MyMedicare
What is MyMedicare?
MyMedicare is a voluntary registration system designed to enhance healthcare delivery and patient experiences by allowing individuals to choose their preferred General or Nurse Practitioner and healthcare team. By registering with MyMedicare, patients and practices gain access to a variety of benefits, including:
- Longer MBS-funded telephone calls
- Triple bulk billing incentives for telehealth consultations
- Tailored care for complex chronic diseases
Patients can register with a practice if they have had two (2) face to face visits recorded at the same practice in the past 24 months within the MM1 locations. One face to face visit recorded in the previous 24 months for patients registered with practices in MM6 and MM7 locations.
MyMedicare promotes stronger relationships between patients and their care teams, supporting person-centred care and reducing hospitalisations. It is integrated with My Health Record, facilitating effective communication and collaboration among healthcare providers. (updated July 2024)
Why Register with MyMedicare?
A well-supported general practice team can deliver sustainable, equitable, high-value healthcare that benefits both patients and providers.
- Strengthens General Practice: Enhances the role of general practice in the Australian health system.
- Integrated Communication: MyMedicare's integration with My Health Record allows easy communication between hospitals and a patient’s regular GP.
- Better Patient Information: Practices will have improved information about which patients see them regularly, making it easier to tailor services to fit their needs.
- Blended Funding Payments: Supports primary care providers in keeping registered patients with complex chronic diseases out of the hospital.
- General Practice in Aged Care Incentive: Supports GPs in providing regular visits, health assessments, and care plans for residents in aged care homes.
- Chronic Disease Management: From November 2024, items linked to a patient’s registration in MyMedicare will support continuity of care for people with chronic and complex conditions. Patients not registered in MyMedicare can still receive Chronic Disease Management items from their usual GP.
- Improved Continuity of Care: Greater continuity of care with their registered practice, improving health outcomes.
- Longer Telehealth Consultations: Longer MBS-funded telehealth consultations with their GP.
- Triple Bulk Billing Incentive: For longer MBS telehealth consultations for children under 16, pensioners, and concession card holders, starting 1 November 2023.
- Regular GP Visits for Aged Care Residents: More regular visits from their GP and better care planning for people living in residential aged care homes, starting August 2024.
- Appropriate Care Connections: Better connections to appropriate care in general practice for frequent hospital visitors, starting mid-2024.
Who is Eligible?
For detailed information about MyMedicare eligibility for practices, General Practitioners, and patients, please visit the Department of Health and Aged Care website.
General Practice
Patients
- Patients have been eligible to register for MyMedicare since October 1, 2023, provided they have a valid Medicare card or DVA veteran’s card.
- Registration can be completed through a GP-provided form, online via their Medicare Online account, or the Express Plus Medicare app.
- Patients do not need to physically attend a practice to complete the registration.
- If a resident cannot provide consent, a responsible person can do so on their behalf.
- Directors or members with the Owner-Access attribute in Provider Digital Access (PRODA) will automatically have the MyMedicare attribute.
- Other members must be assigned the HPOS-MyMedicare-Program-Staff attribute to access the MyMedicare program, which can only be added by a director or a member with Owner-Access.
- Members also need the HPOS-Access attribute to access Health Professional Online Services (HPOS) on behalf of the organisation in PRODA.
Upcoming changes MBS: Chronic Disease Management Arrangements
The Department of Health and Aged Care has announced upcoming changes to the Medicare Benefits Schedule (MBS) for chronic disease management.
From Deferred until July 2025, MBS items will be changing to.
- Replace the current GP Management Plan and Team Care Arrangements with a single GP Chronic Condition Management Plan
- Support continuity of care by requiring patients enrolled in MyMedicare to access management plans through the practice where they are enrolled. Patients who aren’t enrolled will be able to access management plans through their usual GP
- Encourage management plan reviews by:
- equalising the fees for developing and reviewing plans
- requiring patients to have their plan established or reviewed in the last 18 months so they can retain access to allied health and other services
- Formalise referral processes for allied health services so they are more consistent with other referral arrangements
- Ensure patients do not lose access to their current services through transition arrangements for existing patients with GP Management Plans and Team Care Arrangements.
