Save money by getting a Care Plan!

Analog

This is the Phone No. for the Gold Coast Griffith University Dentist
Phone (07) 55528811. Give them a ring. I would think that NSW would have the same thing.

Val

Thanks for that Val. I wonder if they accept NSW residents.

Cheers Odille

Heaviest 135kgs Sept 2003
Lowest (recent) 101.5kgs May 2006
Current 115kgs - Goal: between 60 & 65kgs
Height 170cms (5'7") Age 59

I used the care plan for visits to Dietitian pre and post Surgery. It can be an expensive exercise.

Yes the dental system has gone, but there is other avenues, I have been going to the Gold Coast University Dentist - free general dentistry for Health Care Card Holders. 3rd and 4th year dentist (training).

Val

Thanks Liz & Tara, I will have a chat with him when I go.

Analog,

The EPC is still up and running.

(EPC covers things like 5 visits per year to - Physio or Chiro, Dietician and Psychologist.)

This will not make any difference to Bariatric Surgery or the cost.

The Dental plan finished on 30.11.2013

Hi Analog I believe the care plan is still available but not for dental. You would need to check with the doctor as to what medical services are covered by the care plan. I am using one to see the dietitian post sleeve.

Good luck

Liz :))

Can anyone confirm the Chronic Conditions care plan thing is now a non event. I believe it was abolished. My doctor put me under one so I could get dental treatment and I had the maximum treatment I could get for the $ amount under it, and I know he put obesity as part of the problem. Had I known about sleeving then (Nov 2011) I would have gone for it! I did get a letter saying after 31 Dec 2012 (I think) dental treatment was nop longer available as the plan was abolished.

I am going back to see him this week to get a referral to a bariatric surgeon once I get replies from a few I have emailed so I can choose one.

Thanks for the info. I went and got a care plan sorted today with the GP.

I get to use it for 5 visits to the dietician and cant wait to get myself sorted!

Now to book a sleeve date

Hi Nel,
Thanks
This is good info, I will share it with the July sleevers. I was thinking i might need to use a physio myself to help with my knee arthritis.

cheers
Zenna

Hi there,

I know this thread has been sleeping awhile. Because I am a GP, thought it might be worth an update.

The GP Management Plan (Medicare Item number 721) is for a person with at least one medical condition that has been present (or is likely to be) for at least 6 months. I think it used to be that the patient had to have 3 serious, chronic conditions, so that might be part of the confusion among docs.

Once you have a GPMP, your doctor can also do something called a team care arrangement (TCA -- Item 723). To qualify for a TCA, a patient who has a GP management plan has to need to see at least 3 health professionals, including the GP. So for us, who need to see a nutritionist/dietician and a physio for a rehab/exercise program or a psychologist, for example, we should qualify. You get six consults (I think) in a year. So you might get three with the psychologist, 2 sessions with a dietician and one with the physio, for example. The GP should work out with you which allied health people you see and how many visits to each are subsidised. Most allied health people charge a gap on top of what Medicare pays, as our sister described below. So you might pay $30 for your visit instead of $140.

A patient can only get one GPMP and TCA a year. The doctor has to talk to the people she or he refers you to, which is good for your care (it's called a collaborative arrangement).

Here is a patient brochure about this:

http://www.health.gov.au/internet/main/publishing.nsf/Content/2D0515377A0F7ED6CA25767200080F17/$File/cdm%20Patient%20Information%20Brochure.pdf

If you want to spend more time with a psychologist when you are making this transition, there is also the GP Mental Health Treatment Plan to help you afford to be able to access their services. This qualifies you for 10 subsidised psychologist sessions a year, which be really good. You have to admit to a degree of craziness to qualify, that is, admit to the history of severe depression most us here have experienced.

Not all GPs are qualified to do the Mental Health plans, but most are. You need to book a longer appointment for any of these plans. Most GPs will be happy to do them for morbid obesity if you book a longer appointment. Might be worth mentioning to the receptionist when you book (if you are not too shy about it) that you would like a plan done so that he or she can book you with the doc who does them happily and well.

