Care plans can save you money while getting you the best treatment.
Are you getting the most out of your GP visits? Medical jargon used to explain your diabetes journey can often be confusing: Care Plan; Chronic Disease Management Plan; GP Management Plan; Team Care Arrangement?
If, like many people living with diabetes, you aren’t sure what these terms mean or how they apply to you, we can help.
What is a Care Plan?
A Care Plan is a type of Chronic Disease Management (CDM) Plan. A GP Management Plan (GPMP) is a type of CDM plan coordinated by your GP and practice nurse. When preparing your GPMP, the practice nurse will consider all of your health needs and together you will devise some health goals and an action plan to help get you there.
Diabetes is a complex condition and extra help is often needed for you to reach your health goals. GP Management Plans offer this extra help, in the form of Medicare-subsidised consults with allied health professionals:
1. Individual allied health services
If your GP or practice nurse believes you could benefit from the support of at least two allied health providers like a diabetes educator, exercise physiologist, dietitian, or podiatrist, they can refer you for consults through a Team Care Arrangement (TCA). This is where your GP or practice nurse works in collaboration with allied health providers to deliver your diabetes care. You will receive five subsidised visits to the allied health providers of your choice each calendar year.
2. Group allied health services
In addition, you may also be eligible to attend a type 2 diabetes group education program run by diabetes educators, exercise physiologists and dietitians in your local area. These services are approximately one hour in duration and take up to 12 people. Through your GPMP you can attend up to eight subsidised group education sessions each calendar year.
Who is eligible for Care Plans?
There are a few essential criteria that need to be met to access a Care Plan:
- Must have a chronic medical condition that has or will persist for at least six months. There is no list of eligible chronic conditions. It is up to your GP whether he or she thinks you will benefit from a Care Plan.
- Not have an existing Care Plan (for example, at a different medical centre) within the past 12 months.
When should I get a Care Plan
As soon as you are diagnosed with a chronic medical condition and every year thereafter. GP Management Plans and Team Care Arrangements are valid for 12 months and should be reviewed every three months to track progress towards your goals.
Where can I get a Care Plan?
Your regular GP/medical centre
Why do I need a Care Plan?
Care Plans ensure best-practice diabetes management including regular monitoring to help prevent diabetes complications. They provide subsided access to allied health and group diabetes education services through Medicare.
How do I go about arranging a Care Plan?
- Ask your GP if you have a GP Management Plan and if not, ask him or her to prepare one for you at your next visit.
- Ensure you book a long consultation. Set aside half an hour to talk to your GP, nurse practitioner or practice nurse about your health needs and goals.
- Ask about subsided access to individual and group allied health services.
- Make sure your Care Plan is reviewed regularly, ideally every three months.
How much does it cost?
The set-up of your GP Management Plan is bulk-billed by your GP through Medicare.
If your GP recommends a TCA or group education program, these visits are subsidised by Medicare. How much you pay varies from provider to provider. Some allied health providers bulk-bill and others charge a gap payment (like GPs), so make sure to ask your GP, nurse practitioner or practice nurse about the costs involved.
If you have private health insurance, make sure to compare the cost of visiting your selected allied health providers and swiping your fund card with the cost of a TCA. Sometimes it can be more expensive to go through a TCA, depending on your level of ‘extras’ cover. Your health fund will not cover the gap payment through a TCA – you can only claim one rebate – through either Medicare or private health insurance.
Top tips for an effective Care Plan
You only have five individual allied health visits per year so use them wisely:
- Talk to your GP, nurse practitioner or practice nurse about how frequently you need to visit certain allied health professionals (some do not require multiple visits per year).
- Discuss with your GP, nurse practitioner or practice nurse which services will best help you to reach your goals.
If you’re not sure where to start goal setting and planning, come along to one of our diabetes management programs to get a taste of what it’s all about.