Medicare Rebates

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You may be entitled to access a Medicare plan to help cover the cost of sessions.

 

When utilising a Medicare plan, we ask you pay in full on the day of your appointment. We can then process the rebate for you and Medicare will deposit your rebate into your nominated account. Alternatively, we can provide you with a copy of your paid invoice, and you can claim directly with Medicare.

 

Some important points to note:

  • To receive a rebate for your session, all referrals must be dated prior to/on the day of the scheduled appointment at Okey Dokey.  A rebate cannot be claimed for an appointment dated before the MHTP. GP’s and Paediatricians do not ‘back-date’ referrals.
    Please present all referrals to reception prior to attempting to access a Medicare rebate.
  • The rebate amount may differ based on your past paid medical expenses. If you have spent a certain amount on medical related costs across the calendar year, you may have reached the Medicare safety net. In this case, Medicare will pay for 80% of your out of pocket expenses. If you believe you are close to/have reached this threshold, contact Medicare Australia directly. For more information, please refer to the Medicare website.

 

Please see your GP or Paediatrician to see if you are eligible for one of the following plans:

Mental Health Care Plan (MHTP)

In order to discuss the possibility of accessing the Mental Health Treatment Plan (“MHTP”) under the Better Access to Mental Health Initiative, ensure you book an appointment with your GP or paediatrician prior to your psychology appointment.

 

Your doctor can provide an initial 6 sessions of therapy with a Medicare rebate. The practitioner will then provide the referring GP with a written letter commenting on the progress made across the 6 sessions. After this 6th session, you must make an appointment with the referring doctor to review the progress made. If required, the GP will allow for a further 4 sessions with a Medicare rebate and provide you with a new referral letter to provide to Okey Dokey. Once all 10 sessions have been utilised, the review process will resume again (if necessary) by the practitioner and you may return to your GP for another MHTP review plan (4 – 6 sessions).

 

Please note: If you have already claimed 10 sessions through the Medicare MHTP for the calendar year, these added review sessions cannot be accessed until January of the following year. The process may then repeat until practitioner support is no longer required.

 

In addition to individual psychology sessions, a MHTP also entitles a client to access 10 group sessions with a registered psychologist. This includes some (but not all) social skill groups run by Okey Dokey. Much like individual sessions, these group sessions are provided across a calendar year.

 

For more information on Mental Health Care Plans, please visit the Medicare website

Chronic Disease Management Plan (CDMP)

A Chronic Disease Management Plan (CDMP) (formerly known as an EPC – Enhanced Primary Care Plan) entitles a client with a chronic/complex medical illness a referral for up to 5 session per calendar year with a range of allied health professionals as determined by your GP, and may include: Psychology, Occupational Therapy and Speech Pathology.

 

A CDMP can be accessed through a GP – similar to the process/guidelines outlined above for the MHTP. There is no session review period with the GP for the CDMP.

 

There is no group rebate available for this plan.

 

Paediatricians cannot issue CDMP to clients.

Helping Children with Autism/PDD (HCWA)

The Helping Children with Autism Program (HCWA), provides Medicare rebatable sessions to families to assist with the costs associated in the early diagnosis and treatment of children with autism or pervasive developmental disorder (PDD). This plan can only be unlocked by a paediatrician or psychiatrist to access a Medicare rebate for sessions relating to Autism or PDD.

 

Please note, the following guidelines are applied to the HCWA benefit scheme:

  • HCWA can be utilised for children undergoing Autism Spectrum Disorder diagnosis and/or assessment services for a child under the age of 13 years (up to 4 x Assessment Sessions).
  • Once diagnosed by a Paediatrician, a child can be delegated up to a further 20 treatment sessions to use until the age of 15. These services must be activated by a paediatrician before the child’s 13th birthday.
  • These services are a once per lifetime service that cannot be reactivated once exhausted.