View Full Version : Can we still claim 80% of OB fees from medicare once reach limit?
Vanessa80
04-05-2010, 08:13
Im confused. I thought this ceased at 1/1/10 and that they only paid a scheduled amount for OB fees (which isnt much!) but I was in there the other day and the medicare staff didnt know what i was on about and said you can still claim the 80% of the fee once you reach your limit. Can anyone confirm this? I must admit i dont think the staff understood what I meant but you think they would know given OB fees are big claims! And if the change isnt in yet does anyone know when it does come in?
Vanessa80
04-05-2010, 19:36
bump
hasnt anyone claimed OB fees this year from medicare who can confirm?
TIA :)
I am pretty sure it is capped.
You get a maximum of $400 (it may be slightly more but definately under $500) back. Obstetrics no longer counts towards the safety net so the 80% doesnt apply. This is from 1 Jan this year.
Staff dont really need to know what they are talking about because as soon as they process your invoice the system will tell them.
Kittylou
04-05-2010, 19:53
Not entirely sure but I thought the change was just that only a small amount of the management fee was counted towards the safety net so you are out of pocket for the bulk of your management fee. But, if you reach the safety net then I would assume you would get back 80% of your regular consultation fees from that point.
emmysmummy
04-05-2010, 20:25
The pregnancy management fee for a private Ob is capped at around $400-odd. After I paid this ($2300) in January this year and my 20-week scan, I started receiving $67.20 back for a $75 Ob consult - which is really good now that I am nearly 36 weeks and having weekly visits. Info here: http://www.health.gov.au/internet/mbsonline/publishing.nsf/Content/News-medicare-rebates-for-obstetric-services
Don't forget you can claim medical expenses on your tax if you have spent over $1500 in a financial year as well.
The pregnancy management fee for a private Ob is capped at around $400-odd. After I paid this ($2300) in January this year and my 20-week scan, I started receiving $67.20 back for a $75 Ob consult - which is really good now that I am nearly 36 weeks and having weekly visits. Info here: http://www.health.gov.au/internet/mbsonline/publishing.nsf/Content/News-medicare-rebates-for-obstetric-services
Don't forget you can claim medical expenses on your tax if you have spent over $1500 in a financial year as well.
Ah thats interesting. So the management fee still pushes you over the safety net for everything else but you dont get 80% of it back. Good to know as the OB appointments become a lot more frequent at the end.
For anyone curious about claiming on tax it is 20% of any costs over $1500.
Vanessa80
05-05-2010, 10:26
Thanks ladies, very helpful. So management fee counts towards Medicare safety net threshold but refund limited to $400-500. Oh well will have to claim the excess in my tax return!
wigglemum
06-05-2010, 14:20
Have a look into it, as I did get back bulk of my management fee. I had already reached the threshhold for this year and from my $4000 ob fee I got back $3200. Thank goodness. And the medicare girl did comment on the fact that there were so many unhappy ladies as they were only getting back $400.
emma2938
07-05-2010, 07:05
Wigglemum - when did you oay your OB the management fee and when did you claim it? That could be the difference...
wigglemum
08-05-2010, 16:48
Hi , I paid it 5 weeks ago and claimed it back the next day. So I am not really sure of what happened, but I do remeber the medicare lady saying how lucky I was to be getting back so much, as a few ladies had bills of $6000 and still only got back $400.
pregnantladybird
22-05-2010, 22:03
Hi , I paid it 5 weeks ago and claimed it back the next day. So I am not really sure of what happened, but I do remeber the medicare lady saying how lucky I was to be getting back so much, as a few ladies had bills of $6000 and still only got back $400.
wigglemum, really interested in how you managed this. i thought maybe because of the order, you had already reached the threshold before giving the Ob invoice?
But I rang medicare to ask if this would be the case and she said no there is still a cap around $200-400 is the most we would get for management fee even though it costs $4000 :-(
do you have a record of what item number/description they put on your invoice? was it just the management fee or did they have any tricks up their sleeve?
Obviously it would make a huge difference if we could get more back!!
