Q. How do I get placed on an EPC plan?
If you have been suffering or will suffer from a condition for longer than 6 months or have numerous health issues then you qualify for the EPC program. Visit your GP and ask them to prepare an EPC plan.
Q. Can I use my private health insurance cover in conjunction with EPC?
You need to decide if you are going to use your Medicare rebate or your private health insurance as you can not claim from both for the same consultation. Once you have claimed all your Medicare rebates from your Health Associates practitioner you can then claim any further consultations through your private health insurance.
Q. What is meant by chronic conditions and complex care needs?
Chronic conditions are defined as conditions which have been, or are likely to be, present for six (6) months or more. Complex care needs means that, in your GP’s opinion, you would benefit from care provided by a range of health professionals, who provide different services.
Q. Once I’m on an EPC plan, how do I get my Medicare rebate?
Your GP must first refer you to our clinic under the “EPC” scheme and lodge the relevant paperwork. You then need to bring a copy of your forms with you to Health Associates for our reception staff to process. Providing all paperwork has been lodged correctly we are able to claim your rebate through online services.
It is strongly recommended that you make reasonable enquiries in respect to your medical entitlements before any appointments are made to avoid surprises.
Q What if I need treatment before my EPC is approved?
Any appointments prior to EPC confirmation may not be eligible for any Medicare rebate. You can not claim retrospectively from the date your GP referred you under the EPC scheme. This means you can only claim visits that occurred AFTER the referral date. If you are not sure, check with your local Medicare outlet if you qualify for a Medicare rebate.
Q What if I need treatment before I see my GP in regards to an EPC Plan?
Unfortunately Medicare will not pay for any visits PRIOR the date the EPC plan was started. This means you must see your GP FIRST before you see us. You can still come in for treatment but you will have to pay on the day and claim via your private health insurance if you have Chiropractic cover. Medicare will not rebate you for these visits.
Q What if Medicare does not pay for my visits?
Unfortunately it is a matter between you, your GP and Medicare. We are unable to assist you due to privacy laws. If Medicare refuses to pay for whatever reason, find out why and return to your GP to see if he or she can help as often it is because the paperwork that your GP submitted is not correct or you have exceeded your maximum allowance which is 5 per calendar year.
Q. I have already used my 5 EPC entitlements this year can I have more?
Currently you are only eligible for a maximum of 5 EPC visits each calendar year hence you will need to wait until January the following year to reapply for a further 5 EPC visits. Make sure your GP applies for the full 5 visits otherwise you may only be eligible for less (depending on what your GP submits to Medicare). If you don’t use your 5 visits each year you will forfeit them.
Q. I’m not sure if I have used my EPC entitlements this year?
If you have seen any other Health Practitioners other than your GP or Medical Specialist, then chances are, you have used part or all of your EPC entitlements. To check contact Medicare directly on 132 150.
Q. Am I always entitled to 5 EPC visits?
Only if your GP says so!. So if you want the 5 visits make sure you mention this to your GP to request the maximum 5 visits in the EPC forms. The GP will then need to decide whether or not you meet the criteria to qualify for this service.
Q. Does EPC cover for any X-Rays?
No, but the majority of X-rays requested by our Chiropractors are bulked billed at local radiological centers. This excludes CT Scan & MRI referrals.
If you have been suffering or will suffer from a condition for longer than 6 months or have numerous health issues then you qualify for the EPC program. Visit your GP and ask them to prepare an EPC plan.
Q. Can I use my private health insurance cover in conjunction with EPC?
You need to decide if you are going to use your Medicare rebate or your private health insurance as you can not claim from both for the same consultation. Once you have claimed all your Medicare rebates from your Health Associates practitioner you can then claim any further consultations through your private health insurance.
Q. What is meant by chronic conditions and complex care needs?
Chronic conditions are defined as conditions which have been, or are likely to be, present for six (6) months or more. Complex care needs means that, in your GP’s opinion, you would benefit from care provided by a range of health professionals, who provide different services.
Q. Once I’m on an EPC plan, how do I get my Medicare rebate?
Your GP must first refer you to our clinic under the “EPC” scheme and lodge the relevant paperwork. You then need to bring a copy of your forms with you to Health Associates for our reception staff to process. Providing all paperwork has been lodged correctly we are able to claim your rebate through online services.
It is strongly recommended that you make reasonable enquiries in respect to your medical entitlements before any appointments are made to avoid surprises.
Q What if I need treatment before my EPC is approved?
Any appointments prior to EPC confirmation may not be eligible for any Medicare rebate. You can not claim retrospectively from the date your GP referred you under the EPC scheme. This means you can only claim visits that occurred AFTER the referral date. If you are not sure, check with your local Medicare outlet if you qualify for a Medicare rebate.
Q What if I need treatment before I see my GP in regards to an EPC Plan?
Unfortunately Medicare will not pay for any visits PRIOR the date the EPC plan was started. This means you must see your GP FIRST before you see us. You can still come in for treatment but you will have to pay on the day and claim via your private health insurance if you have Chiropractic cover. Medicare will not rebate you for these visits.
Q What if Medicare does not pay for my visits?
Unfortunately it is a matter between you, your GP and Medicare. We are unable to assist you due to privacy laws. If Medicare refuses to pay for whatever reason, find out why and return to your GP to see if he or she can help as often it is because the paperwork that your GP submitted is not correct or you have exceeded your maximum allowance which is 5 per calendar year.
Q. I have already used my 5 EPC entitlements this year can I have more?
Currently you are only eligible for a maximum of 5 EPC visits each calendar year hence you will need to wait until January the following year to reapply for a further 5 EPC visits. Make sure your GP applies for the full 5 visits otherwise you may only be eligible for less (depending on what your GP submits to Medicare). If you don’t use your 5 visits each year you will forfeit them.
Q. I’m not sure if I have used my EPC entitlements this year?
If you have seen any other Health Practitioners other than your GP or Medical Specialist, then chances are, you have used part or all of your EPC entitlements. To check contact Medicare directly on 132 150.
Q. Am I always entitled to 5 EPC visits?
Only if your GP says so!. So if you want the 5 visits make sure you mention this to your GP to request the maximum 5 visits in the EPC forms. The GP will then need to decide whether or not you meet the criteria to qualify for this service.
Q. Does EPC cover for any X-Rays?
No, but the majority of X-rays requested by our Chiropractors are bulked billed at local radiological centers. This excludes CT Scan & MRI referrals.