By Nicole Walker
What Medicare funding is available for Eating Disorders?
At the end of 2019 Medicare increased their funding for Eating Disorders care by a Dietitian. People with an Eating Disorders Management Plan (EDMP) can now access up to 20 sessions over a 12 month period with an Accredited Practicing Dietitian. The Medicare rebate for your dietitian appointment is $54.60*. The 12 month period starts from when the plan is created.
How do I get access to Medicare funding?
You need to go to your GP, Consultant Psychiatrist or Paediatrician who will give you an Eating Disorders Questionnaire (EDE-Q) to fill out. If you meet the criteria your GP will create with you an Eating Disorders Management Plan which involves naming some healthcare professionals to help with your care such as a Dietitian, Psychologist and/or Psychiatrist. Your GP can probably suggest some options however you can also state your preferred practitioner or Dietitian.
How do I get my rebate from my Dietitian appointment?
Book an appointment with Dietitian and send your Eating Disorders Management Plan to reception, then we can process your rebate as soon as possible after the appointment. You will pay up front the full cost of the appointment, however if your care plan is processed your Dietitian or reception team will claim the rebate at the time of payment on your behalf and the rebate should return to your bank account within a few days.
How do I plan my sessions throughout the 12 months?
It is useful to plan your 12 months with your Dietitian in the first couple of appointments. This is to make sure you can space out the 20 sessions over the year. Your Dietitian might consider sessions weekly or fortnightly at first to give more intensive support and then extend to monthly toward the second half of the year. Or you might decide to have sessions regularly every two – three weeks to keep you on track.
What about the Chronic Disease Management Plan (Enhanced Primary Care – EPC)?
People with Type 1 or Type 2 Diabetes as well as other people with a chronic disease are eligible for a Chronic Disease Management plan with or without an Eating Disorder. With this plan you can access up to 5 sessions over a calendar year with an Allied Healthcare professional including a Dietitian, Credentialled Diabetes Educator (CDE) or other professionals such as an Exercise Physiologist (EP) or Podiatrist. You can choose how you want to use the 5 sessions between these professionals. For example; if you have diabetes you might choose to use 2 sessions with your Dietitian, 2 sessions with your CDE and one on your podiatrist or EP. See the full list of Allied Health professionals and other information here.
But I have Diabetes and an Eating Disorder, can I get both plans?
Yes, you can access both the Eating Disorders Management Plan and the Chronic Disease Management Plan if you have a chronic disease (including Type 1 and Type 2 Diabetes) and an Eating Disorder. However, you can only access 20 sessions in total. Therefore, if you choose to see another Allied Health Professional such as a Credentialled Diabetes Educator for the 5 Chronic Disease Management plan sessions, the Eating Disorders Care plan is reduced to 15 sessions with a Dietitian. You are able to tailor both plans to your needs eg: 3 sessions with a Credentialled Diabetes Educator, one with an Exercise Physiologist and 16 with a Dietitian if you choose.
Further rebates from Medicare are available after the Medicare Safety Net is reached
People with Diabetes and people with Eating Disorders often have to spend a lot of money on their healthcare with multiple health professionals. The Medicare Safety Net reduces costs further for those with high medical and healthcare costs calculated over the calendar year. If you spend more than $2133 out of pocket for an individual or a family for your healthcare costs, Medicare will provide a higher rebate of 80% of the full appointment costs. You need to register if you are a family, if you are an individual it will calculate automatically. For concession and eligible card holders the Medicare Safety Net is reached at a lower threshold of $697.00. Read here for more information.
Can I access my Medicare rebate for a Dietitian appointment via Telehealth?
Yes, Medicare rebates are available for Telehealth including video calls and telephone calls during the COVID-19 period as stated by the Government. Telehealth via video is also available at all times if you live a certain distance from your Dietitian.
I am a GP, I am unsure how to do the Eating Disorder Management Plan?
- Assess the person using the recommended EDE-Q. If you do not feel confident in Eating Disorders Management – you are not alone! If you wish to refer on Inside Out and the Butterfly Foundation have treatment databases of ED clinicians
- Fill out with the patient and carer an Eating Disorders Management Plan
- Refer to Dietitian and other Healthcare Professionals
- Referrals at Macintyre Health are accepted via Medical Objects, email or fax to our reception or use our easy referral form online.
- For more information and FAQ’s have a look at the Butterfly foundation and MBS Online.
- Feel free to contact our reception if you have any questions
*Costs are true at the time of writing Feb 2021, please check website for most up to date rebates.
We do not talk about it as often as we should and sometimes healthcare professionals are not confident in one of the diagnoses either the diabetes or the eating disorder. If you are experiencing eating problems please get in touch with me for chat, on your terms. No matter how mild or severe you think your situation or if you haven’t seen anyone before about this – that’s ok we can help you or even just listen. Often reaching out is the hardest part. Give us a call today and remember the first appointment always starts with just a chat.
Nicole Walker, Consultant Dietitian