• Storytelling & Memory Keeping
    • Digital Scrapbooking Hybrid Scrapbooking Mobile Memory Keeping All
      December Daily

      What is December Daily?

      September 12, 2021

      Digital Scrapbooking

      Digital Scrapbooking Freebies are out there – Persnickety…

      July 18, 2018

      Digital Scrapbooking

      Project Life Digital – Freebies Are Out There…

      October 21, 2012

      Digital Scrapbooking

      Digital Project Life – How to get started?

      October 14, 2012

      Hybrid Scrapbooking

      Favourite Scrapbooking Tools – Silhouette Cameo 4

      September 13, 2021

      Hybrid Scrapbooking

      What is December Daily?

      September 12, 2021

      Mobile Memory Keeping

      Project Life App

      August 2, 2015

      Mobile Memory Keeping

      How to do Project 365 and how do…

      January 3, 2012

      Storytelling & Memory Keeping

      Favourite Scrapbooking Tools – Silhouette Cameo 4

      September 13, 2021

      Storytelling & Memory Keeping

      What is December Daily?

      September 12, 2021

      Storytelling & Memory Keeping

      Digital Scrapbooking Freebies are out there – Persnickety…

      July 18, 2018

      Storytelling & Memory Keeping

      2017 Project 365 – Preparations and Lessons Learnt

      December 31, 2016

  • Projects
    • December Daily Photography Project Life and Project 365 Wordless Wednesday All
      December Daily

      Favourite Scrapbooking Tools – Silhouette Cameo 4

      September 13, 2021

      December Daily

      What is December Daily?

      September 12, 2021

      December Daily

      Merry Christmas Everyone!!

      December 20, 2011

      Photography

      Digital Project Life – How to get started?

      October 14, 2012

      Photography

      Wordless Wednesday – Thomas & The Train Shed

      December 21, 2011

      Photography

      Wordless Wednesday ….

      November 16, 2011

      Photography

      Wordless Wednesday

      August 24, 2011

      Project Life and Project 365

      Favourite Scrapbooking Tools – Silhouette Cameo 4

      September 13, 2021

      Project Life and Project 365

      Digital Project Life – How to get started?

      October 14, 2012

      Project Life and Project 365

      How to do Project 365 and how do…

      January 3, 2012

      Wordless Wednesday

      Wordless Wednesday – Thomas & The Train Shed

      December 21, 2011

      Wordless Wednesday

      Wordless Wednesday ….

      November 16, 2011

      Wordless Wednesday

      Wordless ….

      October 9, 2011

      Wordless Wednesday

      Wordless Wednesday – Miss Outside

      September 21, 2011

      Craft Projects

      Favourite Scrapbooking Tools – Silhouette Cameo 4

      September 13, 2021

      Craft Projects

      What is December Daily?

      September 12, 2021

      Craft Projects

      Digital Project Life – How to get started?

      October 14, 2012

      Craft Projects

      How to do Project 365 and how do…

      January 3, 2012

  • Life
    • Community & Kids Disability Grateful Inspiration Laughter, Song & Dance Mind & Spirit Play & Rest Technology Travel All
      Community & Kids

