MyMedicare

MyMedicare aims to strengthen the relationship between patients, their general practice, GP and primary care teams. It formalises the GP’s role as central care provider, and unlocks significant benefits, including:

• access to more comprehensive information from other providers about regular patients, and a reduction in the fragmentation of care
• additional funding that is not restricted by fee-for-service, allowing greater flexibility in providing alternative models of care tailored to patient health needs
• greater support for practices and others who provide services in aged care homes.

Registration to MyMedicare helps patients access best-practice care across the health system. Benefits include:

• being able to choose and remain with a regular GP, strengthening the patient-doctor relationship
• increasing options for access to a GP and health care team, whether it’s face-to-face or via telehealth
• improving communication between patients, GP, specialists and hospitals.

MyMedicare is an important element in building:

• greater continuity of care and improving patient outcomes
• increased capacity for multi-disciplinary teamwork in primary care
• improved communication between providers and reducing duplication of services
• targeted support for residents in aged care homes, and patients who frequently present to hospital.

To be eligible for MyMedicare, general practices must:

• Provide Medicare-funded services.
• Be accredited against the National General Practice Accreditation Scheme. Non-accredited practices will have 12 months to register with an accreditation agency and gain accreditation.
• Be registered in:
  • Provider Digital Access (PRODA)
  • Health Professional Online Services (HPOS)
  • Be linked to the Organisational Register (in HPOS) with one eligible provider linked to the practice.
    • Note – 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.
• Practices registered before 1 October 2023 need to add MyMedicare as a program in their Organisation Register in HPOS, so patients can register with them. This step is incorporated for practices registering after that date.

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

• in rural settings
• in residential aged care
• in disability residential settings
• to Aboriginal and Torres Strait Islander patients
• to people experiencing homelessness.

Resources to help your practice register

• Refer to the MyMedicare registration checklist to ensure you have all the required information available.
• Instructions are available through videos and eLearning guides on Service Australia’s website.
• Watch now:
  • Systems overview for practices to register with MyMedicare
  • Systems overview for practices to register their patients with MyMedicare (both webinars recorded in October 2024 by the Australian Government Department of Health and Aged Care and Services Australia)
• Practice managers and providers are encouraged to contact Services Australia directly on 13 21 50 for enquiries about completing their practice registration.

MyMedicare is open for voluntary registration to Australians with a valid Medicare card or a Department of Veterans’ Affairs (DVA) Veteran card.

Registering with MyMedicare will tell your general practice that you see them as your regular care team and this will help them to provide you with better care. You’ll be able to access longer telephone telehealth consultations with any GP at your registered practice and they will receive funding from the Australian Government to deliver the care you need.

The registration process may be different depending on your personal situation and the type of practice you attend. Please visit the Australian Government Department of Health and Aged Care website: MyMedicare – information for patients to get started.

• 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 July 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.
• RACH residents will be required to be registered in MyMedicare and the GP linked to the patient’s registered practice for GPs to access this incentive.
• This incentive, to be known as the General Practice in Aged Care Incentive will replace the GP Aged Care Access Incentive from 1 July 2024.
• The payments are:
  • $300 per patient, per year, paid to the responsible provider.
  • $130 per patient, per year, paid to the practice.
  • The $300 and $130 incentives are per patient, per year, paid quarterly.
• To receive the $300 incentive, GPs must be registered in MyMedicare and provide a (RACH) patient at least 8 visits over a 12-month period. The consultations must be twice per quarter, in separate calendar months. One of the 2 visits each quarter, however, can be by another GP within the same practice, a registrar, a nurse practitioner, or an Aboriginal and Torres Strait Islander health practitioner or worker (see fact sheet here).
• GPs must also deliver 2 care planning services over a 12-month period, which includes a range of Medicare Benefits Schedule items across several categories.
• General practices, which can register for the new incentive through MyMedicare from 1 July 2024, will receive $130 per eligible patient.
• The General Practice in Aged Care Incentive has no limit to the number of patients a GP can visit, unlike the current aged care incentive which is capped at $10,000 a year.
• PHNs will be funded to work with RACHs to match residents with a regular primary care provider in MyMedicare, if they do not already have one.
• Program guidelines can be found here.
• A list of FAQs are also available for GPs and practices, aged care providers, and residents and carers.

Medicare Benefits Schedule (MBS) items for chronic disease management will change in 2025-26. The changes promote continuity of care and regular reviews for patients with chronic conditions, and enhance communication within multidisciplinary teams.

The updated MBS items:

• replace GP Management Plan and Team Care Arrangements with a single GP Chronic Condition Management Plan
• support continuity of care by requiring patients registered for MyMedicare to access management plans through the practice where they are registered. Patients who aren’t registered will be able to access management plans through their usual GP.

They 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

They also:

• 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.

For more detail, please see this Department of Health and Aged Care webpage. These changes were recommended by the MBS Review Taskforce.

Resources to support your practice

Click here to access our self-directed practice activation resources, which provide practical ideas structured around the foundations of the reforms.

For more information, contact primarycare@nwmphn.org.au

• Additional patient cohorts are expected to be incentivised through MyMedicare in 2025 and beyond. For example: patients experiencing mental ill health, and patients in the first 2000 days of life.
• Frequent hospital users incentive: New incentives for GPs to provide quality continuity of care to people who frequently attend hospital because of complex chronic disease. The aim is to reduce the likelihood of further admissions through enhanced general practice support.
• This initiative will be trialled in nine primary health network catchments – yet to be announced – after which it will be progressively introduced over 3 years across the country.

• MyMedicare registration is voluntary and free.
• You can still be a patient at this practice without being registered.
• If you do register at this practice, you may be entitled to longer phone or video (telehealth) consultations that are funded by Medicare.
• Registration will also help the practice deliver health care services that better meet your needs, including those provided by practice nurses and allied health professionals.
• You don’t have to see a practice nurse or allied health professional if you would prefer to see your GP.
• You can still see another GP at another practice should you wish but you won’t be able to access the longer (Medicare-funded) telehealth consultations.
• We can provide you with a form to register with a GP at this practice.
• (See resource here)

• MyMedicare is voluntary and free.
• I can still provide health services to you if you don’t register with me (or this practice).
• If you do register with me (or this practice), you will be able to access longer telephone consultations and may be eligible for longer telehealth video consultations.
• Over time, MyMedicare will help this practice better understand your health needs and provide suitable services.
• MyMedicare will help ensure continuity of care, provide a greater focus on prevention, and more funding to support a team of health professionals to meet your health care needs.
• (See resource here)