Malinda Halley

Nov 30, 20162 min

OUR fees and the MEDICARE CUTS

We wrote a short note for our patients to read after the 2014/2015 Federal Budget announced the cuts and slashes to the optometry rebates and exams. This is an update:

In 1997, Medicare announced the first cut to optometry. If a patient without a medical problem wanted a second opinion on their eyes, they had to wait 24 months to access a full rebate, or accept a 50% rebate and pick a new practitioner straight away. Some exceptions existed for eye or medical eye care.

In 2012, the Medicare rebate was frozen for the entire health industry. Practitioners who bulk-billed a consultation (doctors, specialists, optometrist etc) had their fees frozen. While staff wages, electricity, postage and other costs went up, the rebate did not change. At this point, some health practices either saw more patients per hour, and required patients to only present one problem per visit (the medical centre model) or they stopped bulk-billing, or simply absorbed the cost in the short term, to see what would happen. This was a cost-saving exercise for the Federal Government.

In 2013, the Medicare rebates were still frozen.

In 2014, the Medicare rebates remained frozen.

In late 2014, it was announced that the Medicare rebates would remain frozen until at least 2020!

In the Federal Budget 2014 / 2015 more cuts to Medicare were announced. The gap between eye exams was extended to 3 years for people under 65 years of age (see this link). Under 3 years, a Medicare rebate is still available, but drops to 50%.

The Medicare Rebate was slashed by a further 5% from 1 January 2016.

This slashing occurred to the already frozen 2012 rebates ! (see this reference from the Medicare website).

The only benefit was for those over 65 years, where the interval was reduced to only 1 year. However, most patients over 65 years were already able to have 1 year exams due to common ageing problems such as cataract, dry eyes, diabetes, hypertension that allowed use of alternative items numbers at a full rebate anyway.

On 1 January, 2015, we sadly stopped bulk-billing all eye exams.

We installed two methods to claim patient rebates in-office (no trip to a Medicare branch)

We trained our staff in processing rebates on the spot for patient claims.

Our practice seeks to provide a high level of care to our patients. We simply can't afford to do that, and bulk-bill everything. We have settled for now on a blended system, where we bulk-bill some things and not others. We take a thorough medical and ocular history. We will ask detailed questions about your eyes and vision. We understand the Medicare item numbers, and will always seek to bill the correct item number to give you the correct rebate.

Our staff can provide fee information.

If you'd like to contact your Federal Minister for Health this is the website.

If you'd like to contact your state member this is the link.

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