Hope this is helpful and warm wishes for your journey,

Nel

I just asked my gp and she did it in about 2 minutes no questions asked (for dietician and psychologist)! It's so confusing how they all do different things!

thankyou

Ask questions. Talk about your history and really listen to the questions they ask you. Are they insightful? Do they seem to understand your point of view? Do they treat you like the consumer you are or just another number? And most of all, do they have a God complex? If so, run a mile!!!!!

If after explaining your history and desire for the sleeve surgery, you present the APRA letter sample and ask for a letter written in the same format and they comply with your request, then I think you have a keeper!!! LOL. Seriously, you need to pick your Dr like you pick your sofa - try it out, see if it supports you in the way you like and expect, and most of all, you have to like it!!!! LOL.

Apra said i have $3000 saved up & i could use that (1 . cheap operation lol, 2 have 2 vehicles to register this month & have holiday booked)



they nit picking & cos ex gp wrote the letter the way she saw fit they said know, i see specialist in a month so i am hoping his letter will help, in the mean time im in a new town & know no-one to ask about dr's so im going blind



i am shopping for a new dr but how do you find the right one

Why wont APRA release funds? Go to a better, more organised GP and get the letter and refferal from them. Your (ex) GP sounds like a prat!

hi Jacko



this will be my 3rd appointment to see her about the care plan & its costing me money each time, she said she would do one, then she wouldnt, now whe wants to see me about what we can do



ARGGGGGGGGGGGGG



Deb

Care plan will save you money get it

now im really confused GP wants to see me again to see if we can find a way to do the gp management plan - she is confusing me



we can do one, we cant do one, come in & we will see what we can do -

her receptionist made sure i knew it was the doctors day off & she is doing this to help me

well after my dr initially saying she would do 1 for me, she now wont, so im going to find a dr who will, it seems being obese isnt enough - i should have other health problems - which fortunately i dont, apart from my weight im 100% healthy

The Dept of Health specifically says "Obesity" CAN be a reason for a chronic disease care plan, if it needs treatment by others are judged by the GP.

Link: http://www.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare-chronicdiseasemanagement-qanda#1_2

"The Department has received queries about whether the following are chronic medical conditions for the purposes of the items: alcohol or other substance abuse; smoking; obesity; unspecified chronic pain; hypertension, hypercholesterolemia, or syndrome X; impaired fasting glucose tolerance or impaired glucose tolerance; pregnancy. In some cases these would not be commonly regarded as chronic medical conditions in themselves: some may more accurately be regarded as risk factors for development of chronic conditions; some possibly relate more to personal choice/behavioral issues; and some (pregnancy without complications) could be regarded as a normal part of life.

The Department recognises, however, that conditions such as these can occur across a wide spectrum of severity and in a broad range of circumstances, with, for example, some patients with one (or more) of the above conditions being unable to self-manage or comply with care and treatment, being functionally disabled by their condition etc. In many cases a patient may have complications or comorbidities that may be a result of or exacerbated by such conditions or risk factors and would make them eligible for CDM services.

In these cases, the GP should satisfy themselves that their peers would regard the provision of a CDM service as appropriate for that patient, given the patient’s needs and circumstances."

---------------------------

I'm off in the next week to try and convince my GP to do both a mental health care plan (for psych appointment/s) and a Chronic Disease Management plan (for dietician). Is that right, do you need both? Or can they just organize both dietician and psychologist on the one GP management plan?

Edit: Looks like you have to choose either PHI or MEdicare rebates, and my PHI rebate is 75% of the fee, so that might be higher than the Medicare rebate.

Issi- I had the same thing happen to me. The doctor I saw said that just being fat wasnt reason enough to get a care plan.
I think that if I had of seen my normal gp she would have done it for me, but I couldnt get an appointment with her so I saw a different gp in the same practice.

I didn't have any problems getting mine either, I my doc put on mobid obesity as the health issue.

They did on mine and it all went thru without a hitch :) Obesity was all that was needed...maybe all docs are different in how they treat care plans??

I asked my doctor for a care plan (for obesity) and he said obesity is not recognized as a chronic condition to qualify, otherwise most of the country would qualify. I was however able to qualify because of my sever GERD, but they cannot put Obesity on the form as a reason.