Over-50s will soon be denied Medicare rebates for knee MRI scans

Over-50s will soon be denied Medicare rebates for knee MRI scans

Australians over the age of 50 will be denied Medicare rebates for GP-ordered knee MRIs from November 1.

According to an exclusive report published in the Daily Telegraph, older Australians will be forced to wait months to see a specialist or pay up to $500 for a scan. The new system is set to impact 80,000 Australians when it comes into effect in just two weeks’ time.

The Department of Health first announced changes to Medicare-funded knee imaging services in May, explaining that changes were being made to ensure services are aligned with best practice. The changes came after recommendations from the Medicare Benefits Schedule Review Taskforce.

“From 1 November 2018, GPs will no longer be able to directly request knee MRIs for patients aged 50 years and over,” the spokesperson said. “These MRI services can continue to be requested for all patients by specialists.”

13 comments

 

Stated in the above

'The Department said patients will benefit because they will be receiving recognised best practice knee imaging services and they won’t undergo unnecessary knee MRIs or be exposed to radiation

What are they lying about now!?   There is NO Radiation in an MRI!


Here is the site


https://startsat60.com/health/everyday-health/joint-health/medicare-rebates-knee-mri-over-50s







 

 

 

... Yes!  That was on the news today - it is going to cost people as much as $500 -  that was the figure I heard?

They don't care about 50+ "peeps"  - we are all becoming the "Invisible People" - kill us off as quickly as they can!  

Just another disgusting cost saving exercise!!

Stop giving Foreign Aid to countries that misuse the money for military weapons for a start!!!  

Bloody appaulingFoxy -- Morrison has just turned 50 -- but of course, he will have a  ---ing pension for  life and have no worries scum that he is

 

GPs have been creaming it off for years ordering unnecessary knee MRIs. This is a good move to prevent the charlatan get rich quick GP from lining his/her pocket.

Well when my GP asked me to have an MRI -- it was going to cost me $500 -- but if an MRI has or--was ordered by a Specialist was free --  I guess you paid for it in his enormous fee paid to the Specialist

But I can not understand why the below 50s are unable to get the MRI but the younger are -- most of under 50 would not need any way!

 

About time they cracked down on GPs as the amount of tests they order is ridiculous. GPs today are only good as writing scripts for poisions and passing one onto specialists. Every time I see a GP they bill Meicare for over $300 for that visit. 

Wow Old Geezer that is very OTT -- what  a rip off

Yeah, that’s because every time he sees his doctor they have to reshod his hooves,  he keeps putting them in his mouth hahah

I have a bad knee damaged through injury and live with it. Knee surgery does not work and can make things worse. Population growth will continue to put a strain on Medicare. 

Over 50s are not being denied Medicare rebates for knee MRIs at all.  Where a knee is suspected of requiring specialist care, a referral should be made and doubtless the specialist will require a MRI if needed.

Any prudent government would have moved to control apparent overuse of MRIs by GPs that was draining the health budget.

The media have shamelessly twisted and sensationalised what was a prudent, necessary initiative to scare the affected public and get a bigger audience for their advertisers.  This is why many are shedding the tabloids and switching off the tripe on morning TV.

 

You see the same eggbeater being used to froth up protest and cause alarm over gay rights prior to the Wentworth by-election.

LJ ...The problem is this will not be cut costs on our health system.

Most doctors have patients x-rayed first then refer patients to a specialist whether that be one at a public hospital or a private consultation.  An MRI requested by a specialist will not make it less expensive. 

Hi jackie,

It will slow down GPs who are having MRIs done as a routine.

Again, we have a misleading headline designed to scare the readers. Over 50's will not be denied Medicare rebates for MRI knee scans. If a scan is ordered by a specialist the rebate will be given. The rebate is not accessible by GP's.

Old Man I was made aware of this some years ago, I wonder why it is only now being brought out into the open.  GPs can send us for a CAT scan but not an MRI scan.     

Years ago I was one of the first to have an MRI scan in the UK.  It cost husband five hundred pounds back then, the darn scan came out black and was useless for the surgeon.

Maybe that is another reason for staying in Private Health - look at the costs frequently and wonder and then you guys come along and make sure I stay in. You having shares?

Does you private health fund pay for MRIs?

Wife had one a while back, did not get a bill so the fund must have paid it.

 

 

It depends which Table of Private Health Insurance you are on.

35 years ago I injured my knee, tore the ligament and cartilage, GP said if I send you to a surgeon there is no guarantee he will be able to fix the issue. So I am going to wrap the knee up in a boomarang shape, this has to be kept like this for three weeks, then come back to me.

Well it was darn awkward getting in and out of the shower and getting into a car, but it worked!    The issue was pushing the clutch down, so it was then I changed to an automatic gear.     I have never looked back and thank goodness for the wisdom of my GP.

 

Can private health insurance cover MRI scans?

MRI scans are typically classified as outpatient services, which health funds are prohibited from covering under Federal Government regulations. However, if you are admitted to hospital as a private patient and require an MRI scan during the course of your treatment you may be able to claim a benefit.

Full details.

Information about changes to Medicare rebates for MRI knee imaging from the Royal Australian College of General Practitioners (RACGP).

https://www1.racgp.org.au/newsGP/Professional/Changes-to-Medicare-Benefits-Schedule-items-for-kn

 

Unless a person has suffered an obvious knee injury..what is the point of an MRI? Mostly knee pain is caused by arthritis and according to the experts..exercise and a good diet is more beneficial than a useless MRI in the early stages..

