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  1. #11
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    I paid my $2k ob fee yesterday and claimed medicare of which i received $487.50 back. It is now capped.

    HOWEVER, because you should have reached the safety net (we did just with that one bill) you will then receive 80% back of your specialist appt costs and scans as far as i am aware these are not capped. It is only the management fee that is capped.

    I would call medicare and double check but that's my understanding of it all.

  2. #12
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    Quote Originally Posted by TripleTime View Post
    Sounds like the hospital i was at. Id seriously consider going public, may spend more time in the car but there care is there if something goes wrong & it will safe you money.
    King Edward Perth? If so how was your experience?
    I might be having bub b4 34 weeks so won't be able to go to my private hosp any way but don't know if I can bring my self to go to king eddys... Will be seeing my ob on Monday so and he will be going over all my blood tests so will hopefully will have some idea how early I will deliver.

  3. #13
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    $487 sounds pretty good!! My OB 20 week fee will be around $2000 so really that's not too bad.
    I just called medicare and they said all OB rebates have changed an most you don't get 80% back on but couldn't tell me any more as I didn't have any item numbers. I am gnu try call my OB and get some item numbers now. Thanks everyone. How mug hve you all been getting back for your 19 week morph scan and regular OB apps?

  4. #14
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    If you are going to have your bub before 34 weeks they will send you to king edward regardless of where you were booked in to have bub.

    It may look dodgy but I have heard that it's the best place to be if any complications arise. As they have state of the art facilities.

    Can I ask what hospital your currently booked into?

  5. #15
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    I don't know if Medicare will pay all scans . Don't they only pay for dating 12 and 19 week?

  6. #16
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    Quote Originally Posted by happygirl1982 View Post
    I don't know if Medicare will pay all scans . Don't they only pay for dating 12 and 19 week?
    They will for any that are medically necessary.

  7. #17
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    Whoops sorry double post stupid phone lol

  8. #18
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    I am booked into SJOG Murdoch they will deliver bubs 34 weeks + but that depends on what condition mum n bub is in. They have a special neonatal ambulance on standby if bub needs to be transferred.
    I know I wont be going past 36 weeks but I am really hoping to not go before then.

    Bubbles10: I need to have scans to check the blood flow to bubs brain and a few other things I can't remember the technical term for it but basically if the scan doesn't look good I would have my baby that day.. It's very stressful.
    I have antibodies in my blood which attack the baby and make it anemic and so the baby gets severely jaundiced and could need a full blood transfusion at birth. I got it from a blood transfusion I had due to internal bleeding after surgery which because the doctors didn't believe me I was vomiting blood left me so long I needed transfusions, anyway after this and a few other horrible things happen at public hospitals Iam really scared to go public again.

  9. #19
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    Re: regular ob appointments = my obs fee schedule goes something like this1st Appt: $170 (70 back from m/care)Preg mgmt fee: $2000 - due 28-32wks (487 back from m/care)6wk post birth checkup - $200ish (about 70 back?)All other appointments i havent paid for - yet, however i will get a bill some time after birth and before 6wk checkup for all appointments i have had. I can then take this to medicare and they will issue a cheque for the entire amount so effectively it is bulk billed.Hope that helps!(and as for the private vs public debate - i havent actually read through others replies, but after having an uncomplicated birth with DD via the public system there was no way i was having any other child public. I couldn't imagine what it would be like having a complex situation. The 1 on 1 care is for me all the way)
    Last edited by mrsmamo; 11-01-2012 at 20:46. Reason: baby brain spelling :/

  10. #20
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    Just got on the laptop and wanted to clarify a little more....

    There isn't really a limit on how many specialist appointments you need for obstetrics, and the $2000 thing is actually a GOOD thing for you.

    Basically all outpatient services attract a standard benefit of 80% of the medicare benefit Schedule of fees (MBS)

    So for example (and I take this from http://www.mbsonline.gov.au/internet...Factsheet-EMSN) so it's 2010 figures

    You're charged for am item 16404 - Subsequent specialist attendance by a practitioner in the practice of obstetrics

    The MBS was $40.60 so your benefit is 80% of that - $34.55

    Your dr can charge you the MBS of $40.60 and you get back 80%(34.55). Your dr can charge you $100 and you still only get 80% of the MBS so $34.55

    ****
    Because people who are going to dr's often would have their out of pockets skyrocket really quick the government also introduced a safetynet system.
    Once your out of pockets go over a threshold (different for different people- ask medicare what your threshold is), you can get an extra 80% of the out of pockets back in adition to the 80% of the MBS.

    The problem that medicare then faced was that some dr's would use the safety net to thier advantage- basically saying that once you hit the threshold you get an extra 80% back so we can charge what we like. SOOOOO the government brought in the Extended Medicare Safety Net (EMSN).

    The EMSN was a way of limiting how much extra they'd pay for some services. Obstetrics was identified as one of the biggest problem area so now these items have a medicare benefit schedule amount, and an EMSN amount (maximum safety net amount payable per item number).

    So lets go back to the same item number...
    16404 has a MBS of $40.60 so your benefit is 80% of that - $34.55
    if your dr charges more and you've gone over the threshold you're also entitled to an aditional 80% of your out of pockets up to a maximum of $30.45 (the current dollar amounts item numbers are listed here http://www.mbsonline.gov.au/internet...wnloads-201201 or better yet, call or visit medicare).
    So the absolute maximum you can get for an item 16404 is...
    $34.55 MBS + $30.45 Safety net = $65.00
    The EMSN would only affect you if your dr charged more than $72.60 for an item 16404. Cause if they charged less the cap wouldn't be reached.

    I hope that helped, although I probably confused you more... the system is a tad confusing.
    Last edited by Izy; 11-01-2012 at 21:30.

  11. The Following User Says Thank You to Izy For This Useful Post:

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