Hi , I paid it 5 weeks ago and claimed it back the next day. So I am not really sure of what happened, but I do remeber the medicare lady saying how lucky I was to be getting back so much, as a few ladies had bills of $6000 and still only got back $400.
I believe you have to sign up for the safety net (which entitles you to receive 80% of your money back once you have reached the threshold of $1500), at the start of every calendar year now. You still get the 80% back
(I think*). But, if you haven't signed up for it or re-signed up for it then you won't get 80% no matter how much you have paid.
They change the rules so often. You are better off asking your Obstetrician or their medical clerk as they might have a better idea. I hope that helps!
1CrazyMoose
25-05-2010, 21:41
Hi guys,
It is true about being capped from 1st of Jan 2010 and you only get back $400-$500 but yes it does take you over the saftey net (that you do need to sign for) But I claimed in March and was also over the family saftey net thing then and still only got $400-$500 back. It kind of sucks because it costs so much. So I wouldnt count on getting 80% back anymore, if you do think yourself very lucky :D
Vanessa80
26-05-2010, 14:32
do you have to register for the safety net every calender year? i didnt know that! woops
1CrazyMoose
26-05-2010, 14:45
Ms Pie - You have to register in the first place, if you have done that years ago then its fine. I had to set it all up with my first son however this time round once I reached the saftey net they sent me a confirmation letter/forms to fill out and send back. I didnt though. I just told them that I had reached it when I went in to claim some things back and they said thats fine, they finalised it there. I didnt have to sign anything etc. Just them clicking yes on the computer system I think. No stress, if you have had it before you will just get that confirmation letter.
Ms Pie - You have to register in the first place, if you have done that years ago then its fine. I had to set it all up with my first son however this time round once I reached the saftey net they sent me a confirmation letter/forms to fill out and send back. I didnt though. I just told them that I had reached it when I went in to claim some things back and they said thats fine, they finalised it there. I didnt have to sign anything etc. Just them clicking yes on the computer system I think. No stress, if you have had it before you will just get that confirmation letter.
You actually have to re-register at the start of every calander year now. And you can do it online, thankfully! But I feel like a dill for even telling you because you obviously already know.
do you have to register for the safety net every calender year? i didnt know that! woops
Neither did I, until this year, when I went to claim at medicare lol. Luckily you can do it online!
Vanessa80
27-05-2010, 09:20
OK thanks will check out online. I registered with my DH a year or 2 ago, I assumed that would carry on and then I would just add on children. Not that I need to keep doing it each year. Good to know the sooner the better!
(I dont really understand why though when he is on my card and i can claim for his etc - you think they would know we are a family!)
overitand36
27-05-2010, 21:08
depends on item number 16590 is capped at around $400
what OB charges that for a management fee
what item number did they use
You actually have to re-register at the start of every calander year now. And you can do it online, thankfully! But I feel like a dill for even telling you because you obviously already know.
I was told this week at medicare that you don't have to re-register every year, but if there are any changes to your family they will need to make sure you are all included, that is, when I had DS they had to update it to include him. But DH and I were already registered and didn't have to re-register.
1CrazyMoose
03-06-2010, 12:57
Peajae - Thats what I was told aswell, only have to register if your updating otherwise its automatic and they just send you a confirmation letter to make sure your details are up to date. That was all for me.
babynomad
16-06-2010, 17:48
Is it just me or does your brain ache from all of this.... i just glaze over when reading my PHI!! I wish it was just written in plain english EXACTLY what happens!
overitand36
17-06-2010, 13:29
PHI has nothing to do with management fees, covers no part of it really annoying
Hannahsmumma
18-06-2010, 11:55
I would love to know the item number that was used for the bubhub member who paid $4,000 and got $3,200 back.
It makes such a massive difference. I am not pregnant yet but I always rely on getting back a large portion of the management fee and will be the same this time around too (when that time hurry's up).
I would love to know the item number that was used for the bubhub member who paid $4,000 and got $3,200 back.
It makes such a massive difference. I am not pregnant yet but I always rely on getting back a large portion of the management fee and will be the same this time around too (when that time hurry's up).
I wouldnt be relying on it as you simply wont get it. Everyone I know that has claimed it since 1 Jan has only got $400 back.
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