      Carers Allowance & 2018 Federal Budget

      July 19, 2018

      Community & Kids

      Pool Safety … Is Your Pool Ready For…

      October 19, 2012

      Community & Kids

      Autism and Travel Insurance

      October 4, 2012

      Community & Kids

      School Holiday Ideas – Thomas & the Train…

      September 24, 2012

      Disability

      Carers Allowance & 2018 Federal Budget

      July 19, 2018

      Disability

      Social Model Of Disability And Why It Is…

      July 8, 2018

      Disability

      iOS Guided Access – How to help focus…

      June 8, 2013

      Disability

      Autism and Travel Insurance

      October 4, 2012

      Grateful

      Grateful for TED

      September 24, 2011

      Grateful

      Grateful for … Spoken Word

      September 15, 2011

      Grateful

      Grateful for … Poetry

      September 8, 2011

      Grateful

      Grateful for … our GP

      August 23, 2011

      Inspiration

      Some Days I Miss … the Theatre

      December 29, 2011

      Inspiration

      Favourite Quotations – Steve Jobs – Change the…

      November 21, 2011

      Inspiration

      Grateful for TED

      September 24, 2011

      Inspiration

      Grateful for … Spoken Word

      September 15, 2011

      Laughter, Song & Dance

      Most Wuthering Heights Day Ever 2018 – An…

      July 15, 2018

      Laughter, Song & Dance

      If Moms Talked to Each Other The Way…

      October 17, 2015

      Laughter, Song & Dance

      Friday Funny: Lullaby

      August 24, 2012

      Laughter, Song & Dance

      Friday Funny – Fotoshop by Adobé

      April 20, 2012

      Mind & Spirit

      I Miss My Dad

      April 29, 2012

      Mind & Spirit

      Grateful for TED

      September 24, 2011

      Mind & Spirit

      Less than perfect – Good Enough Mum

      August 16, 2011

      Mind & Spirit

      Words of Wisdom for New Mums

      January 19, 2009

      Play & Rest

      If Moms Talked to Each Other The Way…

      October 17, 2015

      Play & Rest

      Review: Sydney Good Food and Wine Show

      June 24, 2012

      Play & Rest

      Get Your Motors Running – Autism Motorcyle Ride

      April 20, 2012

      Play & Rest

      Royal Easter Show 2012 – Last minute Show…

      April 6, 2012

      Technology

      iOS Guided Access – How to help focus…

      June 8, 2013

      Technology

      Do you Backup Your Blog?

      September 22, 2012

      Technology

      Apple Junkie: Preview of iOS5

      June 6, 2011

      Travel

      Things I love about London – St Pauls

      March 9, 2012

      Travel

      Things I love about London – British Museum

      February 29, 2012

      Travel

      Things I Love About London – Tower of…

      February 9, 2012

      Travel

      Crazy Dreams – Vespa Ape

      July 24, 2011

      Stories of Life

      Remembering 9/11 20 Years On

      September 11, 2021

      Stories of Life

      Carers Allowance & 2018 Federal Budget

      July 19, 2018

      Stories of Life

      Most Wuthering Heights Day Ever 2018 – An…

      July 15, 2018

      Stories of Life

      Social Model Of Disability And Why It Is…

      July 8, 2018

  • Stories
  • Instagram
  • About me
    • Contact Me
    • Guest Post Submission Guidelines
N My Life
- crafting life -
Tag:

Better Outcomes for Mental Health

Disability

Navigating the Funding Maze – Medicare

by bronwyn October 4, 2011
written by bronwyn

I remember before Autism, Medicare used to be really simple. You got a doctors bill and you took it to Medicare and then depending on what it was and how much you had already spent that year, you got back some money. Really simple. I remember when I was pregnant I used to go to Medicare regularly … but it was really simple. However, unfortunately, this is not the case when it comes to managing the paperwork for a child with Autism. I know when I was starting I found it a bit confusing .. but I hope that I can help someone out there with some of the things I have learnt.

  • Enhanced Primary Care (EPC) (DOHA)
  • Better Outcomes for Mental Health (DOHA)
  • Helping Children with Autism – Treatment

Health Care Plans

Enhanced Primary Care

  • Enhanced Primary Care Plan is for people with chronic or complex health conditions.
  • Enhanced Primary Care Plan must be prepared by your GP (Item 721 or 725)
  • Maximum of 5 sessions per calendar year
  • Unused sessions can not be transferred to the next year
  • Enhanced Primary Care Plan can be used by GPs to refer to Allied Professionals – Psychologists (Item 10968), Occupational Therapists(Item 10958), Speech Therapists(Item 10970), Physiotherapy (Item 10960) and Dietitians (Item 10954)
  • Enhanced Primary Care Plan requires the GP to specify how many services to what professional. So you need to know how you want to allocate them before you get to the office.
  • Medicare rebate of $47.85 per service, with out-of-pocket costs counting towards the extended Medicare Safety Net. You get more back if you have already reached your safety net

For more information visit the Department of Health and Ageing

Better Outcomes for Mental Health

  • Better Outcomes for Mental Health Plan is for people with identified Mental Health needs that would be best serviced by Allied Health Professionals.
  • Better Outcomes for Mental Health Plan can be prepared by your GP (Item 2710) or Pediatrician (Item 2702)
  • Number of Visits – Unfortunately this was affected by cuts in the recent budget. Changes will be implemented from 1 November 2011. See Medicare for more details
    • On or Before October 31 2011 – up to 12 individual sessions (with the possibility of an additional 6 if deemed required by referring GP or Pediatrician) per calendar year and up to 12 group sessions per calendar year
    • After 1 November 2011 – Maximum of 10 visits per calendar year
  • Unused sessions can not be transferred to the next year
  • Better Outcomes for Mental Health Plan can be used by GPs and Pediatrician to refer to Allied Professionals – 1:1 Psychological Sessions (Item 80110),  Group Psychological Sessions (Item 80120) and OT
  • Medicare rebate of $53-94 per service, with out-of-pocket costs counting towards the extended Medicare Safety Net. You get more back if you have already reached your safety net

