Medicare Management Plan

Medicare Management Plan

Helping You With Your Medicare Management Plan

In Australia, more people are living with chronic health conditions every year. Health care providers struggle to deal with the increased demand for their services, caused by the ongoing pressures of managing complex chronic health conditions.

Essential to the development of care for patients is ensuring access to coordinated and cost-effective services that are personalised to their needs. Medicare Management Plans are designed to help people with chronic medical conditions. It provides an organised approach to their care to improve the management and treatment of their chronic conditions.

What Is A Chronic Medical Condition?

A chronic medical condition has been or is expected to be, present for six months or more. While there is no complete ‘list’ of such conditions, Services Australia has found that below are the most widespread chronic conditions that Australians have to live with:

These medical conditions often need a structured approach where GPs can plan and coordinate the care of patients with complex conditions, requiring care from a multidisciplinary team. Your chosen GP can determine whether a medicare management plan is appropriate for you.

Useful Acronyms to Know

Here are among the most popular acronyms used when discussing Medicare Management Plans. There are two types of plans that can be prepared by a GP for Chronic Disease Management: GP Management Plans and Team Care Arrangements.

General PractitionerGP
Chronic Disease ManagementCDM
GP Management PlansGPMP
Team Care ArrangementsTCAs

Patient Eligibility for Medicare Management Plans

To determine whether a patient is eligible to receive Chronic Disease Management (CDM) services, a GP will conduct a thorough, clinical assessment. This procedure considers a patient’s medical condition and care needs, in addition to general support.

Different Forms of Medicare Management Plans

GP Management Plans

If you suffer from a chronic, or terminal, health condition, your GP may propose a GPMP. In its most basic form, a GPMP is a plan of action you have agreed with your GP to organise a care and treatment plan for your chronic medical condition.

This plan seeks to

You must agree to the plan with your GP before any treatment or care can take place; this needs to be a written agreement.  

Team Care Arrangements

Additionally, if you have more complex care requirements and need treatment from multiple health service providers, your GP may recommend TCAs to you.

The purpose of TCAs is to help synchronise the services you receive from your GP and other health care providers. This way, the management of your condition, and the treatment you receive will be aligned within your multidisciplinary team. Your chosen GP needs to collaborate with a minimum of two other health care providers who all provide continuing services to you.

When preparing and recording TCAs, this may involve

List of Eligible Allied Health Providers

If applicable, Medicare covers the payment for the treatment or service. For more detailed information, please get in contact with your GP, Shire Doctors & Dentists.

Bringing Together GPMP and TCAs

GP management plans and team care arrangements help GPs coordinate the care of people living with chronic health conditions, while also helping to decrease the need for ad hoc sessions.

Therefore, it is possible to have a GPMP and TCAs simultaneously. If you have both plans, you may even be entitled to Medicare rebates for specific allied health services.

Your GP has the responsibility to determine whether you are eligible for these allied health services, which must be directly related to the management of your chronic condition. Our practice nurse at Shire Doctors & Dentists would provide support and monitoring between visits to your GP. You would have a copy of your management plan(s), and you and your GP would often review these plan(s).

Start Your Medicare Management Plan in The Shire Today

The introduction of GP Management Plans and Team Care Arrangements has aided many Australians in the management of chronic and complex health needs.

Medicare Management Plans aim to be adaptable, up-to-date, and need to be regularly reviewed by your GP. As an important facet of the plan, you and your GP need to verify that your goals are being met and decide on any necessary changes.

At Shire Doctors and Dentists, we are 100% dedicated to providing high-quality patient care, as well as effective treatment and management of chronic medical conditions. See your trusted GP to start discussing your Medicare Management Plan needs with the professionals at Shire Doctors and Dentists.