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  1. #1
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    Default Medicare out of pocket gap question

    At the moment we are expecting our first baby. Our safety net the moment is 1200 as a couple. When we have the baby it will come own to just under 600. So after bub is born (July) we will get a greater amount ofthe gap back 80% .If I hold off on claiming until after baby born do we get more money back grom Medicare than if I am to claim before the birth when our safety net is higher???Or am I just oe confused pregnant mummy???

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  2. #2
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    Quote Originally Posted by groovin77 View Post
    At the moment we are expecting our first baby. Our safety net the moment is 1200 as a couple. When we have the baby it will come own to just under 600. So after bub is born (July) we will get a greater amount ofthe gap back 80% .If I hold off on claiming until after baby born do we get more money back grom Medicare than if I am to claim before the birth when our safety net is higher???Or am I just oe confused pregnant mummy???

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    I would ring Medicare and ask them. I dont think it does though because if you have paid the provider during the time period that its $1200 per couple, then they take it on that. Not sure though.

  3. #3
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    Not sure but I would think that the refund would go in the date if the service provided - again not sure though maybe just go into Medicare and ask them?

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    The 80% rebate applies after you have crossed the threshold. We crossed it in March last year so for the remainder of the year got 80% back of our OOP expenses. It won't matter if you save up your receipts. From my understanding it doesn't matter if you come close to the threshold. You need to cross it to get the 80%. I went in once and had to be OOP $2.00 or something ridiculous to be over the threshold so was given the usual rebate. On thenext visit the 80% clicked in.
    Last edited by Electric Rodeo; 07-03-2012 at 13:33.

  5. #5
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    Medicare uses the date of service to work these things out.

  6. #6
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    They go on the date you paid the bill... It doesn't matter when you claim it back.
    If you hadn't reached the safety net when you paid the medical bill then you won't get the 80% back.

  7. #7
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    I think there has also been some recent changes to claiming on obstetrics. You still can of course but the amount that you get back has been reduced significantly


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    Medicare definitely go from the date of service, not the date paid or the date you claim

  9. #9
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    Yup, date of service. I claimed a receipt I had from December (we had reached the threshold at that stage) in January, we were paid the 80% as the date of service was before it clicked over to the new year.

    The obstetrics rebates are capped. I've already hit the threshold this year and my $130 OB bills only give me a $70 refund, not 80%.

  10. #10
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    Quote Originally Posted by Winterbubs1012 View Post
    They go on the date you paid the bill... It doesn't matter when you claim it back.
    If you hadn't reached the safety net when you paid the medical bill then you won't get the 80% back.
    When I say the date you paid the bill I mean the date of service... I have to pay my medical bills the day I see my doc so just thought I'd clear that up as some ppl may not have to pay the bill the day they see their doc

    Totally sucks how Medicare have cut obstetrics rebates


 

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