Amber Laris
Chiropractor and Osteopath INFORMATION SHEET Medicare Rebates and Private Health Insurance Cover for Osteopathic Treatment in Australia
I
f you are considering undertaking a course of osteopathic treatment in Australia, it is important to know to what extent your treatment will be covered under either Medicare, the government-funded universal health scheme, or by your private medical health insurance.
Medicare
A patient with a chronic condition (e.g. a long-standing musculoskeletal condition), which is being managed by a GP, is eligible for a Medicare rebate for a maximum of five sessions of osteopathic treatment in a calendar year, as provided by an osteopath registered with the Osteopathy Board of Australia. There are, however, certain conditions that are applied in order for a patient to be eligible for the rebate. Firstly, treatment by an osteopath must be recommended by a GP who has provided MBS Chronic Disease Management services to the patient, and as part of the patient’s GP Management Plan (GPMP) and Team Care Arrangements (TCAs). A referring GP is required to use a referral form that is provided by the Department of Health and
Ageing, and this form should be presented to the osteopath at the first treatment session. Once all five sessions have been undertaken, if further treatment is required, a new GP referral is required. Second, if more than five sessions of osteopathic treatment are undertaken, subsequent sessions are not covered by the Medicare rebate. Third, the osteopath is required to provide the referring GP with a written report, usually at the conclusion of the treatment, that will detail the treatment provided, any tests or assessments carried out, and plans for future management of the patient’s condition.
“Patients receiving treatment from an osteopath in Australia are entitled to claim a Medicare rebate for their treatment, provided they meet certain requirements.” A patient who has private medical insurance but who opts not to claim on that insurance for their osteopathic treatment, instead choosing to claim their Medicare rebate, is also eligible to claim for the cost of five ses-
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