For more information visit the Department of Health and Ageing Website

Helping Children with Autism (Treatment)

  • Helping Children with Autism Package in addition to the $12,000 funding ($6000 a year for 2 years) has additional funding for Medicare treatment.
  • Helping Children with Autism Treatment Plan can be prepared by Pediatrician (Item 135) or Psychiatrist (Item 135)
  • Maximum of 20 sessions in total (not per year) to be used for the child from 0-15 years
  • Helping Children with Autism Treatment Plan can be used by Pediatricians and Psychiatrists to refer to Allied Professionals – Psychological Sessions (Item 82015),  Speech Therapy (Item 82020) and OT (Item 82025)
  • Medicare rebate of $69-75 per service, with out-of-pocket costs counting towards the extended Medicare Safety Net. You get more back if you have already reached your safety net

Medicare Safety Net

  •  The Medicare Safety Net provides families and individuals with financial assistance for high out-of-pocket costs for out-of-hospital Medicare Benefits Schedule services. Once you meet a Medicare Safety Net threshold, you may be eligible for additional Medicare benefits for out-of-hospital MBS services for the rest of the calendar year.
  • Medicare will pay 80% of out-of-pocket costs for out-of-hospital Medicare Benefits Schedule services once you have reached the safety net.
  • You need to register to use the safety net … go now and do it now if you haven’t … here
  • The Standard Threshold is $1157.50 however drops to $578.60 when your child has a Health Care Card (if you have a child with Autism, you should have a Health Care Card as it is provided with the Carer’s allowance).

For more details … see the Medicare website

Tips

If you want to get paid … Medicare Receipt requirements

For a Medicare payments to be made the account/receipt must include the following information:

  • patient’s name;
  • date of service;
  • MBS item number;
  • allied health professional’s name and provider number, or name and practice address;
  • referring medical practitioner’s name and provider number, or name and practice address;
  • date of referral; and
  • amount charged, total amount paid, and any amount outstanding in relation to the service.

You may find that you need to get your account/receipts reissued with all the necessary information for Medicare (as your provider won’t know what you are claiming and when). If you turn up just with your account/receipts) without the Medicare Item numbers and the Care Plan Details they will reject them … trust me … it happened

Getting Set-Up

From my experience … the best way to get set-up is

  1. Register for Medicare Safety Net 
  2. Book 2 Long Appointments with GP. Most GP practices want you get book a long appointment for Health Care Plans. Check with their receptionist when you book appointment
  3. Visit your GP and …
    1. Complete the Enhanced Primary Care Plan (Item 721 or 725)
    2. Get Referral to Pediatrician
    3. Get Referral for Treatment (for tax reasons)
  4. Visit your GP and get the Better Outcomes for Mental Health Plan
  5. Book appointment with Pediatrician
    1. Complete Helping Children with Autism Treatment Plan
    2. Get Referral for Treatment (for tax reasons)

Once you get each of your Treatment Plans and Referrals provide a copy (keep the original) to your provider. I prefer to scan them in and email them to my provider.

Summary

  • Get all of your Health Care Plans as soon as possible. You can only claim from the date of your health care plan. Make sure that you keep them up-to-date.
  • Get to know the Medicare Item Codes. This is the terminology that everyone talks in. If you don’t know it and use the name of the Health Care Plans most people (including Medicare employees) won’t be able to help you.
  • All of your Medicare professional can only use 1 Medicare item code per visit. So if you need to get more than 1 health care plan from the same doctor you need to do 1 visit per health care plan
  • Most doctors want you to book a long appointment for a Health Care Plan. Check when you book the appointment with the receptionist on the polciy used at that surgery.
  • Make sure that you have all of your paperwork in order before you go to Medicare (especially the Receipt Requirements). If you don’t you will be sent away.

What have your experience been with Medicare? Do you have any lessons/scars? Please feel free to add links to more relevant information you have found useful in the comments below.  

October 4, 2011 4 comments
0 FacebookTwitterPinterestEmail
Disability

Navigating the Funding Maze

by bronwyn October 3, 2011
written by bronwyn
green plant in clear glass vase

I remember last year when we entered into the Autism world I felt completely overwhelmed. Not just from the diagnosis and what it would/could mean in LittleMan’s life but also the area around government funding for Autism. I know for me I just found it so confusing.  We were lucky however. I got alot of information from both our  Autism Advisor and the  Lizard Centre.

So I will be sharing in a series of posts some of my learnings that I hope will be useful for you in getting around Medicare, Centrelink, Taxation Office and Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA).

