EPC Medicare Care Plans

How it works:

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You go to your GP and ask for referral. They must complete:

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1. A GP Management Plan (GPMP) - item 721 AND

2. Team Care Managements (TCAs) - item 723 AND

3. A Referral Form

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Either you bring in with you or your GP will send the TCA and the Referral Form to us. When you come in, we will Bulk Bill your visit and not require any gap/further payment.

For your visit please to bring in your Medicare Card with you for ease of claiming.

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FAQ

Q. Who is eligible?

To be eligible for a Medicare rebate, you need to be placed on an Chronic Disease Management (CDM) plan by you GP, that specifically refers you to Dr Alex Powell - Chiropractor.

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Q. How do I get placed on an CDM plan?

If you have been suffering or will suffer from a condition for longer than 6 months or have numerous health issues then you qualify for the CDM program. Visit your GP and ask them to prepare a CDM plan.

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Q. Can I use my private health insurance cover in conjunction with CDM?

No. You need to decide if you are going to use your Medicare rebate or your private health insurance as you can not claim from both for the same consultation. Once you have claimed all your Medicare rebates you can then claim any further consultations through your private health insurance.

Q. What is meant by chronic conditions and complex care needs?

Chronic conditions are defined as conditions which have been, or are likely to be, present for six (6) months or more. Complex care needs means that, in your GP’s opinion, you would benefit from care provided by a range of health professionals, who provide different services.

Q. Once I’m on an CDM plan, how do I pay?

Your visits with us shall be Bulk Billed so please do bring your Medicare Card with you for the Bulk Billing to occur. To be sure you can claim, you require:

1. Your GP fills & submits both 721 & 723 Medicare forms correctly

2. You have not already claimed your CDM allowance elsewhere (podiatrist, speech pathology etc.)

It’s can be a good idea to confirm with your GP or to call Medicare to confirm your eligibility should you have had any other Care Plan visits in the past 12 months. You can call them on 132 011.

Q. I have already used my 5 CDM entitlements this year, can I have more?

You can have a maximum of 5 CDM visits each calendar year. If you want more, you will need to wait until January the following year to reapply for a further 5 CDM visits. 

Q. Am I always entitled to 5 CDM visits?

Only if your GP says so. If you want the 5 visits make sure you mention this to your GP to request the maximum 5 visits in the CDM forms towards Chiropractic.

Q. Does CDM cover for any X-Rays?

No, but if required, we can refer you for x-rays which are mostly bulk billed at our local radiology centre.

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For Referrers:

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Please utilise our details in the contact us section of this website. Referral paperwork can either be delivered via the Patient as they attend our office. If Paperless, we do not have a Fax line, secure email attachment is preferred.