In the past some doctors have been notorious in recommending patients have knee surgery when it was not necessary..as a result many patients have ended up in wheelchairs. Any crackdown on these procedures is to be applauded...

I went to my GP about 2 years ago, I had asked for a MRI and she told me then, that I would have to pay for it, so I am a little confused with this article, was my GP wrong or am I missing something, from what I can glean from some of the responses so far it seems that some GP have been clogging up the system with unnecessary MRI’s, if this is the case then it’s probably a good thing, you can still get a MRI if it is requested by a specialist by the sounds of it, the problem here is that if you have to go to a specialist you will have significant out of pocket expenses, we seem to be having a lot of calls for Royal Commission’s lately maybe it’s about time we had one into the exorbitant fees that some of these specialst’s charge, or is that too insensitive of me because after all specialist save our lives, I know they spend a lot of time getting their qualifications, quite often they get their qualifications in the publis hospitals that are paid for out of our taxes, so in effect we have already paid for them to get their qualifications. Next best thing is to try and find a specialist that bulk bills there are some around that greed isn’t their motivation.

Means we will need two specialist visits . One to get the ok for the MRI and a 2nd visit to be given the  results.

Much dearer than a visit to GP ..

The results are usually sent to your GP.

Exactly Kt.

Exactly what?? It's not necessary to comment if you have nothing of value to say.

Ray, you are correct - Your specialist reports back to your doctor about your results, diagnosis or treatment. This is good because the GP might be easier to talk to and can have further information for you and, if necessary, be able to help you with the next step of your treatment. There is no need to see the specialist for results.

 

Banjo,

If the results are sent back to the GP who then interprets them, diagnoses and treats, what is the point of going to the specialist? Is it just to get the referral at greater cost to the patient? Sounds like an expensive and unnecessary merry-go-round to me. 

BTW your comment “It’s not necessary to comment if you have nothing of value to say” is rude and controlling. Not surprising though, coming from you.

@ Banjo of course its the Specialist you return back to see for results not the GP,  thats when he tells you what he is going to do if surgeon etc. 

Your GP has usually got X Rays etc if needed for the referral but then if more required, like an MRI, the Specialist approves them. He then send results back to your GP. But it is specialist who treats the condition which got you to him in first place. As he specialises in that disease or injury etc. 

GP gets results etc sent as he refers you.

Can discuss it with GP later but he doesnt treat you. Specialist does. 

Banjo - which part of "Specialist" are you having trouble understanding. The GP does not have the training/knowledge to treat your problem so you're sent to a specialist, that person requests the tests and the "specialist" is the person who can interpret as they have the training/knowledge. The tests are just factual information, no recommendations about what should be done and if you rely on a GP to interpret the tests the diagnosis may well be wrong, and if surgery is required back to the specialist again anyway. 

 

Do you know the meaning of the word “interpret” Greg? It means to clarify something. The GP helps you to understand what the specialist says. If your GP is not qualified to do that then they should not be treating patients. Find another GP.

If a GP wants to know more about your problem i.e. a more specialised opinion, he sends you to a “specialist” (yes I do know the meaning of the word). Usually before you visit the specialist, the GP may request you have X-rays or blood tests and these results you take when you see the specialist, or the GP may have already given them to the specialist. Depending on the problem the specialist may be able to give you results on the spot. If not, the results are sent to your referring doctor, who explains them to you. On some occasions the specialist may ask you to return. Other times your GP may be able to manage your condition upon instructions from the specialist. If you’re not getting this type of information or treatment, then you should be asking why.

 

 

 

... always so very nice until you appear!  Must be cool to think you "know" everything!  Your arrogance is appalling! 

 

MRI scans are covered by Medicare if you are already in Hospital.  Husband had a lot of surgery on his spine and shoulder over an 11 month periord. When the specialist needed the MRI scan it was covered, but the patient has to already be in hospital.

 The human body is mostly water. Water molecules (H2O) contain hydrogen nuclei (protons), which become aligned in a magnetic field. An MRI scanner applies a very strong magnetic field (about 0.2 to 3 teslas, or roughly a thousand times the strength of a typical fridge magnet), which aligns the proton "spins."Aug 11, 2017What is an MRI (Magnetic Resonance Imaging)? - Live Science
https://www.livescience.com/39074-what-is-an-mri.html Image result for how does an MRI scan work?     

Thank you Banjo, as usual a most intelligent and informative post.

Some good information there Celia.

No one has yet commented on the fact that was stated about radiation >>>

'The Department said patients will benefit because they will be receiving recognised best practice knee imaging services and they won’t undergo unnecessary knee MRIs or be exposed to radiation

What are they lying about now!?   There is NO Radiation in an MRI!

Plan B are they suggesting a CAT scan?

No one will be denied anything. What it means is, the doctors who are trigger happy with writing referrals for no good reason will be halted in their tracks.

You have to pay a stack to see a specialist and if they send you for an MRI or Scan -- then they get the results and yo have to pay to go and get them -- which costs a heap of money but you get the MRI for   "free" -- I always ask for a copy of the MRI or Scan on a disc -- for myself -- and they have always been very happy to give me a copy

Are you saying you have personal experience of having to return to the specialist to get the results PlanB?

Specialist fees vary from surgeon to surgeon.  We have paid between $250 to $130 [each visit]  I guess it depends on the surgeon's greed.   The surgery can be in the thousands, but that includes the after surgery consultation when the patient has been home for a week or more.

Private Health Insurance has paid for all Hospital Fees [depends on the Table] but only partial cost of the surgeons fee.

So if you are a pensioner and everything is free you are very lucky.      

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