Private Health Insurance and Medicare Rebates

**MummaBear03** · 19-10-2010 10:45

DD is going to see a psychologist who charges $270 for the initial consultation with a Medicare rebate of a minimum $117, depending on if we've reached the threshold or not.

To see the same psychologist using a Private Health Fund the rebate is up to a maximum of $80.

Just so people know

I found it quite surprising when I rang and was told this.

Another one is fully bulk billing under Medicare, but with up to $80 rebate with Private Health, leaving a person out of pocket around $80 for that one.

**chicken and eggs mum** · 19-10-2010 10:54

I think, dont quote me, that the rebate is different with/without phi because you can claim a portion on phi as well as medicare if you have both....

thats is what i have alwasy found.....

**MummaBear03** · 19-10-2010 10:58

They didn't ask if I had PHI just told me that I'm better off going through Medicare because it's a higher rebate and I can't do both.

**chicken and eggs mum** · 19-10-2010 11:03

hmm.. thats interesting then!!! there are so many different variations on phi/medicare and what each provider charges, it is so damn confusing!!!

**MummaBear03** · 19-10-2010 11:10

I don't know where I'm going to find the money though with or without rebates

**RedPanda** · 19-10-2010 11:32

Pretty pricey! With Medicare though, I think you're limited to five funded session, whereas PHI covers you until your limit is reached (I think for psych it's usually $800 worth of funding, depending on the level of cover).

**MummaBear03** · 19-10-2010 11:41

She gets 12 sessions through Medicare, and it can be done every 2 years so seeing a psychologist every 2 months will take her to the 2 years and she can see the case worker at other times. The other sessions are much shorter, still with the $117 cover until the threshold is reached.

**Nowhere** · 19-10-2010 11:53

Have you tried talking to the Dr about the situation, I know many many drs will see children at the rebate price if there is a real need for the child to be seen, We see the top peadiatric surgen and all we do is sign a form even in his private room, Same with Neuro, All the others we see at the hospital so that is just billed straight to medicare anyway.

The only time we use out private health insurance is when DD is admited to hospital, I have however had her admited both private and public and the care is just as great, the only thing differnt is that the hospital get more money directly from insurance, We dont get a bill from any of the drs.

One thing that does frustrate me but is that path west send the acounts to us as apose to private coer and medicare so we have to sort it out.

**Nowhere** · 19-10-2010 11:54

Originally Posted by chicken and eggs mum

hmm.. thats interesting then!!! there are so many different variations on phi/medicare and what each provider charges, it is so damn confusing!!!

yerp it depends what medicare number they put it thorugh as also.

**rapidlygrowingbrood** · 19-10-2010 12:13

The rebate you are talking about is that using the metal health plan? We got mental health plans for the boys which gave 6 sessions with a psychologist at a heavily rebated amount from Medicare. We were originally using PHI but realised we got alot more back through medicare cause we reached the threshold with PHI very quickly.