Current details about the changes to MBS chronic disease management arrangements are available on the Department of Health and Aged Care webpage with more information to be released in time.
What does it mean for providers?
The changes aim to simplify, streamline, and modernise the arrangements for health professionals.
Key changes include:
- Removal of multiple plans
- Collaboration with members of the patient’s multidisciplinary team will no longer be required in the development of the plan
- Use of referral letters will support the provision of relevant clinical information to allied health professionals
- Practice nurses, Aboriginal and Torres Strait Islander health practitioners and Aboriginal health workers can assist with the preparation and review of GP chronic condition management plans.
How can general practices prepare for the change?
Ahead of the changes, there are some practical steps you can take to ready your practice. Prior to 1 November, practices are encouraged
- To register your practice for MyMedicare and link your participating providers to your Organisation Site Record (if you have not done so already) and,
- register your patients with chronic conditions or existing care plans in MyMedicare
Further details can be found (attached and Upcoming changes to MBS Chronic Disease Management Arrangements | Australian Government Department of Health and Aged Care)
Key Dates
Deferred until July 2025
General practices can register for the MyMedicare program. To do this you must:
For more information please visit the Service Australia Website.
- Access to levels C and D telephone consultations for registered patients.
- Access to triple bulk billing incentive for levels C, D and E (video only) telehealth consultations for registered patients under 16 years and Commonwealth concession card holders.
- Removal of red tape for telehealth: no need to meet the 12-month rule for registered patients.
- Visit MBS Online for more information.
From 1 August 2024, GPs and practices registered in MyMedicare will receive incentives for providing their registered patients who permanently live in a residential aged care home (RACH) with proactive face-to-face visits, regular planned reviews, and coordinated care planning, improving continuity of care and reducing avoidable hospitalisations.
For more information on this incentive, please click here.
Chronic Disease Management items linked to a patient’s registration in MyMedicare from November 2024, to support continuity of care for people with chronic and complex conditions.
Patients who are not registered in MyMedicare will still be able to receive Chronic Disease Management items from their usual GP.
For more information visit the Department of Health and Aged Care Website
Further registration benefits for patients are expected to be added as part of Strengthening Medicare. Adelaide PHN will continue to update and maintain information on this page.
For more information visit the Department of Health and Aged Care Website
General Practice in Aged Care Incentive (GPACI)
The General Practice in Aged Care Incentive (GPACI) began on 1 August 2024.
GPACI supports older people living in Residential Aged Care Homes (RACHs) to receive planned, quality primary care services from a regular general practice and GP at the patient’s aged care home rather than at the GP practice.
GPACI has replaced the Practice Incentives Program (PIP) General Practitioner (GP) Aged Care Access Incentive (ACAI), which ceased 31 July 2024.
Incentive payments
Payments are made quarterly:
- $300 per patient, per year, paid to the responsible provider
- $130 per patient, per year, paid to the practice
The incentive payments will be quarterly, on top of existing Medicare Benefits Scheme (MBS) and Department of Veterans’ Affairs (DVA) rebates for services delivered.
In any given assessment period (quarter), to be eligible to receive incentive payments, providers and practices must meet both eligibility and servicing requirements. To find out more about requirements, payments & eligibility please refer to the Program Guidelines.
Australian Association of Practice Managers (AAPM) is available to assist and support Practices in the set-up of MyMedicare and its subsequent incentives as required.
AAPM provides ongoing assistance as required and will assist all Practices, regardless of if they are a member or not. To contact AAPM Phone: (61) 1800 196 000 or Email: nationaloffice@aapm.org.au
Short video series
The following short (2 – 5 minute) video series produced by Southeast Melbourne PHN featuring Dr Billy Stoupas quickly explains MyMedicare and the General Practice in Aged Care Incentive from the perspective of a GP.
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Video 1 - MyMedicare and an overview of GPACI
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Video 2 – detailed video on GPACI and service and eligibility requirements
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Video 3 – information on registration
General Practice & GPs - Useful Resources
Residential Aged Care Providers, Carers & Families - Useful Resources
