necessary.
This may be to a specialist or another allied health care practitioner.
If you are a private patient, you do not require a referral to see an Osteopath.
Correct provider
Treatment must be performed by the clinic to where the referral letter is written.
You can not get a referral and later decide to change clinics.
In these circumstances, you would need to go back to the doctor first and amend the referral.
For example, you see an Osteopath at another clinic with a care plan.Due to a change of circumstances, you decide to come to Koru.
As a result, in this instance, you would need to contact your doctors clinic and ask them to change the referral before an appointment.
Osteopaths provide treatment under Medicare
The good news here is, all Osteopaths are Medicare providers and we are able to see you.
If your doctor refers for x number of appointments with one provider and x for another. Unfortunately you can not decide you want this changed on your own.
Let us provide an example for you.
Your doctor allocates you 3 osteopathic appointments and 2 podiatry appointments. You decide you only need 1 podiatry appointment.Additional treatment sessions can not automatically be allocated to the osteopath.Therefore in this situation, you will need to discuss this with your doctor.
Unfortunately we are unable to do this on your behalf.
Maximum appointment number
The CDMP provides 5 rebatable medicare consultations in total per year.These can be used for a variety of allied health appointments. This includes dietetics, podiatry, speech pathology, osteopathy and many more.
Renewed yearly
Every year, you must review your plan with your doctor. It does not automatically renew. Due to this process, this effectively means you need a new referral on a yearly basis. We are unable to organise or process this for you.
Paperwork
We must receive a copy of your paperwork in order to process the referral.
There is no way around this.
We recommend you bring a paper copy with you to your appointment to avoid disappointment.
Conditions eligible for rebate
Some of the most common complaints people come to see us for under the CDMP program are back pain and headaches.Similarly we also see people experiencing joint pain, arthritis, repetitive strain injuries as well as people with many other conditions.
We use our on site hicaps machine to quickly and efficiently process your payment and medicare rebate for osteopathy. For this reason and in order for this to occur smoothly, we need you to bring a debit card and medicare card to all appointments.
As of July 2019, the rebate is $53.80, however can be higher if you have reached the medicare safety net.
You pay the full fee upfront and transfer of your rebate is automatic back into your bank account via a debit card. Consequently, if your card isn’t working, you will need to pay in full and receive the rebate back at a local medicare office.Alternatively you can submit your receipt online. Unfortunately we are unable to bulk bill osteopathy appointments at our clinic. This means there is a small gap, or out of pocket expense associated with these appointments. The amount varies according to if you have exceeded the medicare safety net. To wrap it all together:
Yes, you can get a medicare rebate osteopathic treatment. You need a specific referral from your GP (doctor). A rebate of $53.80 (and upwards if you have exceeded the medicare safety net) for up to 5 sessions per year is available. There will always be a small gap fee. We can process your rebate on-the-spot via our HICAPS terminal straight back onto your debit card. The chronic disease management plan provided by Medicare with a rebate goes a long way towards providing you with high quality osteopathy treatment. Book an appointment.Payment
Summary