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Better Access

The purpose of the Better Access initiative is to improve treatment and management of mental illness within the community. The Better Access initiative is increasing community access to mental health professionals and team-based mental health care, with general practitioners encouraged to work more closely and collaboratively with psychiatrists, clinical psychologists, registered psychologists and appropriately trained social workers and occupational therapists.

Medicare Subsidised Sessions

If you have a Mental Health Care Plan from your GP, you will be entitled to receive up to 10 sessions subsidised by Medicare per calendar year. After the initial 6 sessions, you will require a Mental Health Care Plan Review from your GP to obtain access to the additional 4 subsidised sessions. Medicare will subsidise a minimum amount of $96.65 for each session.

Medicare Safety Net Information

If you see a doctor often, or have tests regularly, your medical costs could be high. Visiting a doctor or having tests may cost you less once you reach a Medicare Safety Net threshold.

Once you reach the relevant threshold, the Medicare Safety Net may provide a higher Medicare benefit for all eligible services for the rest of the calendar year. This may mean that visits to your doctor or having tests could cost you less. For example, once you reach the relevant threshold, you still pay the same amount upfront to your doctor, however Medicare may subsidise a higher amount for each session, making your out of pocket expenses much less.

If your family is close to reaching a Medicare Safety Net threshold, Medicare will ask you to confirm the members of your Medicare Safety Net family for that year. Confirming your details allows Medicare to check your family’s eligibility for higher Medicare benefits.

The Medicare Safety Net covers a range of out of hospital doctor visits and tests covered by the Medicare Benefits Schedule. These include:

  • Healthcare professional consultations, including psychology and psychiatry
  • Blood tests
  • CT scans
  • Pap smears
  • Radiotherapy
  • Tissue biopsies
  • Ultrasounds
  • X-rays

If a service is not in the Medicare Benefits Schedule it does not count towards the Medicare Safety Net. If you have surgery, see a doctor or have tests while you are in hospital, these services don’t count towards the Medicare Safety Net.

If you pay your doctor before claiming your Medicare benefit, Medicare automatically keep a tally of your out of pocket medical expenses.

If you claim from Medicare before paying your doctor:

  1. Medicare will send you a cheque made payable to the doctor, which you take or send to your doctor with any outstanding balance you owe
  2. Take to Medicare the doctor’s receipt and the Medicare statement you received with our cheque and we will add your out of pocket amount to your Medicare Safety Net balance
  3. Medicare will contact you when you are nearing a Medicare Safety Net threshold and may ask you to verify any unpaid claims

If you only pay the gap amount to the doctor Medicare usually add your out of pocket amount to your Medicare Safety Net threshold for you.

Once you reach the relevant threshold, the Medicare Safety Net may provide a higher Medicare benefit for all eligible services for the rest of the calendar year.

Couples and families need to register as a Medicare Safety Net family, even if you are all on the same Medicare card, in order for us to keep a total of the medical expenses you have as a family. For Medicare Safety Net purposes, a family consists of:

  • A couple who are legally married and not separated, or a couple in a de facto relationship, with or without dependent children
  • A single person with dependent children

A dependant is someone who the family contact or spouse supports financially and is either a 1) child dependant aged under 16 years, or 2) a student dependant aged between 16 and 25 who is in full time education.

Dependants who are members of 2 families: Dependants may be a member of 2 Medicare Safety Net families, for example because of separation or divorce. The out of pocket medical expenses will count towards the Medicare Safety Net of the family whose Medicare card is used to claim the Medicare benefit. Only the family that pays the cost of the medical service receives the Medicare benefit.

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