Topics will include

  • Medicare Health Care Plans – Better Outcomes for Mental Health and Enhanced Primary Care Scheme
  • Medicare Safety Net
  • Helping Children with Autism – Early intervention funding, Medicare Items, Play Connect Playgroups and Early Days Workshops
  • Medical Expenses Tax Offset
  • Carer Allowance and Health Care Concession Cards
  • Carer Adjustment Payment
  • Health Insurance Coverage
  • Inclusion Support

If you have any questions or suggestions for things that you would like to also cover … please let me know.

Photo by Visual Stories || Micheile on Unsplash

October 3, 2011 0 comment
0 FacebookTwitterPinterestEmail

About Me

About Me

Hi, I'm Bronwyn. I like to eat, laugh, take photos, tell stories, dream, help people & balance that with being a mum of 2 autistic kids. All my own opinions

Keep in touch

Facebook Twitter Instagram Pinterest Goodreads

Recent Posts

  • Favourite Scrapbooking Tools – Silhouette Cameo 4

    September 13, 2021
  • What is December Daily?

    September 12, 2021
  • Remembering 9/11 20 Years On

    September 11, 2021
  • Carers Allowance & 2018 Federal Budget

    July 19, 2018

Instagram

Categories

  • Craft Projects (10)
    • December Daily (3)
    • Photography (4)
    • Project Life and Project 365 (3)
    • Wordless Wednesday (5)
  • Retire (3)
  • Stories of Life (175)
    • Community & Kids (59)
    • Disability (51)
    • Grateful (7)
    • Inspiration (11)
    • Laughter, Song & Dance (18)
    • Mind & Spirit (4)
    • Play & Rest (14)
    • Technology (3)
    • Travel (9)
  • Storytelling & Memory Keeping (14)
    • Digital Scrapbooking (9)
    • Hybrid Scrapbooking (2)
    • Mobile Memory Keeping (2)

Recent Posts

  • Favourite Scrapbooking Tools – Silhouette Cameo 4

    September 13, 2021
  • What is December Daily?

    September 12, 2021
  • Remembering 9/11 20 Years On

    September 11, 2021

Categories

  • Storytelling & Memory Keeping
  • Craft Projects
  • Stories of Life
    • Disability
    • Grateful
    • Laughter, Song & Dance
    • Play & Rest
    • Travel

Popular Posts

  • 1

    Digital Scrapbooking Freebies are out there – Persnickety Prints

    July 18, 2018
  • 2

    How to do Project 365 and how do I do it with Instagram?

    January 3, 2012
  • 3

    Project Life Digital – Freebies Are Out There ..

    October 21, 2012

Instagram

  • Facebook
  • Twitter
  • Instagram
  • Pinterest
  • Goodreads

@2021 - Bronwyn Orsatti

N My Life
  • Storytelling & Memory Keeping
    • Digital Scrapbooking Hybrid Scrapbooking Mobile Memory Keeping All
      December Daily

      What is December Daily?

      September 12, 2021

      Digital Scrapbooking

      Digital Scrapbooking Freebies are out there – Persnickety…

      July 18, 2018

      Digital Scrapbooking

      Project Life Digital – Freebies Are Out There…

      October 21, 2012

      Digital Scrapbooking

      Digital Project Life – How to get started?

      October 14, 2012

      Hybrid Scrapbooking

      Favourite Scrapbooking Tools – Silhouette Cameo 4

      September 13, 2021

      Hybrid Scrapbooking

      What is December Daily?

      September 12, 2021

      Mobile Memory Keeping

      Project Life App

      August 2, 2015

      Mobile Memory Keeping

      How to do Project 365 and how do…

      January 3, 2012

      Storytelling & Memory Keeping

      Favourite Scrapbooking Tools – Silhouette Cameo 4

      September 13, 2021

      Storytelling & Memory Keeping

      What is December Daily?

      September 12, 2021

      Storytelling & Memory Keeping

      Digital Scrapbooking Freebies are out there – Persnickety…

      July 18, 2018

      Storytelling & Memory Keeping

      2017 Project 365 – Preparations and Lessons Learnt

      December 31, 2016

  • Projects
    • December Daily Photography Project Life and Project 365 Wordless Wednesday All
      December Daily

      Favourite Scrapbooking Tools – Silhouette Cameo 4

      September 13, 2021

      December Daily

      What is December Daily?

      September 12, 2021

      December Daily

      Merry Christmas Everyone!!

      December 20, 2011

      Photography

      Digital Project Life – How to get started?

      October 14, 2012

      Photography

      Wordless Wednesday – Thomas & The Train Shed

      December 21, 2011

      Photography

      Wordless Wednesday ….

