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  1. #11
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    Quote Originally Posted by Molros View Post
    @GM01 if you are under the safety net you will get $275.50 back, if you are over the safety net you will get $494.95, so I'd wait if I were you
    Not correct as this invoice will put her over.

    My PMF was my first claim for the year so automatically put me over and I got $494.95.

    I will try and post a photo of my receipt claimed 6th Jan.

    She will be $200 better off is she claims it before any more antenatal appts.

  2. #12
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    Hopefully you can see it.
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  3. #13
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    Quote Originally Posted by Ngaiz View Post
    My PMF was my first claim for the year so automatically put me over and I got $494.95.
    Ah that's a perfect example then if it was your first claim of a calendar year, thank you!

  4. #14
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    This one might be better.
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  5. #15
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    @GM01 and @Ngaiz sorry! That was how it was explained to me by Medicare when I asked a few months ago. One thing I find strange is surely most people would go over the cap when they pay this so I wonder why they have two levels?

    as a side note with my first FET eatly this year this took us over the cap straight away yet we didn't get as much back as we did with the second?!

  6. #16
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    Quote Originally Posted by Ngaiz View Post
    It will put you over the threshold but it's a capped rebate do you will still only get the same amount back regardless
    This is true, it changed in 2009/10 because with my firstborn I got maximum back as I was over safety net - with my second a few years later I was over the safety net, same PM fee and only $500 rebate.

  7. #17
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    @Molros I found that many staff had no idea themselves how it works
    The 75% is the standard rate for ALL items prior to reaching the threshold. So, with your antenatal appts, you would get 75% of the schedule fee. Once you have met the EMSN you then go up to 85% + 80% of your OOP up to the capped amounts.

    Eg:
    My appts cost $90 with a schedule fee of $47.15 so at 75%, I would get a rebate of $35.40.

    After reaching the EMSN I would get $40.10 (85% of the schedule fee) + the EMSN rebate of $32.95=a total capped rebate of $73.05.

    Like you said, you automatically go over when paying a high fee. I think what GM quoted from their website is a very poor example of how it works and is misleading.

    Very strange about your second FET?.. It all depends on what item code they ate charging you under. I have only done fresh cycles so don't know how claiming works with a FET.

  8. The Following User Says Thank You to Ngaiz For This Useful Post:

    Molros  (22-08-2014)

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    @Ngaiz Thanks! Its all pretty confusing tbh! I get the 'general' idea/theory (!) but yep, the FET is why I think I got muddled. Cos the first one took us straight over the cap and you'd think you'd get the same back for the 1st and 2nd transfers! I remember when we did the stim cycle in Nov some people were saying wait til Jan to go straight over the cap instead of hitting it late in the year but we didn't want to wait hahaha!
    At least with all out ob appts and the scans we had we got a bit extra back and every little helps!!!


 

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