Hopefully you can see it.
This one might be better.
@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?!
@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.
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.
@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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