      November 16, 2011

      Photography

      Wordless Wednesday

      August 24, 2011

      Project Life and Project 365

      Favourite Scrapbooking Tools – Silhouette Cameo 4

      September 13, 2021

      Project Life and Project 365

      Digital Project Life – How to get started?

      October 14, 2012

      Project Life and Project 365

      How to do Project 365 and how do…

      January 3, 2012

      Wordless Wednesday

      Wordless Wednesday – Thomas & The Train Shed

      December 21, 2011

      Wordless Wednesday

      Wordless Wednesday ….

      November 16, 2011

      Wordless Wednesday

      Wordless ….

      October 9, 2011

      Wordless Wednesday

      Wordless Wednesday – Miss Outside

      September 21, 2011

      Craft Projects

      Favourite Scrapbooking Tools – Silhouette Cameo 4

      September 13, 2021

      Craft Projects

      What is December Daily?

      September 12, 2021

      Craft Projects

      Digital Project Life – How to get started?

      October 14, 2012

      Craft Projects

      How to do Project 365 and how do…

      January 3, 2012

  • Life
    • Community & Kids Disability Grateful Inspiration Laughter, Song & Dance Mind & Spirit Play & Rest Technology Travel All
      Community & Kids

      Carers Allowance & 2018 Federal Budget

      July 19, 2018

      Community & Kids

      Pool Safety … Is Your Pool Ready For…

      October 19, 2012

      Community & Kids

      Autism and Travel Insurance

      October 4, 2012

      Community & Kids

      School Holiday Ideas – Thomas & the Train…

      September 24, 2012

      Disability

      Carers Allowance & 2018 Federal Budget

      July 19, 2018

      Disability

      Social Model Of Disability And Why It Is…

      July 8, 2018

      Disability

      iOS Guided Access – How to help focus…

      June 8, 2013

      Disability

      Autism and Travel Insurance

      October 4, 2012

      Grateful

      Grateful for TED

      September 24, 2011

      Grateful

      Grateful for … Spoken Word

      September 15, 2011

      Grateful

      Grateful for … Poetry

      September 8, 2011

      Grateful

      Grateful for … our GP

      August 23, 2011

      Inspiration

      Some Days I Miss … the Theatre

      December 29, 2011

      Inspiration

      Favourite Quotations – Steve Jobs – Change the…

      November 21, 2011

      Inspiration

      Grateful for TED

      September 24, 2011

      Inspiration

      Grateful for … Spoken Word

      September 15, 2011

      Laughter, Song & Dance

      Most Wuthering Heights Day Ever 2018 – An…

      July 15, 2018

      Laughter, Song & Dance

      If Moms Talked to Each Other The Way…

      October 17, 2015

      Laughter, Song & Dance

      Friday Funny: Lullaby

      August 24, 2012

      Laughter, Song & Dance

      Friday Funny – Fotoshop by Adobé

      April 20, 2012

      Mind & Spirit

      I Miss My Dad

      April 29, 2012

      Mind & Spirit

      Grateful for TED

      September 24, 2011

      Mind & Spirit

      Less than perfect – Good Enough Mum

      August 16, 2011

      Mind & Spirit

      Words of Wisdom for New Mums

      January 19, 2009

      Play & Rest

      If Moms Talked to Each Other The Way…

      October 17, 2015

      Play & Rest

      Review: Sydney Good Food and Wine Show

      June 24, 2012

      Play & Rest

      Get Your Motors Running – Autism Motorcyle Ride

      April 20, 2012

      Play & Rest

      Royal Easter Show 2012 – Last minute Show…

      April 6, 2012

      Technology

      iOS Guided Access – How to help focus…

      June 8, 2013

      Technology

      Do you Backup Your Blog?

      September 22, 2012

      Technology

      Apple Junkie: Preview of iOS5

      June 6, 2011

      Travel

      Things I love about London – St Pauls

      March 9, 2012

      Travel

      Things I love about London – British Museum

      February 29, 2012

      Travel

      Things I Love About London – Tower of…

      February 9, 2012

      Travel

      Crazy Dreams – Vespa Ape

      July 24, 2011

      Stories of Life

      Remembering 9/11 20 Years On

      September 11, 2021

      Stories of Life

      Carers Allowance & 2018 Federal Budget

      July 19, 2018

      Stories of Life

      Most Wuthering Heights Day Ever 2018 – An…

      July 15, 2018

      Stories of Life

      Social Model Of Disability And Why It Is…

      July 8, 2018

  • Stories
  • Instagram
  • About me
    • Contact Me
    • Guest Post Submission Guidelines