Costs associated with a chronic disease such as mito can soon escalate and can be compounded by a loss of income. The Australian Government offers payments to people suffering from a disabling illness, their family members and carers. Unfortunately these payment systems can be confusing and time-consuming to access.

This webpage provides information about government support and payments you may be entitled to.

Government payments website page

Medicare Benefits Scheme

Medicare is an Australian Government administered, publicly-funded, medical insurance scheme that gives Australian citizens and permanent residents access to healthcare, including health and hospital services. 

Genetic testing for mitochondrial disease (mito) has been added to the Medicare Benefits Scheme (MBS). From 1 November 2023, the Australian mito community can access a Medicare subsidy for genetic testing of mito. Read more about this important milestone here. 

The Medicare system is funded by Australian taxpayers and provides free or heavily subsidised benefits across the following areas:

Hospital services

You can get free treatment at a public hospital if you have a Medicare card. This includes emergency and non-emergency treatment. Depending on how urgent your condition is, you may have to wait before getting admitted. You won’t have the option to choose your doctor, and non-urgent or elective procedures may have a waiting period.

Health professional services

Services provided outside the hospital by Medicare include visiting a general practitioner (GP) or specialist consultation, diagnostic tests, pathology and more. The cost of the service may be fully covered (bulk-billed) or partly covered, which may incur an out-of-pocket expense. You can check the Medicare benefit entitlements with your provider when you make your appointment.

If you have a chronic health issue, your medical costs could be high. However, visiting a doctor or having tests may cost you less once you reach the relevant annual Medicare Safety Net threshold. After you have spent up to the Medicare Safety Net amount, you will receive a higher Medicare rebate for all eligible services for the rest of the calendar year.

If you are an individual with no dependents, you don’t need to register for this safety net. Medicare will do that for you automatically. Couples and families can register to combine their costs and reach the safety net sooner. You’ll need to register online via the link above or by calling the Medicare general enquiries line on 132 011 (7 days a week 24 hours a day).

There are two types of plans that can be prepared by a GP for chronic disease management. If you have a chronic medical condition, your GP may suggest a GP Management Plan (GPMP). There is no age limit or list of eligible conditions. These plans are determined by you and your GP to identify your health care needs and decide on a suitable course of action.

If you need treatment from more than one allied health professional, your doctor may also put a Team Care Arrangement (TCA) in place for you. This lets your doctor work with, and refer you to, at least two other health professionals who will provide treatment or services to you.

Medicare rebate assistance is available for this plan for up to a maximum of five appointments per patient per calendar year.

If you are experiencing mental health issues such as anxiety or depression, talk to your GP as they can provide an impartial ear and, if appropriate, prescribe medication and recommend a Mental Health Treatment Plan for you.

This may involve referring you to a psychologist, psychiatrist, counsellor or another allied mental health professional. In most cases, Medicare benefits are available for up to 10 appointments per patient per calendar year.

Pharmaceutical services

The Pharmaceutical Benefits Schedule lists all of the medications available on prescription to patients at a government-subsidised price. These medications have been intensely reviewed by the Therapeutic Goods Association before being approved for use by patients.

The Schedule is part of the wider Pharmaceutical Benefits Scheme (PBS) managed by the federal Department of Health and Aged Care and administered by Services Australia. The Scheme is available to all Australian residents who hold a current Medicare card.

If you have chronic health issues, your co-payments can add up quickly. For many, this can mean taking medications less often even if it adversely affects their health. These costs can also have a major and negative impact on the household budget.

The PBS Safety Net reduces the cost of prescription medicines for individuals and families once the PBS Safety Net threshold has been reached. There are different thresholds for general patients and concession card holders. The threshold limits are based on your co-payment totals in each calendar year.

It is important to keep a record of your PBS medicines on a Prescription Record Form, available online or from your pharmacist. Use this form to record your PBS medicines so you know when you have reached the PBS Safety Net threshold. You can combine the amounts for all eligible family members to help you reach the safety net sooner.

The following payments and benefits are available through Centrelink. Each has specific eligibility requirements. See the Centrelink Payment and Services Finder for more information.

Disability Support Pension (DSP) If you have a physical, intellectual or psychiatric condition and you meet the medical and non-medical access rules, you may be eligible for the DSP.

The Mobility Allowance is a Centrelink payment that can help you with travel costs if you have an illness, disability or injury. The Mobility Allowance is not income tested and you can receive it whether or not you receive other Centrelink benefits.

Concession and Health Care Cards give you access to cheaper prescription medicines under the Pharmaceutical Benefits Scheme (PBS) and concessions on expenses such as public transport, household energy and internet bills and a range of health services.

National Disability Insurance Scheme

The NDIS provides financial support to eligible Australians with a permanent and significant disability. Each person on the NDIS has an individual plan that details their goals and approved funding.

The NDIS can seem overwhelming to many people. To address this, Mito Foundation developed the NDIS Navigation Service.

My Health Record

My Health Record is an online summary of your health information. You have the option of whether you want your record to be active and you control what goes into your record, and who is allowed to access it. The My Health Record also allows you to share your health information with doctors, hospitals and other registered healthcare providers.

Assistance with accessing rural health services

The National Rural Health Alliance Ltd has collated a list of the Patient Assisted Travel Schemes designed to provide equitable access to essential health services for people in rural and remote Australia. The schemes are managed by the states and territories and provide travel and accommodation subsidies to and from medical services based on your eligibility.

Government concessions and benefits

Costs associated with a chronic disease such as mito can soon escalate and can be compounded by a loss of income. The Australian Government offers payments to people suffering from a disabling illness, their family members and carers.

State government concessions

Each state or territory government may also offer their own payments and benefits for those holding current Centrelink pension or concession cards. You can learn more about these through your respective Australian state or territory government website:

To find out more about state-specific concessions and services available to people impacted by mito, click on your state or territory below.

Disclaimer: Resources provided by the Australian Mitochondrial Disease Foundation Limited (Mito Foundation), offers general information and is not a substitute for medical advice. It is essential to assess the suitability of the content for your individual circumstances and make decisions based on your medical condition. The information’s accuracy is subject to change, and we do not guarantee ongoing currency or availability. While efforts are made to ensure accuracy, Mito Foundation is not obligated to provide updated information. The copyright for this document and its content belongs to, or is licensed to, Mito Foundation, and reproduction without prior written consent is prohibited.

Author(s): Mito Foundation
Version: 1.1
Date published: 30 August 2023