Can I use Medicare to pay for my podiatry appointment?

by Hayley Uden on July 16, 2021

Yes, you can!

The Medicare contribution that can be used for podiatry has gone by many names…..Enhanced primary care plan or EPC……… but it is now commonly known as the “Chronic Disease Management Plan” or CDM for short.

Who’s eligible?

Whether or not you are eligible to be considered for a CDM is up to the clinical judgement of your GP. However, the following considerations need to be present for a patient to be eligible:

  • The patient must have a chronic condition

A chronic condition is considered chronic if it is (or likely to be) present for six months or longer.

  • This chronic condition requires on-going care that would benefit from the care of an allied health multi-disciplinary team

Allied health professions include, but are not limited to; podiatrists, physiotherapists, diabetes educators, dietitians, speech therapists

Did you know that this Medicare contribution is worth more than the majority of the private health insurance claims?!

What are you eligible for?

A CDM entitles you to up to 5 x Medicare contributions towards allied health appointments per calendar year. Depending on your needs (and your chronic condition) you can ‘split’ these 5 x contributions amongst several different professions. For example, in one calendar year you could use 3 x of these appointments with your physio and 2 x with your podiatrist.  If your needs change in the following calendar year, you can of course change how you use the 5 x contributions.

So you think you are eligible, what now?

If you are eligible for a CDM, your GP will formulate a referral made out to the allied health practitioner of your choice. This paper work will then be required for your podiatrist to claim the Medicare contribution towards the cost of your appointment.

Not sure if you are eligible for a Medicare contribution? It is as easy as checking with your GP when you are there next.

How do you claim the CDM?

Once you have your paper work from the GP you can either have the referral faxed to our practice or bring it with you to your appointment.

After your appointment, we will swipe your Medicare card on our HICAPS machine and then like magic your Medicare contribution will be paid towards your appointment.

How much is the Medicare contribution?

As of 1st of July 2021, the Medicare contribution is $55.10.

We do not offer Gap free appointments at our practice, therefore there will be a gap between the Medicare contribution and the total price of our appointments. For a better understanding of your financial contributions towards our services please don’t hesitate to give us a call; 8356 0071.

Is it worth the hassle of setting it up?

Absolutely! Did you know that this Medicare contribution is worth more than the majority of the private health insurance claims?! A payment of $55.10 towards your appointment is close to 50% of a new patient appointment.

GP clinics are extremely well-oiled machines for accommodating CDM appointments. You will just need to let your receptionist know at the time of making your GP appointment.