Changes to Medicare for optometrist consultations

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Changes to Medicare for optometrist consultations

The 2014 federal government budget announced wide sweeping changes across Medicare, and although it went largely unreported in the news, optometry has also been affected. As 2015 began, three major changes to Medicare funding for optometry services have occurred.

Firstly the Medicare scheduled fee and rebate for optometry services have both been cut by 5%. Since the late 1990’s, the scheduled fee has increased at a rate below CPI, or since 2012, not at all.  Now it has been cut and will be frozen again until mid 2018. These changes see the government rebate fall further behind the true cost of providing quality eye care.

Secondly, there have been changes to eligibility of patients for a full comprehensive eye examination rebate. Prior to 1st January 2015, if you were without symptoms, Medicare patients were eligible to receive the full rebate for a comprehensive eye examination once every two years. From 1st January 2015 patients aged 65 years and over are now eligible for the full rebate for a comprehensive eye examination every year, but patients under 65 years are now only eligible for the same every three years. This is a positive change for older Australians, but for those under 65, this is not a positive move in ensuring the nation’s eye health and it is unfortunately not evidence based.

It’s important to note that if you are symptomatic, you should present to your optometrist at any time as the full rebate may apply in your instance, even if it falls within the one- or three-year interval.

Finally, prior to 1st January 2015 the Medicare fee schedule for optometrists was capped. This means that unlike most other healthcare providers, optometrists were unable to charge for their professional services beyond the scheduled fee.  Any fees billed above the scheduled fee became ineligible for patients to claim a Medicare rebate.

Optometry was the only health profession to be subject to government set capping, in place since the profession became included in Medicare in 1975. Now optometrists may set their own fees for clinical services under Medicare. This means that, in line with other healthcare providers, optometrists can charge above the Medicare scheduled fee without impacting the patient’s ability to claim the Medicare rebate.

What does this mean for you, as a patient of Gerry & Johnson Optometrists?

  1. Our professional consultation fees at GJO will now be standardised, instead of varying up and down dependent on the Medicare rebate as they have previously. Click here for information on our professional fees schedule, which we have adopted in line with the recommendations of Optometry Australia.
  2. We will still use the Easyclaim system we have been using since early 2009, where we claim your Medicare rebate for you on the spot and it is paid back onto your cheque or savings card. Your Medicare rebate will unfortunately reduce, however people over 65 may see an increase in their overall rebate amount over the course of their clinical care.
  3. We are no longer able to bulk bill concession card holders and patients over 65 as we have previously, but have introduced a discount on optical products to assist with balancing costs.
  4. We are now able to include use of our cutting edge diagnostic technology in all consultations without additional charge, or at a reduced fee. This will be explained to you where relevant to your clinical care.

Our focus still remains entirely on providing you with the pinnacle of professional care for your vision and your eye health.

By | 2018-06-28T07:03:02+00:00 30th January 2015|Eyesight and Health, In the news|0 Comments

About the Author:

Kate Gifford
Kate Gifford is a clinical optometrist, researcher, educator and professional leader. She is also a mediocre runner, voracious reader, decaf coffee addict, experimental paleo chef, fledgling blogger and interstate stepmum.

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