Medical expenses

The Australian Government offers several benefits that can help you pay for medical treatments, tests, prescription medicines and other medical supplies.

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Register for the Medicare Safety Net

Cancer treatment can mean that you are paying for many private medical appointments and tests. Medicare will usually contribute a certain amount towards these expenses, but you’ll need to pay the difference out of your own pocket.

Through the Medicare Safety Net, once you reach a set threshold of out-of-pocket expenses, Medicare will pay a higher benefit for many services until the end of the calendar year. This may mean that you receive more money back from Medicare for your appointments and tests.

How to apply

If you are an individual, you do not need to register for the Medicare Safety Net as Medicare automatically keeps a total of your expenses. If you are part of a couple or family, you do need to register even if you are all on the same Medicare card. You can download the form from humanservices.gov.au/customer/services/medicare/medicare-safety-net, or call Medicare on 132 011.

Read more about the Medicare Safety Net

Receive Medicare benefits for allied health services

If you have a chronic health condition (one present for at least six months or that is terminal), you may be able to get Medicare benefits for allied health services, such as physiotherapy and counselling, that help manage your condition. Under the Chronic Disease Management plan, your doctor can refer you to appropriate allied health practitioners for your condition, and you can claim at least part of their fees on Medicare.

How to apply

Talk to your GP about whether this plan would be helpful for your condition. If so, the GP will prepare a GP Management Plan and Team Care Arrangements, and can then refer you to the allied health practitioners listed in the Team Care Arrangements.


Get a PBS Safety Net Card

The Pharmaceutical Benefits Scheme (PBS) subsidises the cost of prescription medicines for all Australian residents with a current Medicare card. The PBS Safety Net further reduces the cost of prescription medicines once you or your family has spent a certain amount on prescription medicines. This amount is known as the Safety Net threshold.

There are two PBS Safety Net thresholds – one for general patients and one for concession card holders.

How to apply

To obtain a PBS Safety Net card, keep a record of any PBS medicines you buy. You can use a Prescription Record Form, which you can get from your pharmacy. Your pharmacist might be able to keep a computer record for you, but if you visit different pharmacies, it is best to keep your own paper record.

If you are part of a couple or family, ask your pharmacist to combine the amounts for your family Safety Net total so you can reach the threshold sooner.

Once you or your family reach the threshold for the year, you can get a PBS Safety Net card from your pharmacist. With this card, your medicines will be further discounted (or free if you also hold a concession card) for the rest of the year.

Non-PBS medicines

Some medicines are not listed on the PBS – you will still need to pay full price for these.

For people with gastrointestinal cancers (such as bowel, stomach or liver cancer), the John Logan Foundation offers grants to help pay for prescribed treatments that are not subsidised on the PBS.

Read more about the PBS Safety Net Card

Use your concession card

Some medicines will be cheaper through the PBS if you have:

  • a Pensioner Concession Card
  • a Commonwealth Seniors Health Card
  • a Health Care Card
  • a Department of Veterans’ Affairs health

The card may also entitle you to free medicines once you reach the PBS Safety Net threshold, as well as more refunds for medical expenses through the Medicare Safety Net. Some doctors offer bulk-billing to concession card holders, although this is up to the doctor.

How to apply

If you have one of the eligible cards, show it to your pharmacist when you are getting a script filled. You can also ask your doctor if they will bulk-bill your appointments.


Use the Pharmaceutical Allowance

The Pharmaceutical Allowance is a small amount that helps some people cover the costs of medicines. People receiving the Sickness Allowance and some other Centrelink payments automatically receive this extra allowance with their main payment each fortnight. For people receiving the Disability Support Pension, Age Pension or Carer Payment, the allowance is included in the Pension Supplement.

How to apply

You do not need to make a claim for the Pharmaceutical Allowance or the Pension Supplement, as Centrelink will automatically assess your eligibility and pay you with your regular fortnightly payments if you qualify.


Receive help with the cost of continence aids

If the cancer or its treatment has left you with permanent or severe incontinence (difficulty controlling your bladder or bowel movements), you may be able to receive help with the cost of continence products under the Continence Aids Payment Scheme (CAPS) through Centrelink. For most cancers, this is available only if you hold a Pensioner Concession Card and meet other criteria. For a small number of neurological conditions, including brain and spinal tumours, you can receive the payment without a Pensioner Concession Card.

How to apply

Check with your doctors if you meet the CAPS criteria, then complete an application form and send it to Medicare. For forms and more information, call the National Continence Helpline on 1800 33 00 66 or visit bladderbowel.gov.au/caps.


Be reimbursed for external breast prostheses

An external breast prosthesis is an artificial breast worn under clothing to imitate the shape of the breast. Women who have had a mastectomy because of breast cancer can access the External Breast Prostheses Reimbursement Program if they hold a Medicare card. The program reimburses you for new or replacement external breast prostheses purchased after 1 July 2008. You can usually make only one claim for every two-year period.

How to apply

Call Medicare on 132 011 or visit humanservices.gov.au to see if you are eligible for reimbursement and to get a claim form. You will need to send the completed form with the receipt to Medicare.


Receive free stoma supplies

In some cases, surgery for bowel or anal cancer can result in a temporary or permanent stoma, an opening in the abdomen that allows faeces to be collected in a stoma bag. Stoma bags and other supplies are available free under the Stoma Appliance Scheme if you hold a Medicare card and belong to a stoma association.

How to apply

Your stomal therapy nurse can help you join an approved stoma association and you will then be able to obtain free stoma appliances and products. For more information, go to health.gov.au and type ‘Stoma Appliance Scheme’ into the search box, or visit the Australian Council of Stoma Associations at australianstoma.com.au.


This information was last reviewed in October 2015
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