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  1. #1
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    Default Pregnancy Management Fee- Medicare Refund..

    I've tried looking at old posts and the medicare website but I'm no closer to understanding if I will get anything from my private OB fee of $1230?

    These are the details I've found on the medicare website, but I'm curious what others got back from medicare for this fee??

    16590
    Planning and management of a pregnancy that has progressed
    beyond 20 weeks provided the fee does not include any amount for the management
    of the labour and delivery, payable once only for any pregnancy that has
    progressed beyond 20 weeks where the practitioner intends to undertake the
    delivery for a privately admitted patient, not being a service to which item
    16591 applies.
    Fee: $318.05 Benefit: 75% = $238.55 85% = $270.35
    Extended
    Medicare Safety Net Cap:
    $216.85
    ME- 29 & DP- 32
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  3. #2
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    When pregnant with DS I definitely received a Medicare rebate, either the standard or slightly higher. I think I had passed safety net by then. Mine was about $1200 too. Medicare works on codes. You could ask your dr or the receptionist for the code on the bill and then check with Medicare. Good luck

  4. #3
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    My OB's fee was around $1600 and I think I got about $500 back from Medicare

  5. #4
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    The rudd govt made some chahges & now i think max you get back from medicare is aprox $400. My P&M fee was $2500 & i got $400 bacl

  6. #5
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    Manny is right, it is around $400 regardless of safety net or the amount the ob charges. When I had my first I got back majority of p&m fee, this time only $400. Obs can now charge what they like too.

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    Yep, rebate is just over $400 now. Geez, my OB was $4,500, so you've got yourself a good deal there!

  8. #7
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    Just over $400 because the government put a cap on it. I love how politics work - give with one hand for paid Mat leave but take away with the other by capping Medicare rebates!

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    Quote Originally Posted by bohogirls View Post
    Just over $400 because the government put a cap on it. I love how politics work - give with one hand for paid Mat leave but take away with the other by capping Medicare rebates!
    Um it was capped in a bid to stop OBs ripping the public off. Personally I'm glad it's got a cap on it, you choose to go private don't expect tax payers to pay for it.

    Why are some services capped?
    Following an announcement in the 2009-2010 Budget, on 1 January 2010 some Medicare items were capped after they were identified as areas of concern in the Extended Medicare Safety Net Review Report 2009 (the Review report). The Review report showed that for some services, such as obstetrics and assisted reproductive technology (ART), the EMSN had been used by specialist doctors to raise their fees knowing the taxpayer would cover 80 per cent of the fee rise. This has implications for people that have not qualified for the EMSN. The EMSN benefit is intended to be a patient benefit; it is not intended to be a mechanism for doctors to increase their fees.

    Since 1 January 2010 a number of MBS services have since been listed on the MBS with EMSN benefit caps in place. These services have been capped to maintain consistency with the existing capped items, or as a result of recommendations made by the Medical Services Advisory Committee (MSAC) regarding cost effectiveness.

    http://www.health.gov.au/internet/mbsonline/publishing.nsf/Content/Factsheet-EMSN-1_Jan_2012
    Last edited by headoverfeet; 16-05-2012 at 19:20.
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    Des could always charge whatever they like

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  12. #10
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    Quote Originally Posted by Thermolicious View Post
    Um it was capped in a bid to stop OBs ripping the public off. Personally I'm glad it's got a cap on it, you choose to go private don't expect tax payers to pay for it.

    Why are some services capped?
    Following an announcement in the 2009-2010 Budget, on 1 January 2010 some Medicare items were capped after they were identified as areas of concern in the Extended Medicare Safety Net Review Report 2009 (the Review report). The Review report showed that for some services, such as obstetrics and assisted reproductive technology (ART), the EMSN had been used by specialist doctors to raise their fees knowing the taxpayer would cover 80 per cent of the fee rise. This has implications for people that have not qualified for the EMSN. The EMSN benefit is intended to be a patient benefit; it is not intended to be a mechanism for doctors to increase their fees.

    Since 1 January 2010 a number of MBS services have since been listed on the MBS with EMSN benefit caps in place. These services have been capped to maintain consistency with the existing capped items, or as a result of recommendations made by the Medical Services Advisory Committee (MSAC) regarding cost effectiveness.

    http://www.health.gov.au/internet/mb...MSN-1_Jan_2012
    The cap then needs to be placed on what doctors charge.

    Some are charging exorbitant amounts in management fees and for what?

    Non-fat lattes and iced vo-vos during prenatal visits? I don't think so.

    You are getting same care he/she is obligated to provide as an OB who doesn't charge a management fee.

    You could be paying $4.5k on an OB who's nothing more than average in his field just because he can.

    Yes it's your choice to use a particular doctor but for a lot of anxious first time mothers or those uneducated in how the health system and private health works, the desire to have the best care can take over.

    Moreover, just because you have private health insurance does not make you exempt from paying tax.
    Last edited by bohogirls; 17-05-2012 at 18:34.


 

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