Whilst many people are aware that health insurance extras often give some rebate for osteopathic treatment, a number of people would not be aware that in certain circumstances Medicare rebates are available for osteopathic treatment as well. All our osteopaths at Lower Plenty Osteopathy are able to participate in Medicare chronic disease management plans.
There are conditions and requirements that need to be met to be eligible to access this Medicare rebate which will be discussed below.
CHRONIC DISEASE MANAGEMENT (CDM)PLAN
Chronic disease management plans, also known as enhanced care plans, team care arrangements or allied health plans, are a scheme introduced by the government to enable subsidised access to treatments/consultations with primary health care providers for those suffering from chronic conditions. Chronic conditions refer to those conditions that have been, or are likely to be, present for at least 6 months.
CHRONIC CONDITIONS THAT COULD BE ELIGIBLE
- Musculoskeletal conditions (could include: chronic neck pain, back pain, shoulder pain, disc injuries, ligament tears, arthritic conditions, etc)
- Asthma
- Diabetes
- Cancer
- Stroke
- Cardiovascular disease
HOW DO I GET A CARE PLAN FOR OSTEOPATHIC TREATMENT?
The first step to getting a CDM plan is to consult with your GP. Only your GP is able to determine if you are eligible. In most cases you will need to be seeing at least 2 health practitioners (excluding the GP) to be eligible. These could be a specialist or another allied health professional such as a podiatrist, physiotherapist or dietician.
If your GP determines that you are eligible, a plan will be written and sent or brought to Lower Plenty Osteopathy for your osteopath to sign off on and make any adjustments to the plan that they feel necessary.
Your osteopath will write a letter to your GP updating them after the first CDM session and the last CDM session.
HOW MANY MEDICARE REBATED OSTEOPATHIC TREATMENTS AM I ENTITLED TO?
Your GP is able to allocate up to 5 CDM sessions per calendar year. These sessions may be allocated all to your osteopath, or in combination with another practitioner (eg, 3 sessions osteopathy, 2 sessions podiatry). You do not have to use all the allocated sessions in a calendar year, however, any you carry over into the following year will be deemed as part of the up to 5 allowed for that calendar year. Your GP will determine if you are eligible for a new CDM plan in the following year.
WHAT IS THE REBATE FROM MEDICARE FOR OSTEOPATHY AND HOW DO I CLAIM?
The current Medicare rebate (June 2024) for osteopathy is $58.30 and this is increased incrementally every financial year. You will still be required to contribute an amount to your consultation fee.
The claim process is able to be performed immediately after your appointment at Lower Plenty Osteopathy. It is a quick process using the following steps:
- Pay your full consultation fee on a card of your choice.
- Present your Medicare card to us and we input some required data (GP name and date of referral) into our HICAPS machine.
- Present a card that has a cheque or savings account attached so we can immediately reimburse your rebate to that account.
If you are not sure if you might be eligible for a CDM plan, please consult with your GP or talk to your osteopath at your next consultation.
