MyMedicare

About MyMedicare

MyMedicare is a new voluntary patient registration model. It aims to strengthen the relationship between patients, their general practice, general practitioner (GP) and primary care teams.

Registration in MyMedicare is voluntary for patients, practices and providers. The 2023–24 Budget invests $19.7 million over 4 years in MyMedicare.

A further $39.8 million will be delivered over 4 years to support systems delivery through Services Australia.

Why it is important

MyMedicare patients will have access to:

• greater continuity of care with their registered practice, improving health outcomes
• longer MBS-funded telephone calls (Levels C and D) with their usual general practice
• triple bulk billing incentive for longer MBS telehealth consultations (Levels C, D and E) for children under 16, pensioners, and concession card holders
• if they live in a residential aged care home, more regular visits from their GP and better care planning, from August 2024
• if they visit hospital frequently, connections to more appropriate care in general practice, from the 2024-25 financial year.

MyMedicare practices will have access to:

• more information about regular patients, making it easier to tailor services to fit the patient’s needs.
• the new longer telehealth items linked to MyMedicare outlined above.
• the General Practice in Aged Care Incentive from 1 August 2024, which will support regular health assessments, care plans and regular GP visits for people in residential aged care homes.
• new blended funding payments to support better care in the community for people with complex, chronic disease who frequently attend hospitals. These arrangements will roll out progressively across the country over three years from the 2024–25 financial year.
• 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.

Practices that provide services to patients who would benefit from the new MyMedicare-linked MBS longer telehealth services or provide care to people in residential aged care are encouraged to register those patients in MyMedicare as priority cohorts over the next 3 months.

Eligibility

General practices

To be eligible for MyMedicare, general practices must:

• provide Medicare-funded services
• be registered in the following Services Australia systems:
  • Provider Digital Access (PRODA)
  • Health Professional Online Services (HPOS)
  • the Organisation Register
• have at least one eligible GP linked to the practice in the Organisation Register. Eligible GPs can be a vocationally registered GP, non-vocationally registered GP or a GP registrar
• be accredited against the National General Practice Accreditation Scheme – non-accredited practices will have 12 months to gain accreditation through a registered accreditation agency from the date they register in MyMedicare as a practice.

An accreditation exemption is available until 30 June 2025. This is available to non-accredited practices (including sole providers) who deliver general practice services entirely through mobile and outreach models:

• in rural settings
• in residential aged care
• in disability residential settings
• to First Nations Australians
• to people experiencing homelessness.

For more information and support on accreditation processes, see the Australian Commission on Safety and Quality in Health Care (for general practice) or contact your local Primary Health Network.

Healthcare providers

To be eligible for MyMedicare, providers must:

• work at a MyMedicare eligible practice
• be linked to the practice on the Organisation Register
• have a valid provider number and be eligible to deliver Medicare Benefits Schedule (MBS) or Department of Veterans’ Affairs equivalent services.

Vocationally registered GPs, non-vocationally registered GPs and GP registrars are all eligible to be selected as a patient’s preferred GP.

If you have questions about your participation in MyMedicare you should talk to your practice or go to the Services Australia Health Professional Education website.

Patients

To register in MyMedicare, patients must have either:

• a Medicare card
• Department of Veterans’ Affairs (DVA) Veteran Card.

Most patients will need to have 2 face-to-face visits recorded with the same practice in the previous 24 months to be eligible to register with that practice.

For patients registered with a practice in a remote location (in Modified Monash Model (MMM) 6 and 7 locations) this requirement is reduced to one face-to-face visit recorded at the same practice in the previous 24 months.

Parents/guardians and children can be registered at the same practice if one of them is eligible and registered at the practice.

Patients can only be registered with one practice at a time.

Eligible visits can be billed through:

• Medicare
• DVA
• a combination of both.

Exemptions from all eligibility requirements will apply to people who are facing hardship including people experiencing domestic and family violence and/or homelessness. A trusted practice or GP will be able to help with direct registration in MyMedicare.

How to register

General practices

To register in MyMedicare as a general practice, you must:

1. make sure your practice is eligible
2. link an organisation in PRODA to Health Professional Online Services (HPOS).
3. access the Organisation Register in HPOS to:
   • register your practice
   • link your eligible GPs providers.

Then from 1 October 2023, return to the Organisation Register and add MyMedicare program to your practice registration.

If your practice is already registered and all participating providers are linked in the Organisation Register, you do not need to complete a second registration process.

For more information on registering your practice, visit the Services Australia Health Professional Education website.

Patients

Patients can register for MyMedicare from 1 October 2023.

Patients will be able to register with their regular general practice, Aboriginal Community Controlled Health Service or Aboriginal Medicare Service and select their preferred GP at the practice.

MyMedicare registration will not prevent patients from accessing care from other practices and health care providers. The longer MBS telehealth items and the new aged care and frequent hospital users incentives will be linked to the patient’s registered practice.

Patients can complete registration in one of the following ways:

• Patients can commence the registration process in their Medicare online services (Medicare Online Account or the Express Plus Medicare mobile application) and the practice staff can then accept or decline the registration in MyMedicare.
• Practice staff can start the patient registration process in MyMedicare. The patient will then complete and provide consent for the registration in their Medicare online services.
• Patients can fill out a registration form at the practice (or provided by their visiting GP) and sign the form to provide consent. The practice will then enter the patient’s registration details into the MyMedicare system to complete the registration.

Patients who register with a DVA Veteran Card will need to fill out a registration form at the practice as registration via Medicare online services can only be completed using a Medicare card.

A parent/guardian will need to register a child under 14 years and provide consent on their behalf.

Young people aged 14 to 17 years will be able to register and provide consent without a parent/guardian. It is important to note that registration for a child under 14 years will need to be completed at the practice.

Changing preferred practices or GPs.

Patients can change their preferred GP within their registered practice at any time. Practices can link the patient to a new preferred GP within the practice if required, with the patient’s consent.

Patients will be able to move to and register with a new practice once they meet the eligibility requirements and that practice is registered in MyMedicare.

If a GP moves to a new practice, patients will be able to follow their GP to the new practice provided the practice is registered in MyMedicare. The patient will not need to meet new eligibility requirements at the new practice as their existing relationship with their GP will be recognised.

Patients registering with an Aboriginal Community Controlled Health Service (ACCHS) or Aboriginal Medical Service (AMS).

The MyMedicare system is designed to reflect the way that services are provided by ACCHS and AMS.

A patient will be able to register with the main practice location (hub) and continue to access services from other practice locations linked to the hub.

Services Australia can assist ACCHS and AMS practices to support registration of their patients if their patients access services in this way.

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