Private Health Insurance & EPC

Chronic Disease Management Plans (formerly known as Enhance Primary Care Plans) are designed for people who suffer from a chronic medical condition likely to last more than 6 months and require input from a multidisciplinary team (Ie. Your GP plus 2 other allied health professionals).

Once your GP has deemed that your condition requires a CDM, you are then allowed to claim a Medicare rebate for up to 5 visits from an allied health professional per calendar year. If you happen to be referred towards the end of the year and don’t use all 5 visits, the remaining visits can be rolled over to the following year. However, those services will then be counted towards the 5 rebates for all allied services available to you for that year.

Generally you are entitled to a rebate of $52.95 per visit, however, if you have gone over the Original Medicare Safety Net Threshold, you will be entitled to a higher rebate, possibly up to 80% of the scheduled fee (Item 10960). There is also an Extended General Safety Net Threshold amount and if you were to go over this you will be reimbursed an even greater amount. The Medicare rebate can also be processed using our HICAPS facilities in the clinic, saving you a trip to Medicare to claim the benefits!

If you think that this may apply to you, feel free to have a chat with us at your next appointment and we will discuss whether or not you may be applicable for this service.

Check out our blog below for more information on the Chronic Disease Management Plan and to see if you may be applicable.